2.  Health care providers who specialize in the prevention, assessment, treatment and rehabilitation of emergency, acute and chronic injuries and illnesses  Licensed by the Board of Medicine to practice Athletic Training

3.  All injuries & illnesses must be reported to the Athletic Trainer  All injuries must be reported prior to return to activity regardless of severity or physician consultation  Our philosophy is to return injured athletes to participation in the quickest and SAFEST manner possible using a progressive return to activity

4.  If you take your child to a physician, it is REQUIRED that a note is provided to the Athletic Trainer for any sport stating the INJURY DIAGNOSIS, TREATMENT, SPORT RESTRICTIONS, and RETURN TO PLAY STATUS. If your child has been to a doctor and does not produce a physician note, he or she will not participate until one is provided

5.  ATC can only be in one place at a time!

6.  “Assumption of Risk”  Not all injuries can be prevented  Catastrophic injuries can occur in any sport  Based on the number and severity of catastrophic injuries, the following collision sports require ATC supervision at all times: Football, Boys Lacrosse and Wrestling

7.  The Athletic Trainer will be available for evaluations, treatments, rehabilitation, and questions from student athletes, parents, and physicians each school day afternoon from 3:20-4:00 or by appointment

11.  Brain is violently rocked back and forth or twisted inside the skull from a direct blow to the head, face, neck or elsewhere on the body  “Egg Yolk in Egg Shell Analogy”

12.  http://www.cces.ca/files/pdfs/SCAT2%5B 1%5D.pdf http://www.cces.ca/files/pdfs/SCAT2%5B 1%5D.pdf

13.  “Recognize, Remove, Refer”  1. Recognize the Signs and Symptoms of a Concussion  2. Remove individual from practice or game  2. Refer the individual for medical evaluation and attention right away

14.  Dazed Look  Vacant Stare  Amnesia  Blurred vision  Dizziness  Drowsiness  Excess sleep  Easily distracted  Feeling in “a fog” or slowed down  Headache  Inappropriate emotions (sad, angry, aggressive, restless)  Irritability  Loss of consciousness  Loss of orientation  Just “don’t feel right”  Slowed/Incoherent Body Movements or Reaction Time  Memory problems  Nausea  Nervousness  Personality changes  Poor balance/coordination  Poor concentration  Ringing in ears  Seeing stars  Fatigue/Low Energy/Lethargic  Sensitivity to light/noise  Sleep disturbance  Vacant stare/glossy eyes  Vomiting  Confusion  Pressure in Head

15.  The signs and symptoms of a concussion can show up immediately after the injury or may not appear for hours or days after the injury

16.  Any athlete with a suspected Concussion should be removed from the practice or game immediately and NOT allowed to Return to Play the Same Day

17.  Refer the individual to the appropriate healthcare professional (Physician, Athletic Trainer, etc.) who is experienced in evaluating and managing a Concussion

18.  Avoid giving concussed individuals Ibuprofen, Tylenol, Aspirin, etc. for the first 24-48 hours  These medications can “mask” the real signs and symptoms the athlete is experiencing and we need to know what’s going on!

19.  Driving (especially if individual experiences dizziness)  Watching TV  Listening to ipod or talking on the phone  Reading  Texting  Using a computer  Playing Video Games  Exposure to bright lights or loud noises  Any Strenuous Activity (Physical Education, yardwork, household chores, etc.)  School/Homework

20.  Check eyes with a flashlight  Wake them up every hour *It is OK to check on child’s breathing and pulse but not necessary to constantly wake them up  Set alarm clock (“Kill the Clock” to allow them to sleep and awake naturally)

21.  PHYSICAL and COGNITIVE Rest are key after a Concussion  The Brain needs time to Heal  Continuing to play with the signs and symptoms of a Concussion leaves the young athlete especially vulnerable to greater injury

22.  Blow to the head of an individual still symptomatic from previous mild brain injury  Rapid, swelling of the brain, increase in intracranial pressure, often resulting in death  If athlete sustained one concussion, they become 3x more likely to sustain another  Usually occurs in younger athletes (under the age of 20)

23.  Once cleared by a healthcare professional to begin activity AND once the athlete is symptom free, he or she will start a progressive, graded, step-by-step procedure outlined in the following chart:

24. *The progressions will advance at the rate of one step per day *Athlete’s progression continues as long as he or she is asymptomatic at current activity level *If the athlete experiences ANY post concussion symptoms, he/she will wait 24 hours and start the progressions again at the previous step

25.  This First Week is Critical  Most kids average 7 days for full recovery  75% of Repeat Concussions occur within these first 7 days when a child returns to play too early  92% of Repeat Concussions occur within the first 10 days

26.  No Activity, Full Rest  Decrease Energy Demands on the brain to allow it to fully recover  Limit classwork, homework, reading, math, writing, etc. that require attention, concentration and memory skills  Things that are OK to do: 1. Sleep/Rest 2. Ice Pack on Head or Neck as needed for comfort 3. Light Diet

27.  Cognitive Return to School Protocol after an Athlete sustains a Concussion:  Day 1: No School (until Symptom Free)  Day 2: Half Day, no homework  Day 3: Full Day, no homework  Day 4: Full Day, homework for 30 minutes  Day 5: Full Day, homework for 60 minutes  Day 6: Full Day, homework for more than 90 minutes

28.  ESPN “Outside the Lines” and “E60” have a number of short, but informative videos on Concussions including:  1. “OTL High School Concussions”  2. “OTL Future of Football”  3. “OTL Second Impact Syndrome”  4. “E60 Unprotected”  http://espn.go.com/video/clip?id=51631 51 http://espn.go.com/video/clip?id=51631 51

29.  Over 50% of Concussions go unreported (possibly up to 75-80%)  Educate Parents and Kids it’s not smart to play with a Concussion  Do Not let your kids convince you they are “fine”  Teach proper tackling techniques: 1. Head Up…See what you Hit 2. No Spear Tackling with the Crown of the Helmet 3. Make sure equipment is properly fitted (Helmet, mouthpiece, shoulder pads, etc.)  “When in Doubt, Sit them Out”

31.  http://www.sportconcussions.com/html/ Zurich%20Statement.pdf http://www.sportconcussions.com/html/ Zurich%20Statement.pdf  http://www.vahealth.org/injury/TBI/docu ments/2011/pdf/Outlines%20of%20curren t%20state%20of%20knowledge.pdf http://www.vahealth.org/injury/TBI/docu ments/2011/pdf/Outlines%20of%20curren t%20state%20of%20knowledge.pdf  https://www.castilleja.org/uploaded/Ath letics/Documents/Sports_Med/ACE_Car e_Plan_School_Version.pdf https://www.castilleja.org/uploaded/Ath letics/Documents/Sports_Med/ACE_Car e_Plan_School_Version.pdf