If you are a parent or a coach, here are some concussion related questions to ask yourself. Do you know the correct answers?
- There must be some sort of loss of consciousness and/or headache to be a true concussion.
- You can sustain a concussion even if you do not hit your head.
- Concussions typically are diagnosed by using MRI or CAT scans.
- It is OK to give Ibuprofen, Aspirin, or Tylenol to your athlete to help alleviate their headache.
- A student should take a short leave of absence from school while highly symptomatic following a concussion.
- Adolescents generally take longer to recover from a concussion than adults do.
- As soon as the athlete is symptom-free, they have healed from his/her concussion.
Here are some signs/symptoms that a parent or coach may observe:
- Loses consciousness
- Appears dazed, stunned
- Confused about assignment/forgets plays
- Unsure of game/score/opponent
- Moves clumsily or appears “drunk”
- Answers questions slowly
- Memory loss (before or after hit)
- Behavior/Personality changes (such as increased irritability or anxiety)
- ADHD-like signs, depression, mood swings
- Changes in academic/cognitive performance
- Dizziness, balance problems, or unsteadiness
- Double or fuzzy vision
- Sensitivity to light or noise
- Feeling sluggish, groggy, or foggy.
- Sleep disturbances
- Concentration or memory problems, trouble with school work
- Does not “feel right”
- First and foremost – REMOVE the person from participation in ANY physical activity if any indication of concussion is present, and make sure he or she is evaluated by an appropriate medical professional (such as a certified athletic trainer (ATC) or a physician or nurse trained in concussion management) before a return to activity determination is made.
Appropriate concussion assessment involves:
- Orientation assessment
- Symptom checklist/assessment
- Neurological testing (i.e. balance, coordination, reflexes, strength)
- Cognitive testing (i.e. ImPACT, memory, pattern recognition)
- Physiological stress (i.e. graduated return to athletics protocol)
- REST is necessary. This includes physical, cognitive, AND social rest (no going to the movies, attending loud sporting events, or riding on amusement park rides!)
- Tylenol is OK to use to try and control the headache, but DO NOT give aspirin or ibuprofen (these may possibly increase bleeding in the brain)
- Maintain a healthy diet and proper hydration. Changes in appetite can occur post concussion. Maintaining health eating and hydration habits allows the body to heal more efficiently. Additionally, there is some research that has demonstrated a) delayed healing associated with highly saturated fat diets, and b) Omega 3-rich foods and supplementation may aid in expiditing the healing process.
- Monitor symptoms daily, making note of any changes. It is especially important to note which (if any) stimuli increase symptoms, and avoid these until completely symptom-free.
- Maintain communication with others involved (i.e. parents, other coaches, school support staff. This is KEY when dealing with an athlete who is in school and/or participating on multiple athletic teams/clubs.
The injured person must be seen right away in an emergency department if they exhibit any of the following:
- ANY loss of consciousness, convulsions, or seizures
- One pupil larger than the other
- Severe drowsiness or cannot be awakened
- Headache and/or confusion that is getting progressively worse
- Weakness, numbness, or decreased coordination
- Repeated vomiting or severe nausea
- Slurred speech or significantly unusual behavior
- Difficulty recognizing people
- Watching TV, playing video games, and using the computer or smart phone use can increase symptoms
- Social situations where there is a high level of environmental stimulus (i.e. parties/social gatherings, shopping at the mall, listening to loud music)
- Driving or traveling longer trips
- Pass ImPACT Computer Test or other acceptable neurocognitive evaluation (if available)
- Normal findings on thorough subjective, objective, and special test evaluation by an appropriate health care professional (ie ATC, Physician)
- Graduated return to athletics protocol completed (6 levels – see below) without a return of symptoms. If no athletic trainer available to monitor this, must have written clearance by a physician to begin protocol after a 7-day symptom-free rest/recovery period.
- Written clearance by a physician for full return to activity
Graduated Return-to-Athletics Protocol Progression Levels (one level = minimum of 24 hours, must be symptom-free to progress to the next level.
|Level 1||Complete “normal” day of cognitive activities (I.e. school day, studying, watching practice). ESSENTIAL prior to starting exercise.|
|Level 2||Light aerobic exercise (less than 70% max heart rate). NO resistance training.|
|Level 3||Sport-specific exercise|
|Level 4||Non-contact training drills (sport-specific).May initiate resistance training.|
|Level 5||Full contact practice/return to phys ed class (following medical clearance)|
|Level 6||Return to play (unrestricted)|
Oh, and hopefully you got your answers by now to the questions I posed in the beginning.
Answers: (F, T, F, F, T, T, F)
Be safe and be smart. Is one game worth a lifetime of struggles?
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Ryan Stevens, MPS, ATC, CSCS