CONCUSSION

CONCUSSION Common injury that is likely underreported in student athletes Concussion can cause injury that interferes with school, social and family relationships Recognition and education are paramount because despite protective measures, nothing is shown to prevent concussion PA has a concussion law for interscholastic athletics, cheerleading and school based club sports.

WHAT IS A CONCUSSION? A concussion is a mild traumatic brain injury (MTBI) A concussion is a brain injury that: Occurs when the head moves violently or is struck Can change the way your brain normally works Caused by a bump or blow to the head Can happen even if there is no loss of consciousness Mild traumatic brain injury is interchangeably with the term concussion Even a “ding” or something that seems to be a mild bump or blow to the head can be serious. Concussions range in significance from minor to major, but they all share a common factor– they temporarily interfere with the way your brain works– They can affect memory, judgment, reflexes, speech, balance and coordination.

WHAT IS A CONCUSSION ? (continued) An “invisible” injury – more effect on the function of the brain and not a physical change in the brain Cannot be seen on a CAT scan or traditional MRI The severity of initial trauma does not always correlate with severity of injury *Concussions can have a more significant effect on a young, developing brain. Recognition and response to initial injury can help facilitate recovery You can not see a concussion Signs and symptoms may not appear or be noticed until days or weeks after the injury

SYMPTOMS OF CONCUSSION (What does it look like?) Confusion Balance problems Vomiting Cannot recall events prior to and after injury Dazed Loss of consciousness Forgetful MIGHT APPEAR NORMAL The two most common symptoms of a concussion are confusion and amnesia. The amnesia, which may or may not be preceded by a loss of consciousness, almost always involves the loss of memory of the impact that caused

SYMPTOMS OF CONCUSSION (What does it feel like?) Headache Nausea Visual changes Sensitivity to noise Sensitivity to light Sluggish, hazy, foggy or groggy Fatigue Difficulty paying attention Dizziness

SYMPTOMS OF CONCUSSION Irritable Sad Emotional lability Nervous Sleep disturbances

DANGER SIGNS Loss of consciousness Seizure Worsening headaches Repeated vomiting Slurred speech Severe confusion Significant irritability/behavior change Numbness/weakness 2nd occurrence These students should be sent for immediate evaluation “Second Impact Syndrome” is when a person suffers a mild head injury and returns to play too soon and suffers another head injury before the brain is fully healed. This can lead to a rapid increase in pressure in the brain. The effects of Second Impact Syndrome include paralysis, ,mental disabilities and sometimes death.

POST CONCUSSIVE SYNDROME Prolonged concussion symptoms may last up to a year (usually 2 - 4 months) Most frequent symptoms -Headache -Memory difficulty -Fatigue -Concentration difficulty -Visual disturbances -Sleep disturbance -Balance disturbances -Emotional problems

CONCUSSION CARE Sleep Avoid physical exertion No video games No computer No texting Avoid loud noises and bright lights NO SPORTS OF ANY KIND The injury needs time to rest and heal properly Concussions need to be treated as if they are a big deal– the brain is very important “Second Impact Syndrome”

SUPPORT AT SCHOOL Observe for continuing signs of symptoms of concussion Coach, PE teacher, and/or athletic trainer aware of no return to activity/play until symptom-free both at rest and with exertion Review and follow concussion action plan and district’s concussion policy It is important to note symptoms that worsen and behaviors that seem to represent a change in the student– if a staff member has any questions or concerns at all about the signs and symptoms a student exhibits contact the school nurse or parent Section 504 plan for prolonged symptoms (longer than several weeks) or permanent disability– that can affect the student’s performance in any manner– the accommodations may include environmental, curriculum, organizational and behavioral strategies

SUPPORT AT SCHOOL Time off from school/shortened day Shortened classes (rest break during class) Rest breaks during day Allow extended time to complete assignments and tests Reduced homework/class work load No significant classroom or standardized testing at this time Physicians and school personnel should monitor the students symptoms with cognitive exertion (mental effort such as concentration and studying) to evaluate the need and length of time supports

RETURN TO PLAY PLAN No physical activity Low levels of physical activity Moderate levels of physical activity (reduced time and/or weight from typical routine) Heavy non-contact physical activity Full contact in controlled practice Full contact in game play An individual should not return to sports/recreational activity while experiencing any lingering or persisting MTBI symptoms Low levels of activity– (symptoms do not come back during or after activity) these activities include walking, light jogging, light weightlifting (lower weight , higher reps no bench no squats) Moderate activity including moderate jogging, brief running-, stationary bike Heavy activity- sprinting, running, high intensity stationary biking, high intensity weight lifting

PREVENTION Educate athletes and parents about concussions before the first practice Teach and practice safe playing techniques Ensure that athletes wear the right protective gear for the activity Ensure students practice good sportsmanship Conduct pre-season baseline testing Promote wearing seatbelts when riding in motor vehicle Helmets, padding, and other protective equipment should fit properly, be well maintained, and worn consistently and correctly Pre-season baseline testing are tests that assess brain function such as learning and memory skills, ability to pay attention or concentrate and how quickly someone can think and solve problems. These tests can be used during the season if an athlete has a concussion to help identify effects of the injury.

PA YOUTH CONCUSSION LAW Establishes standards for managing concussions and head injury to student athletes Form signed by students and parents regarding concussion information Coaches to complete a concussion management certification training every year Students with concussion symptoms must be removed from play Penalties for coaches who fail to comply Students must be cleared to return to play by an “appropriate medical professional”

RESOURCES www.cdc.gov/concussion https://www.chop.edu/health-resources/youth-sports- concussion-laws-pa-nj www.concussiontreatment.com (Sports Concussion Institute) https://www.cooperhealth.org/services/pediatric-concussion- and-traumatic-brain-injury/sports-concussion-laws-new-jers www.MayoClinic.com