Concussion

Question 1

what is an SRC and caused by what

Answer 1

traumatic brain injury induced by a biomechanical force, from a direct or indirect blow to the body or head

Question 2

are injuries of an SCR functional or structural and so they appear on an MRI

Answer 2

functional, do not appear

Question 3

3 categories of S&S

Answer 3

somatic
cognitive
neurobehavioral

Question 4

somatic S&S

Answer 4

headache
nausea
vomiting
sensitivity to light and sound
numbness or tinging 
balance/coordination issues

Question 5

cognitive S&S

Answer 5

feeling slowed down
in a fog
difficulty concentrating or remembering

Question 6

neurobehavioral S&S

Answer 6

sleeping more or trouble sleeping 
drowsiness 
fatigue 
sadness/depression 
nervousness 
irritable

Question 7

11 R’s of concussion

Answer 7

Recognize 
Remove 
RE-evaluate 
rest
rehab
refer
recovery 
return to sport
return to play
reconsider
residual effects
risk reduction

Question 8

recognize what to do

Answer 8

sideline evaluation

1. recognition fo injury
2. assess symptoms
3. cognitive function
4. cranial nerve function
5. balance

Question 9

remove what to do

Answer 9

if concussion suspected, out of game
look for a c-spine injury
use SCAT5
keep a close eye on for the next few hours

Question 10

re-evaluate what to do

Answer 10

in emergency room or doctors office:

1. medical assessment with comprehensive medical history, thorough assessment of cognitive function, sleep/wake disturbance, ocular function, vestibular function, gait and balance
2. determine clinic status, including any improvements/declines sine the injury
3. determine need for emergent Neuroimaging to exclude any more serious brain injuries

Question 11

rest what to do

Answer 11

physical and cognitive rest 24-48 hrs post concussion

then more activity, but must be sub symptoms threshold

Question 12

rehab what to do

Answer 12

c spine injury 
peripheral or vestibular system 
psychological 
sub-symptom threshold exercise 
school accommodations 
less screen time

Question 13

refer what is done

Answer 13

for ppl with persistent symptoms

collaborative approach to recovery for the patient

Question 14

recovery what to do

Answer 14

functionally returns to school, work, sports, ADLs after injury
must have resolution of symptoms and clinically normal balance and function

Question 15

return to sport steps

Answer 15

1. limited daily actives the two not provoke symptoms
2. light aerobic exercise, no resistance training
3. sport specific exercise, no head impact
4. non contact training drills, harder training drills, progressive return to resistance training
5. full contact practice following medical clearance
   restore confidence and assess functional skills
6. return to sport, normal game play

Question 16

what should you do if symptoms occur during return to sport protocol

Answer 16

24-48 hrs rest, before beginning progression again

Question 17

how long is each return to play step

Answer 17

24 hrs or more

Question 18

return to play what to do

Answer 18

same at return to sport pretty much but now into full game play

Question 19

reconsider what to do

Answer 19

all athletes managed using the same principle

childs and adolescents all the same

Question 20

residual effects are

Answer 20

long term consequences of securing head trauma

CTE

Question 21

risk reduction

Answer 21

pre participation PPE
prevention
education

Question 22

what is secondary impact syndrome

Answer 22

when an athlete suffers a second head injury before the first has fully healed (still symptomatic)

Question 23

why is second impact syndrome dangerous?

Answer 23

less force needed to cause a second injury

Question 24

results of second impact syndrome

Answer 24

increased symptom severity, increased symptom duration, permanent brain damage, death

Question 25

what is Rowan law

Answer 25

requires sport organization and school to have a removal from sport protocol, safety precaution, concussion code of conduct

Question 26

concussion red flags

Answer 26

Headache worsen
seizure
unusually behaviour change
repeated vomiting
slurred speech
significant irritability 
increasing confusion 
weakness/numbness in arms/legs
can't recognize people or places

Question 27

post concussion what is allowed during recovery/not allowed

Answer 27

limit mental and physical activity, limit screen time, avoid loud noises, no alcohol, no return to play until RTP followed and cleared by doctor

Question 28

return to learn rules

Answer 28

slow integration back into school
modified duration fo day
modified School work, test, assignments
athlete must return to full school - priority over sport return