Head Injuries Flashcards
blow the head or skull fracture that tears the meningeal arteries
epidural hematoma moi
loss of consciousness
head pains
dizziness
nausea
dilation of one pupil (usually on the same side of the injury)
sleepiness
epidural hematoma s/s
CT scan
Surgery
epidural hematoma TX
acceleration/deceleration forces that tear vessels that bridge the dura mater & the brain
subdural hematoma moi
unconsciousness
dilation of one pupil
headache
dizziness
nausea
sleepiness
subdural hematoma s/s
immediate medical attention
CT scan
MRI
subdural hematoma TX
blunt trauma to the skull
skull fracture MOI
severe headache
nausea
blood in the middle ear or ear canal
bleeding through nose
ecchymosis around the eyes (raccoon eyes)
ecchymosis around the ears (battle’s signs)
cerebrospinal fluid may appear in the ear canal & nose
Skull Fracture s/s
immediate hospitalization
referral to neurosurgeion
skull fracture TX
agitation or shaking from being hit
direct or indirect blow
concussion moi
occurs following a concussion
postconcussion syndrome moi
headache
impaired memory
lack of concentration
anxiety
irritability
giddiness
fatigue
depression
visual disturbances
postconcussion syndrome s/s
treat symptoms not allow to return to play until ALL symptoms have resolved
postconcussion syndrome
rapid swelling & herniation of the brain after a second head injury that occurs before the symptoms of a previous head injury has resolved
second impact syndrome moi
dilated pupils
loss of eye movement
loss of consciousness leading to coma
respiratory failure
second impact syndrome s/s
second impact syndrome tx
medical emergency
What % of most diagnosed concussions do not involve a loss of consciousness
90%
who determines if player is ready or not to return
physician
a computer program in which symptoms checklist, concussion history & neuropsychological testing
Impact Testing
Sports Tested for baseline
In the past baseball, basketball, diving, equestrian, football, pole vaulting, soccer, & softball
All sports tested now
3 neurocognitive testing
- IMPACT testing
- C3 Logix
- Baseline testing
MTBI stands for
Mild Traumatic Brain Injury
evaluation asks
- how injury occurred
- 3 word memory
short term memory evaluation
evaluation asks
- day of week
- what did you eat for lunch
long term memory evaluation
evaluation asks
- subtraction from 100 by 7’s
- months of year backward
Processing Functions
Evaluations (3)
- short term memory
- long term memory
- processing functions
- balancing testing
evaluation asks
- double leg stance
- single leg stance
- tandem or heel to toe
balance testing evaluation
If team physician not present
remove from all activities
If concussion is suspected, do not return them that day
observe for a min. of 15 minutes
athletic trainer reevaluates
if athlete is completely asymptomatic
normal neurological exam including balance testing
perform functional testing
If athlete is symptomatic
athlete does not return that day & remains in observation
arrange for physician evaluation
progessive
- walk
- jog
- sprint
running up/downs
bear crawls
observe for symptoms
- bear crawls
- observe for symptoms
do you feel normal (name)
- if yes, allow return
- if no, hold them
Functional Testing
walk
jog
sprint
progressive
Recognize
Remove
Refer
Return
Concussion Management
train athletes
coaches
parents
school staff
recognize of concussion management
develop & implement a sound concussion management policy
remove - concussion management
athlete must be seen by a physicians
refer - concussion management policy
stepwise progression
(prague guidelines & NATA position statement)
Return - concussion management
Requirements:
Every school district that competes in interscholastic athletic activity must establish a concussion oversight team (COT)
All suspected head injuries must be evaluated by a physician
A 5-step return-to-play (RTP) protocol
Must obtain a written release by a physician or health care provider prior to an athlete’s RTP
Signed into law May 17, 2011
Natasha’s Law (House Bill 2038)
Typical recovery for simple head traumas is
5-7 weeks
Typical recovery for complex head trauma is
weeks to years
immediate concussion treatment
tylenol only for pain
refrain from
- physical activity
- texting & emailing
- playing video games
- watching TV, video
- consider excusing from all academics
Physician Evaluation ASAP
- Sport Concussion Assessment Tool 3 (SCAT3)
Appropriate for persons Age 10 and above
- Admitted or Released
- Transportation Arranged
- Athlete given Head injury Handout
- Athlete instructed to follow-up with their staff athletic trainer daily
Diagnosed Concussion
appropriate for persons age 10 & above
physician evaluation ASAP
Symptom Score
Determine athletes best interest depending on symptoms and academic demands
Refer to nutritionist to be placed on DHA Omega 3
- Has been shown to aid the brain tissue
If symptom score is less than 10
Setup IMPACT testing
Daily Follow - Up
When do athletes become active
at or near NO symptoms
at or near return or baseline on IMPACT
Light Aerobic Exercise – Goal= Increase Heart Rate
Walking, Stationary Bike, Swimming -70% max
Sport Specific Exercise- Goal= Add Movement
Running Drills, jogging to sprinting
Training Drills- Goal= Add Coordination and Cognitive Function
Up/Downs, Bear Crawls, Pass Catching,
Graduated Return to Play
Goal= Increase Heart Rate
Walking, Stationary Bike, Swimming -70% max
Light Aerobic Exercise
Goal= Add Movement
Running Drills, jogging to sprinting
Sports specific Exercise
Goal= Add Coordination and Cognitive Function
Up/Downs, Bear Crawls, Pass Catching,
Training Drills Exercise
Walking, Stationary Bike, Swimming -70% max
Light aerobic Exercise
Running Drills, jogging to sprinting
Sport Specific Exercise
Up/Downs, Bear Crawls, Pass Catching,
Training Drills
Athlete is Completely Asymptomatic
Athlete Returns to Baseline on IMPACT
Athlete can accomplish all Return-to-Play activities with NO ONSET of SYMPTOMS
Athlete is referred to physician for final clearance.
Final Clearance
Upon Medical Clearance:
Athlete is released to coaches for normal training exercises including contact drills if appropriate to restore athletes confidence and to determine if athletes is ready to participate.
Ultimate Return-to-Play
ecchymosis around the eyes
raccoon eyes
ecchymosis around the ears
Battle’s sign
