Brain Injuries

Continuous blood flow is necessary to provide brain cells with oxygen and glucose Any interruption will result in a brain injury at some level Reduction of blood supply to the brain will lead to: Permanent brain damage Seizure Strokes

When an injury occurs to brain, often the brain swells Why? Accumulation of Carbon Dioxide or Lactic Acid Increase of Blood to injury or CSF

Stroke Def: Rapid loss of brain function, due to sudden disturbance to blood supply Signs/Symptoms: Depends on area of brain affected Slurred speech numbness, Loss of function of motor skills What do you do? Nothing – CALL 911 Effects Death, permanent motor skill damage, nothing

Seizure Def: Excessive, synchronous electrical activity in brain circuits Brain will recover from a seizure Usually a symptom of another disease or injury Signs/Symptoms: Temporary confusion Uncontrollable jerking movements of the arms and legs Loss of consciousness or awareness What do you do? Leave the victim alone, unless they are in a situation that will damage them more Call 911

Concussions Def: Injury to brain or spinal cord accompanied by loss of neural function Causes temporary stoppage of blood supply to brain Second Impact Syndrome 2nd concussion that is received before signs and symptoms from the 1st have been resolved – Life threatening

Signs & Symptoms of Concussion Headache Dizziness Nausea Disoriented Confusion Loss of consciousness Poor concentration Pupil not functioning Retrograde Amnesia No memory right before the injury Anterograde Amnesia No memory of being injured or right after Sleepiness Loss of coordination Slurred/slow speech Depression Vacant Stare

Things to remember Many times we do not know of or see the injury that causes the concussion Symptoms of concussion can last for many days Do not assume it’s the first concussion, many times the athlete is unaware of the initial injury

Concussion Severity Grade 1 (mild) Guidelines No loss of consciousness Headache and some confusion Mild of the following  nausea, blurred vision, dizziness Guidelines 1st Concussion: Return to play (RTP) 7 days after last symptom 2nd Concussion: RTP 14 days after last symptom 3rd Concussion: Terminate season

Concussion Severity Grade 2 (moderate) Guidelines No loss of consciousness Confusion and amnesia (mild) Nausea Increasing or persistent headaches Blurred vision Disoriented Guidelines 1st Concussion: Return to play (RTP) 7 days after last symptom 2nd Concussion: RTP 1 month after last symptom 3rd Concussion: Terminate season

Concussion Severity Grade 3 (Severe) Guidelines Loss of consciousness 1st Concussion: RTP 1 month after last symptom 2nd Concussion: Terminate season

Treatment Any athlete who has a concussion should not return to play unless released by a doctor What do you do? If it is Grade 1: inform coach, parent, and doctor if available Monitor athlete – typically if condition improves, no problems but athlete needs to be seen by doctor If Grade 2: Monitor athlete but doctor needs to attend athlete or contact 9-1-1 If Grade 3: Call 9-1-1 immediatly

Things you can do to help athlete As long as symptoms are present, athlete should not be left alone Make sure they drink water Place Ice on back of neck After game instructions: Eat & drink Water May take Tylenol Do not go into deep sleep, have someone wake them up every couple hours or so If symptoms get worse at any time – go to ER

Treating a Downed Athlete When an athlete is down and unconscious Always treat for head or neck injury Note time you find athlete or injury Time of injury and/or unconscious time is important to EMS Keep people away from athlete and responder Football – do not remove helmet Try to wake athlete up, do not shake them Check vital signs Get history of injury and how it occured

When athlete is awake, ask questions About injury, basic questions as well Check pupils Are they equal? Do they react normally with light? Check extremities for feeling and strength If no signs of spinal injury, let them sit up on their own