Concussion

Question 1

1 in 5 canadians have gotten one
1 in 3 know someone
70% of children will get one. Cost of 1 billion dollars

If you weren’t ‘knocked out’ then you don’t have a concussion.

Having multiple concussions in sport increases your risk of having another concussion.

If there are no instant symptoms right after the event, then there is no concussion.

Any contact to the head or body causing rapid head movement can cause a concussion.

Answer 1

1 in 5 canadians have gotten one
1 in 3 know someone
70% of children will get one. Cost of 1 billion dollars

If you weren’t ‘knocked out’ then you don’t have a concussion. - FALSE

Having multiple concussions in sport increases your risk of having another concussion. - TRUE

If there are no instant symptoms right after the event, then there is no concussion. - FALSE

Any contact to the head or body causing rapid head movement can cause a concussion. - TRUE

Question 2

What is a concussion?

• A traumatic brain injury caused by a direct blow to the head, neck or body resulting in an impulsive force being transmitted to the brain.
• Symptoms and signs may present immediately, or evolve over minutes or hours, and commonly resolve within days, but may be prolonged.
• No abnormalities seen on standard structural neuroimaging studies.
• Sport-related concussion results in a range of clinical symptoms and signs that may or may not involve loss of consciousness. less than 10%

WHAT MECHANISMS CAN LEAD TO A CONCUSSION?

Answer 2

What is a concussion

• A traumatic brain injury caused by a direct blow to the head, neck or body resulting in an impulsive force being transmitted to the brain.
• Symptoms and signs may present immediately, or evolve over minutes or hours, and commonly resolve within days, but may be prolonged.
• No abnormalities seen on standard structural neuroimaging studies.
• Sport-related concussion results in a range of clinical symptoms and signs that may or may not involve loss of consciousness.

WHAT MECHANISMS CAN LEAD TO A CONCUSSION?
- body check to whiplash
- ball to head
- body part to head
- head to head
- hitting boards

Question 3

EXAMSIGNS VS. SYMPTOMS in concussion

signs are …

symptoms are …
…, …, …, …

What are some common signs you can look out for in yourself or others after a fall or contact to head or body?

Answer 3

EXAMSIGNS VS. SYMPTOMS in concussion

signs are things you see.

symptoms are what you feel. Physical, emotional, cognitive, sleep

What are some common signs you can look out for in yourself or others after a fall or contact to head or body?
dilated pupils, tiredness, confusion, motionless, facial injury, slow to get up, clutching head, blank stare

Question 4

RECOGNITION: CONCUSSION RECOGNITION TOOL
Handout 1: IF IN DOUBT, SIT THEM OUT! SEEK MEDICAL ATTENTION TO CONFIRM DIAGNOSIS

STEP 1: Red Flags?
check for other injuries too, basic first aid, ABCs, if we observe a red flag, sit them out,

Concussion Recognition Tool 5 (CRT5)
do not leave them alone, no alcohol, not driving home, no prescription drugs

on site management
- determine if medical emergency(red flags)
- remove from play, monitor for red flags,
- Assessment, monitor, advise

Question 5

Why is it important that a player with a suspected concussion is removed from play?

• Prolonged recovery
• More severe consequences
• Risk of secondary injury
• _______________________

If managed appropriately, most concussions get better within a few weeks to a month with no long-lasting symptoms
Remember: Early identification and removal from play has been linked to recovering sooner!

Answer 5

Why is it important that a player with a suspected concussion is removed from play?

• Prolonged recovery
• More severe consequences
• Risk of secondary injury
• ______ second impact syndrome_________________

If managed appropriately, most concussions get better within a few weeks to a month with no long-lasting symptoms
Remember: Early identification and removal from play has been linked to recovering sooner!

Question 6

What are some of the tools we use for assessment?

SCAT 5, for use by health care professional only
baseline concussion testing
observable signs, memory assessment, red flags, medical history,

How long should you rest after a concussion? - 24-48 hours of all rest, more harmful to sit out for longer
Follow Return-to-School and Sport-Specific Return-to-Sport protocols
Return to full sport activities with a Medical Clearance Letter

Return to learn before Return to play - stage 6 full academic load

Question 7

Graduated return to sport/play protocol - each stage is 24 hours long

Question 8

Keys to a Good Recovery
Regular …
Balanced …, adequate …
Avoid …

Social Support
* Concussion is an … injury
* Try to understand what they are going through
… frustration
… frustration
* Don’t … them about coming back to their sport
* Be willing to do activities that they can do

Primary Prevention - Prevents initial occurrence
Secondary Prevention - Early detection of the injury
Tertiary Prevention - Full recovery and prevention of second injury

Answer 8

Regular sleep routine
Balanced meals and snacks, adequate hydration
Avoid overtaking pain meds

Social Support
* Concussion is an invisible injury
* Try to understand what they are going through
o School frustration
o Sport frustration
* Don’t pressure them about coming back to their sport
* Be willing to do activities that they can do

Question 9

Prevention – Rules & Policy
58% lower rate of concussion in peewee hockey with no body checking

Mouthguards prevent face and mouth injuries
there is evidence to support the protective effect

• ↓ Dental Injuries
• 28% lower concussion & head injury risk for wearers compared to non-wearers

Prevention - Equipment
- Good-fitting helmets decrease the risk of concussion, More research needed

Question 10

Neuromuscular Training Warm-ups
Components: Aerobic, Strength, Agility,
Balance, Head/Neck Control
Using 3x per week has shown a 35% reduction in concussions when used in team sports
60% lower rate of concussion in rugby with NMT

Schoolboy Rugby - NMT
Concussions most common injury, getting tackled, time loss is substantial

Previous concussion in last 12 months, 2x increase risk of getting any other injury

Question 11

Rule Changes
Head contact rules, Tackle rules, Heading the ball, No contact practices

Equipment
Mouthguards use. Helmet fit

Training Strategies
Neuromuscular training, Contact and tackle training, Load management