Concussion Flashcards
what is a concussion
head injury from direct or indirect hit to head/body causing brain to shift in skull
common name for concussion
brain bruise
type of injury for first concussion
- biochemical injury to nerve connections (axons)
what determines severity of concussion
- amount of bleeding
- area of brain affected
how long does the brain cells stay in a vulnerable state after a concussion
48-72 hours –> may result in other symptoms
how is a concussion diagnosed
- Clinical (subjective - how you feel) diagnosis
- no accurate biomarker or tech-diagnosis available (MRI, blood test, etc)
misconception about concussions
don’t have to lose consciousness to suffer a concussion
MOI of concussion
- force/impact to head (coup)
- direct or indirect (ex. whiplash) hit
- brain moves in skull (contrecoup)
- acceleration, deceleration, shear, rotation, compression forces
- body releases chemicals that changes brain blood flow and glucose metabolism
Common S&S of concussions
- nausea
-vomiting
-dizziness
-confusion - fatigue
- light headedness
- headaches
- feeling foggy
- irriable
- disorientation
- feeling stunned
- depression
- inappropriate behviour
- decreased work
- can’t do daily acitvites
- sleep issues
- vacant stare
- poor balance
- light sensitivity or seeing stars
how long do athletes need to to monitored after concussions
24-48hrs after injury
Red flag symptoms of concussions needing emergency attention
- headaches that worsen
- seizures
- looks drowsy or can’t be awakened
- repeated vomiting*
- slurred speech*
- unable to recognize people or places
- increased confusion, unusual behaviour change or irritability
- weakness or numbness in arms/legs
- significant leg pain
How to recognize a concussion (athlete POV)
- any events that jars or shakes brain
- feel any one or combo of concussion symptoms
- teammate may see something medical team doesn’t
- any of the following is observed –> slow to get up/lying on field, clutching head/helmet, running wrong plays/confused, balance issues, blank stare
- symptoms occur immediately or later
- athlete should advise medical staff
what to do if you have an suspected concussion (athlete pov)
- remove self from play
- not allowed RTP
- monitor athlete over next few hours
- rest and recover
- hydrate
- symptom free after 48 hrs, can start RTP protocol
describe immediate assessment
- watch play for MOI
- ATs run in pairs
- stabilize head + perform primary survey (ABCs)
- awaken unconscious athlete (nail to nailbed, pinch triceps)
- if conscious, calm athlete and perform secondary survey
what is involved in the secondary survey in the immediate assessment of athlete
- what happened? what do you feel? where is the pain?
- palpate neck –> pain, deformity or bone softness
- ask memory questions
- transition from sitting to walking off field carefully
what is involved in the sideline assessment for concussion
- Remove athlete from play, don’t allow athlete to RTP
- sit athlete down on bench
- if Dr., AT or PT is there, allow them to assess while you assist
- inform coach of concussion assessment and cannot play
- preform SCAT6 and King Devick test
- continue to monitor athlete, move to quiet from if needed
- advise athlete of red flag symptoms and recommendations
What is the return to school protocol?
- slowly introduce reading, screen time, and class lecture for timed intervals to not trigger symptoms
- healthcare professionals can direct and assist with professional specialist resources
- physicians at HPC and at SHS (provide letter to profs and give athletes SAS accommodations)
What return to play
- recovery is different for everyone
- going back to sport occurs in steps and take attention, patience and guidance
- gradual and detailed, healthcare professional must clear the athlete to begin activity again
return to play guidelines
- each stage takes minimum of 24 hrs to complete
- move on to next stage when activities are completed without new or worsening symptoms
- if symptoms worsen must go back to last stage for min. 24hrs
- go to physician if symptoms keep getting worse
- symptoms can get worse during the day without exercise
- symptoms return or persist during return to play or after medical clearance for stage 5 and 6, athlete need to see physician
- returning to play before full recovery increases chance of another injury with worse symptoms
- must see physician to return to contact play
return to play protocol
step 1 –> 3 days after concussion may begin light activities (ex going for walk)
step 2 –> light aerobic exercise when symptoms are mild (no running, weightlifting or resistance training) ex. stationary cycling for 10-15min
step 3 –> individual sport specific activities with no contact for 15-30min with no present symptoms
step 4 –> training drills with no contact (nothing too intense), must be cleared by HPC sport physician after this step
step 5 –> light, controlled contact practice after being medically cleared by professional, with no symptoms after can move to step 6 after 24hrs
step 6 –> full contact practice, if no symptoms can move to next step after 24hrs
step 7 –> full return to play, participating in games and competitions
what is post-concussion syndrome?
concussion symptoms last longer than 3 months
common symptoms of post-concussion syndrome
cognitive –> foggy, difficulty concentrating, memory, fatigue
somatic –> headaches, dizziness, nausea, light and sound sensitivity
sleep problems –> difficultly falling asleep, fragmented sleep, too much/too little
mood disruption –> irritability, feeling sad, anxiety
what is chronic traumatic encephalopathy (CTE)
- progressive degenerative disease of brain in people with repeated brain trauma
- tau proteins found in bain
how is CTE diagnosed
on autopsy, postmortem
- even sometimes can’t be diagnosed
other causes of tau protein deposit in brain
- genetic mutation
- drugs
- normal aging
- environmental factors
- postmortem brain processing and toxins
goal of roman’s law
- protect amateur competitive athletes
- reducing risk of injury
- focus on improving safety and awareness on field and in school
requirements of Roman’s law
- coaches and team trainers must review government approved concussion awareness resources including sport organizations concussion code of conduct every year
- done before serving at sport organization or school
when is roman’s law day and its purpose
- september 27
- honour roman stringer’s memory
- raise awareness about concussion safety
things to remember about concussions
- a serious injury
- vary between people
- most improve within couple weeks
- immediately inform therapy staff of injury and symptoms
- require ongoing and frequent monitoring
- must complete return to play protocol and be clear by UofG sports physician
