1. Brain Injuries

2. 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

3. 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

4. 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

6. 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

7. 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

8. 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

9. 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

10. 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

11. 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

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

13. 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 immediatly

14. 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

15. 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

16. 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