View
3.298
Download
0
Category
Tags:
Preview:
DESCRIPTION
Citation preview
2. The Purpose of this Course
To raise awareness on the seriousness of sport concussions.
To decrease the number of sport related concussions.
To provide insight into the newest information on concussion
management and prevention.
2
Sport Concussion3
3. Look on the bright side
3
For a few seconds you forgot you were a Calgary Flame
Sport Concussion3
4. Some Humor
4
Sport Concussion6
5. The Myths of Concussions
Its not a serious injury
A second hit to the head will make the concussed person feel
better
Concussions get better within 7 days
Its only a short-term injury
You have to lose consciousness
Others
5
Sport Concussion84
6. The Challenge of Concussions
6
Sport Concussion84
7. What is a Concussion?
Section 2
7
A Publication of
The Sport Medicine Council of Alberta5
8. Definition
A complex pathophysiological process affecting the brain, induced
by traumatic biomechanical forces.
8
Sport Concussion6
9. Diagnostic Tests
Concussions involve a disruption of brain function rather than
structural damage.
The majority of time CT scans or MRI tests show no obvious
damage.
9
Sport Concussion42
10. Neurometabolic Changes and Concussion
Trauma/Concussion
Diffuse axonal injury
Massive release of K+ ions
Glycolysis for K +pumps
Sport Concussion7
11. Neurometabolic Changes and Concussion
Sport Concussion7
12. fMRI
12
Sport Concussion3
13. fMRI
13
Sport Concussion3
14. Impact Mechanics
A contrecoup injury is a result of axial rotation with
acceleration, this causes an injury away from the actual impact
site.
14
Sport Concussion12
15. Concussion Rates
15
A Publication of
The Sport Medicine Council of Alberta5
16. How Often Do Concussions Occur?
On average, 3-5% of all sport and recreational injuries are head
injuries.
The majority of sport related head injuries are mild.
The most common cause of sport related head injuries are
falls.
16
Sport Concussion15
17. How Often Do Concussions Occur?
Patients younger than 20 years old are more likely to suffer a
sports related head injury.
Males are more frequently injured.These statistics are changing as
more females engage in contact sports.
Very few head injuries are hospitalized.
17
Sport Concussion16
18. Recognition of Concussions
It is common for athletes to underreport the incidence of sport
concussions.
Often athletes do not associate their symptoms with those of a
concussion.
18
Sport Concussion17
19. Athletic Trainers Report
Athletic Trainers from Canada and the United States identified head
injuries as 5% of their total sports injuries.
X Top sports?
19
Sport Concussion18
20. Top Causes of Concussions
Female
Soccer
Horseback Riding
Cycling
Ice Hockey
Snowboarding
Male
Ice Hockey
Cycling
Football
Soccer
Snowboarding
20
Sport Concussion19
21. Sport Specific Rates
Hockey:
High School: 17.6/1000 hours
Peewee: 23.1/1000 hours
Bantam: 10.7/1000 hours
Peewee:
Children under age 6 had twice
the head injuries as older
children.
22. Professional (Europe):14.3% of all injuries; 0.16/1000 hours
23. College (Canadian Intercollegiate): 7.5% of injuries; 1.5/1000
hours 24. High School (US): 18.7/1000 hours21
Sport Concussion21
25. Peewee Hockey
N = 125 (86% response rate)
Average age:11.5 years-old with 5.6 years of playing
experience
No. of players with concussion:11 (incidence rate = 9.87%) 16
total
7 players with 1 concussion
3 with 2 concussions
1 with 3 concussions(1 non hockey related)
Mechanism of Injury:player contact (n= 10)
hits from behind (n = 4)
fall (n = 1)
collision into boards (n = 1)
Avg # of practices missed: 3.25 (range 0 6)
Avg #. of games missed:2.00 (range 0 4)
Avg duration of symptoms:7.03 days (range 1 - 21 days)
No.subjects with ED visit:n = 1
No. with previous concussion:n = 2
22
Sport Concussion21
26. Common Signs/Symptoms
Section 4
23
A Publication of
The Sport Medicine Council of Alberta 22
27. Common Signs/Symptoms
Nausea, vomiting
Dizziness
Confusion
Fatigue
Light headedness
Headaches
Irritability
Disorientation
Seeing bright lights
Feeling of being stunned
Depression
Inappropriate behavior
Decreased work/playing ability
Inability to perform daily activities
Cognitive and memory dysfunction
Sleep disturbances
Vacant stare
Poor balance
24
Sport Concussion24
28. Any 1 Symptom
Signs/symptoms may vary for each athlete.
A concussion should be suspected in the presence of any one
symptom.
25
Sport Concussion25
29. Nausea
Be cautious if nausea is a significant symptom.
Some athletes will suffer a mild cognitive impairment for longer
periods of time when nausea is present.
26
Sport Concussion27
30. How Do I Manage a Suspected Concussion?
Section 5
27
A Publication of
The Sport Medicine Council of Alberta 28
31. Recovery Model
Concussion Recovery Model vs. Orthopedic Recovery Model
Concussions need to be managed differently than orthopedic
injuries.
No pain. No gain. Does not apply.
28
Sport Concussion8
32. Removing a Player from Play
Remove the player from the current game or practice.
Do not leave the player alone; monitor for signs and
symptoms.
Do not administer medication.
Inform coach, parent or guardian about the injury.
Sport Concussion31
33. Return Within a Game?
Be very cautious
Hockey Canada:If player is asymptomatic after 15 minutes, can
return
Not if LOC, NeckInjury, ANY symptom
Must be evaluated by qualified professional
Sport Concussion31
34. When in Doubt, Sit Them Out!
No athlete with a concussion should continue to play or return to a
game after sustaining a concussion.
Center for Disease Control
International Concussion
Guidelines (Zurich, 2009)
31
Sport Concussion33
35. Deteriorating Neurological Function
Athletes need to be carefully monitored for the first 24-48
hours.If any of the below symptoms occur refer them to the
emergency department.
Headaches that worsen
Seizures
Looks drowsy or cant be awakened
Repeated vomiting
Slurred speech
Cant recognize people or places
Increased confusion, unusual behavioral change, or
irritability
Weakness or numbness in arms or legs
Neck pain
32
Sport Concussion34
36. Screening/Diagnosis
Section 6
33
A Publication of
The Sport Medicine Council of Alberta35
37. Simple or Complex
Concussions can be classified as either simple or complex.
34
Sport Concussion36
38. Simple Concussion
A simple concussion usually resolves without complication in 7-10
days.
This is the most common type of head injuries, accounting for 75%
of all concussions.
35
Sport Concussion37
39. Complex Concussion
A complex concussion involves persistent symptoms and prolonged
cognitive impairment.
36
Sport Concussion38
40. Post Concussion Syndrome
Following a concussion, an athlete can suffer from long term sleep
disturbances, memory and concentration troubles, depression and
even psychiatric problems.
37
Sport Concussion39
41. Other Issues
38
A Publication of
The Sport Medicine Council of Alberta35
42. History of Concussion
Athletes with a history of concussion are at an increased risk
of:
Future concussions (3 to 5 x more likely)
Worse on-field presentations following their next concussion
Experiencing acute changes in their memory performance and reaction
times
Slowed recovery
39
Sport Concussion45
43. 3 Concussions
After an athlete has sustained 3 concussions, serious consideration
should be given to removal from contact sports.
However, each athlete should be considered on an individual
basis.
Athletes with a history of 3 or more concussions have a slower
recovery rate than athletes with one prior concussion.
40
Sport Concussion46
44. How Many is too Many?
There is no magic number of how many concussions are too
many.
This must be evaluated individually.
Return to play decisions should be guided by neuropsychological
test results and symptoms reported by the athlete regardless of the
number of concussions.
41
Sport Concussion48
45. Long Term Consequences
Studies from retired NFL players suggested
Increased incidence
Depression (2 to 4x higher than normal population)
Cognitive Difficulties
Chronic Traumatic Encephalopathy
42
Sport Concussion48
46. Does Age Affect Recovery Time?
High school athletes may exhibit slower recovery after sports
related concussions compared to collegiate athletes.
43
Sport Concussion49
47. Younger Athletes
Younger athletes are more prone to complex concussions than college
athletes.
Younger athletes show more signs of mood disturbance (irritability,
lower frustration tolerance) than older athletes.
44
Sport Concussion50
48. Second Impact Syndrome
It is thought to occur when an athlete suffers a second blow to the
head while recovering from an initial concussion.
This can happen up to 14 days post injury.
The result is a catastrophic increase in intracranial pressure
which, in rare cases, can lead to death.
It most often occurs in athletes under 21 years of age.
This is very rare and there is still debate on when it
occurs.
45
Sport Concussion51
49. Return to Activity
Section 8
46
A Publication of
The Sport Medicine Council of Alberta58
50. 47
Sport Concussion6
51. Medical Doctor Evaluation
An athlete should be evaluated by a medical doctor after any blow
to the head.
Hockey Canadas Guidelines
48
Sport Concussion32
52. Medication
Only take medications your medical doctor has prescribed only after
medical assessment.
Do not drink alcohol or
take non-prescription drugs.
49
Sport Concussion56
53. Medical Decision
Return to play is a medical decision that should not be made by a
parent, coach, trainer or athlete.
Each case must be handled individually
7 Day rule does not apply
An athlete should complete a sport specific rehabilitation program
and cleared by a medical doctor.
50
Sport Concussion61
54. Pocket SCAT2
Sport Concussion
55. Symptoms in Sports concussion
Everyone feels fine
Always ask:
1.On a scale of 0 to 100%, how do you feel?
2.what makes you not 100%?
3. Checklist SCAT2
Sport Concussion
56. 6 Return to Activity Steps
If it is decided that an athlete will return to play a stepwise
process must be followed.
(Available in the SCAT-2)
53
Sport Concussion62
57. Graded Exertion Protocol
58. If there is recurrence of symptoms at any stage, return to previous step
Recommended