Meghan Scheeler ATC, LAT

Aurora Sports Medicine InstituteAthletic Trainer at Muskego HS

Children and Teens are more likely to sustain a brain injury, like a concussion, and will take longer to recover than an adult

Each year, there is an estimated 173,285 sports and recreation related concussions in children and teens

This has increased 60% in last decade

What is a Concussion

Immediate Signs and Symptoms

How it Happens

What to do

Expected Outcome and

Management

Return to Play

Sidelined for Safety Act (AB 259)

Traumatic Brain Injury which interferes with normal brain function

All Concussions are Brain Injuries

There is no mild vs. severe

WI Football Coaches Association

http://www.youtube.com/watch?v=zCCD52Pty4A

Caused a bump, blot, jolt or fall to the head or body

Force of the movement causes brain to bump, twist, move against the skull

These movements change normal brain function

This affects how someone walks, talks, thinks, acts, concentrates, and remembers

Signs and Symptoms are indicators of change in brain function = concussion

Physiologic changes that occur usually do not show up on CT, CAT or MRI scans.

Medical Imaging is normal, but person is still hurt.

Thinking/Remembering Physical Emotional/Mood Sleep

Difficulty Thinking Clearly Head ache Irritability Sleeping more than usual

Feeling Slowed Down or Foggy Fuzzy or Blurred Vision Sadness Sleeping Less than usual

Difficulty Concentrating or Focusing Nausea or Vomiting More Emotional Trouble Falling Sleep

Difficulty Remembering New or Old Information Dizziness Nervousness Can’t Stay Asleep

Amnesia (Before and/or After) Sensitivity to Light or Noise Anxiety

Feeling Tired, Having No Energy

Slow to Respond or Easily Confused

Decreased Balance and/or Coordination

Dazed or Stunned in appearance

Loss of Consciousness does not have to occur to have a concussion.

Danger Signs

Complications 2nd Impact Post Concussive Syndrome

Symptoms SignsHeadache that gets worse or does not start to

resolveLook very drowsy or cannot be

awakened

Weakness, numbness or decrease coordination One pupil is larger than other

Loss of Consciousness Convulsions or Seizures

Repeated vomiting or nausea Cannot recognize people or places

Slurred Speech Initial signs and symptoms get worse

Unusual Behavior

http://www.youtube.com/watch?v=f0xJT53SZqQ

Rest and time are the keys to healing properly from a concussion.

Limit stimulation of brain Computer, cell phone, TV, video games, school

No activity that increases heart rate Sports, pick up games, gym class, walking

Do this with both athlete and parentsReview the Signs and Symptoms of a concussionWhat to do if they come backWhy playing with a concussion is bad

With Athlete, review proper techniques and mechanics for sport and emphasize need to do them correctlyDo this before start progression and before Full contact day

Sign and Symptom free 24 hours, maybe more.

Cleared by medical professional.

Able to do regular daily functions without problems without aid of medications.

Gradual re-introduction back into play via step wise progression Stay sign and symptom

free Ensures full and proper

healing of brain injury Shown to prevent

subsequent concussions.

1. Sign and Symptom free for at least 24 hours.

2. 15-30 minutes of light stationary biking, elliptical or treadmill jogging.

3. 45-60 minutes of strenuous activity such as sport specific drills with cones or ladders.

4. Non-Contact drills in uniform. Ok to try weight lifting if appropriate.

5. Full practice with contact. (Before individual starts the practice educate him/her on proper technique, mechanics, concussion signs and symptoms, and what to do if signs and symptoms come back.)

6. Full Game

Each step takes 24 hours.Stop if signs and symptoms appearShould be done under direction of medical professional

Nothing Truly Prevents a ConcussionRisk can be decreased, but they will happen

Biggest way to decrease the risk, is to know the signs and symptoms

and educate other parents and coaches about concussions.

Teach an athlete that it is not smart to play with a concussion.

Helmets do NOT prevent a concussion.

Helmets prevent facial injuries and skull fractures.

Proper Technique Decreases Risk

The head is not a weaponLeading with head puts an individual at higher risk of concussion and/or neck injury.Make sure equipment fits properly.

Have an Emergency Action Plan All venues should be included Concussion Policy Statement

Educate the Community Have handouts ready for before,

during and after a concussion occurs

The more people are aware, the better it is

Wisconsin Act 259

Heath Care Providerperson holding a credential that authorizes the person to provide health careperson is trained in the evaluation and management of concussions and head injuriesperson is practicing within the scope of his/her credential

These people include a physician, physician assistant, advanced nurse prescriber, or an athletic trainer.

Youth Athletic ActivityOrganized athletic activityParticipants are at least 11yrs and under 19yrs of ageEngaged in games or competition against other entitiesEngaged in practice or preparation for organized athletic game or competition against another entity.

1. Coaches and Parents of participants engaged in youth athletic activity will receive information on concussions prior to start of season that need to be signed and returned in order to participate.

Get certified in concussions by the CDC or NFHSFree courses are available

2. A participant with a suspected concussion must be pulled from the game or practice and cannot return until he/she has been cleared by a Health Care Provider trained in concussion evaluation and management in writing.

There is no same day return to play

Get certified in concussions by the CDC or NFHSFree courses are available

3. Any athletic coach, official involved in athletic activity, or volunteer who fails to remove the person suspected of having a concussion or head injury is immune from civil liability for any injury resulting from the failure to remove that person unless it constitutes gross negligence or willful or wanton misconduct. The same goes for a health care provider.

Get certified in concussions by the CDC or NFHSFree courses are available

All references in this presentation are accessible to all individuals.

There is no good reason why you should not be aware of concussions as a coach.

Centers for Disease Control and Prevention (http://www.cdc.gov/concussion/sports/index.html) WI Sports Concussion Collaborative (http://www.wisportsconcussion.org/) WI Interscholastic Athletic Association (http://wiaawi.org/index.php?id=430) National Federation of State High School Associations (http://www.nfhslearn.com/)Milwaukee Journal Sentinel – Dr. Walters Interview (http://www.jsonline.com/multimedia/video/?bctid=1465030068001)