CC - CONCUSSION guest lecture Flashcards
Concussion Facts ?
CDC reveals 1.6-3.8 million concussions occur each year
Estimated 47%- 51% of athletes do report S/S after concussive blow
5-10% of athletes will experience a concussion in any given sports season
Fewer than 10% of sports related concussions involve loss of consciousness
Football is the most common sport with concussions.
Hockey ,boxing and lacrosse are very close.
Soccer is most common for females—50%,Hockey
78% of concussions occur during the game
Females are twice as likely to sustain a concussion and recover slower
Common complaints: Head/neck aches -85%,Dizziness 70-80%
What is a concussion ?
Defined as a mild traumatic brain injury
Sudden movement causing the brain to bounce, twisting inside the skull
Stretches and damages brain cells/synapse
Causes chemical changes in the brain
The primary elements of the pathophysiologic cascade following concussive brain injury include abrupt neuronal depolarization, release of excitatory neurotransmitters, ionic shifts, changes in glucose metabolism, altered cerebral blood flow, and impaired axonal function.
( brain cannot balance itself - always fighting one thing or another trying to defend itself and maintian homeostasis)
Causes of a concussion ?
Jolt, Bump, Blow to the head
Jolt/sudden stop to the body causing coup counter coup motion
**be specific when taking a Hx
females are more honest with sxs .**
Who can get a concussion ?
Toddler - inside cabinet, falls down stairs
Youth -
High school athlete
College athlete
Anyone, anyway, anywhere (regular people, slipping on ice )
0-2,3-5,6-13,14-18,19-40,41-60,60 + . It’s not a Bell shaped curve .
Dx of concussion athlete on field: To ER if ?
Loss of conscience >1 minute
Possible neck injury . C/O neck pain
stabilize it
Numbness or tingling persists or gets worse
Pupils are different sizes
Vision issues
HA that gets worse or will not go away
Siezures
Dx of concussion athlete on bench: To ER if ?
if vomiting starts , constant or gets worse
Headache worsens/starts
Numbness/tingling increases/starts
Neck pain develops
Seizures start
Slurred speech develops
Disoriented x2-3 begins
Review with parents symptoms to observe
Visit medical advise in the next 24-48 hours
-because of Possible hematoma
**these can start 10-15-20 minutes after the blow doesn’t have to be immediate
young kid - review with the parents**
What should parent look for in 1st 24-48 hours ?
Dizziness, clumsiness
Blurred vision, double vision, pupil sizes are different
Headache, numbness, tingling
Balance issues
Fatigue, drowsiness
Sensitivity to light
Altered sleep patterns
Concentration and comprehension decline
Fog (just not right) forgets plays and assignments. Coaches should be aware of this S/S
Any symptoms that get worse ,any ware ,bench ,field, home.
**some of these you wont get on the field right away they may come a day or two after ( some of these may start)
very insidious creature
when do they start and when do they end **
Children and toddler symptoms ?
Appears dazed
Listlessness and tires easily
-rely on the parent
Irritability and crankiness
Loss of balance and unsteadiness walking
Cry excessively, will not stop
Change in eating , nursing habits and sleeping pattern
Lack of interest in favorite toy
**mother bringing baby in
rely on the parent**
When does recovery start ?
Starts right away 85%-90% of concussions usually last 7-10 days (if everything goes will but there are outliers) ,in some cases longer.
When does recovery start: Physical rest ?
No running or jumping
Remove all activities that increase symptoms (triggers)
But don’t over do ,not doing enough can have adverse effects
When does recovery start: Mental rest ?
Limit study time
Limit any computer games or computer activities
Limit school time ,work ,physical or mental
Dont use what when recovering from concussion ?
Do not use Aleve or Ibuprophen as there is a chance of increasing bleeding
Acetaminophen is ok
No alcohol or other recreational drug that masks pain
blood thinning or reaction with anything
Other tips when recovering from a concussion ?
Watch neck position ( because of swelling and not in correct position can arrgivate sxs. ), chest out chin back ,military posture.
Take short naps 30-60 minutes ,keep a routine.
Avoid triggers
- Decrease symptoms faster
- Speeds up recovery
Testing for concussion ?
Do not DX concussions
MRI, CT, X-ray scans
Good for brain contusions, bruises
FX of vertebrae
Any other abnormality
Clinic has two categories: Testing for Athletes ?
Impact tool -Protects the athlete Measures symptoms Measures verbal, visual, memory, processes, reaction time Provide data for action plan Helps determine return to play criteria
Drop Test
-Reaction time test-5 minutes
Balance Testing
- Foot positions
- Hard/ soft surfaces
