Meghan Scheeler ATC, LAT Aurora Sports Medicine Institute Athletic Trainer at Muskego HS

 Children and Teens are more likely to sustain a brain injury, like a concussion, and will take longer to recover than an adult  Each year, there is an estimated 173,285 sports and recreation related concussions in children and teens  This has increased 60% in last decade

 What is a Concussion  Immediate Signs and Symptoms  How it Happens  What to do  Expected Outcome and Management  Return to Play  Sidelined for Safety Act (AB 259)

 Traumatic Brain Injury which interferes with normal brain function  All Concussions are Brain Injuries  There is no mild vs. severe WI Football Coaches Association

 Caused a bump, blot, jolt or fall to the head or body  Force of the movement causes brain to bump, twist, move against the skull  These movements change normal brain function  This affects how someone walks, talks, thinks, acts, concentrates, and remembers

 Signs and Symptoms are indicators of change in brain function = concussion  Physiologic changes that occur usually do not show up on CT, CAT or MRI scans.  Medical Imaging is normal, but person is still hurt.

Thinking/RememberingPhysicalEmotional/MoodSleep Difficulty Thinking ClearlyHead acheIrritabilitySleeping more than usual Feeling Slowed Down or Foggy Fuzzy or Blurred VisionSadnessSleeping Less than usual Difficulty Concentrating or Focusing Nausea or VomitingMore EmotionalTrouble Falling Sleep Difficulty Remembering New or Old Information DizzinessNervousnessCan’t Stay Asleep Amnesia (Before and/or After) Sensitivity to Light or NoiseAnxiety Feeling Tired, Having No Energy Slow to Respond or Easily Confused Decreased Balance and/or Coordination Dazed or Stunned in appearance Loss of Consciousness does not have to occur to have a concussion.

Danger Signs Complications  2 nd Impact  Post Concussive Syndrome SymptomsSigns Headache that gets worse or does not start to resolve Look very drowsy or cannot be awakened Weakness, numbness or decrease coordinationOne pupil is larger than other Loss of ConsciousnessConvulsions or Seizures Repeated vomiting or nauseaCannot recognize people or places Slurred SpeechInitial signs and symptoms get worse Unusual Behavior

Rest and time are the keys to healing properly from a concussion.  Limit stimulation of brain  Computer, cell phone, TV, video games, school  No activity that increases heart rate  Sports, pick up games, gym class, walking

Do this with both athlete and parents  Review the Signs and Symptoms of a concussion  What to do if they come back  Why playing with a concussion is bad  With Athlete, review proper techniques and mechanics for sport and emphasize need to do them correctly Do this before start progression and before Full contact day

 Sign and Symptom free 24 hours, maybe more.  Cleared by medical professional.  Able to do regular daily functions without problems without aid of medications.  Gradual re-introduction back into play via step wise progression  Stay sign and symptom free  Ensures full and proper healing of brain injury  Shown to prevent subsequent concussions.

1.Sign and Symptom free for at least 24 hours minutes of light stationary biking, elliptical or treadmill jogging minutes of strenuous activity such as sport specific drills with cones or ladders. 4.Non-Contact drills in uniform. Ok to try weight lifting if appropriate. 5.Full practice with contact. (Before individual starts the practice educate him/her on proper technique, mechanics, concussion signs and symptoms, and what to do if signs and symptoms come back.) 6.Full Game Each step takes 24 hours. Stop if signs and symptoms appear Should be done under direction of medical professional

Nothing Truly Prevents a Concussion Risk can be decreased, but they will happen Biggest way to decrease the risk, is to know the signs and symptoms and educate other parents and coaches about concussions. Teach an athlete that it is not smart to play with a concussion.

Helmets do NOT prevent a concussion.  Helmets prevent facial injuries and skull fractures. Proper Technique Decreases Risk  The head is not a weapon  Leading with head puts an individual at higher risk of concussion and/or neck injury.  Make sure equipment fits properly.

 Have an Emergency Action Plan  All venues should be included  Concussion Policy Statement  Educate the Community  Have handouts ready for before, during and after a concussion occurs  The more people are aware, the better it is

Wisconsin Act 259

Heath Care Provider  person holding a credential that authorizes the person to provide health care  person is trained in the evaluation and management of concussions and head injuries  person is practicing within the scope of his/her credential These people include a physician, physician assistant, advanced nurse prescriber, or an athletic trainer.

Youth Athletic Activity  Organized athletic activity  Participants are at least 11yrs and under 19yrs of age  Engaged in games or competition against other entities  Engaged in practice or preparation for organized athletic game or competition against another entity.

1.Coaches and Parents of participants engaged in youth athletic activity will receive information on concussions prior to start of season that need to be signed and returned in order to participate. Get certified in concussions by the CDC or NFHS Free courses are available

2.A participant with a suspected concussion must be pulled from the game or practice and cannot return until he/she has been cleared by a Health Care Provider trained in concussion evaluation and management in writing.  There is no same day return to play Get certified in concussions by the CDC or NFHS Free courses are available

3.Any athletic coach, official involved in athletic activity, or volunteer who fails to remove the person suspected of having a concussion or head injury is immune from civil liability for any injury resulting from the failure to remove that person unless it constitutes gross negligence or willful or wanton misconduct. The same goes for a health care provider. Get certified in concussions by the CDC or NFHS Free courses are available

All references in this presentation are accessible to all individuals. There is no good reason why you should not be aware of concussions as a coach.  Centers for Disease Control and Prevention ( dex.html) dex.html  WI Sports Concussion Collaborative (  WI Interscholastic Athletic Association (  National Federation of State High School Associations (  Milwaukee Journal Sentinel – Dr. Walters Interview ( eo/?bctid= ) eo/?bctid=