2.  Concussion is a brain injury and is defined as a complex pathophysiological process affecting the brain, induced by biomechanical forces.  Simply put, a concussion is tissue damage to your brain caused by an outside force. Blow to the head, or other part of the body, resulting in a whip-lash type injury.

5.  Head injury is the most frequent direct cause of death in sports  About 350,000 concussion per year in football  95% are mild, 5% are the others  8 Deaths per year  Acute Subdural Hematoma or Second Impact Syndrome

6.  A concussion is a brain injury and all are serious.  Most concussions occur without loss of consciousness.  Recognition and proper response to concussions when they first occur can help prevent further injury or even death.  71.0% of all sports- and recreation-related TBI emergency department visits were among males.

7.  Headache  Nausea  Vomiting  Drowsiness  Numbness or tingling  Dizziness  Balance Problems  Sleeping more than usual  Difficulty concentrating  Difficulty remembering  Sensitivity to light  Sensitivity to noise  Feeling slowed down  Feeling as if “in fog”  Trouble falling asleep  More emotional than usual  Irritability  Sadness  Nervousness

8.  Cognitive:  Unawareness of period, opposition, game score,  Poor concentration  Confusion  Post Traumatic Amnesia  Retrograde  Antegrade  LOC  Repetitive questioning  Physical:  Poor coordination  Unstable gait  Seizure  Vomiting  Slurred speech  Inappropriate behavior or emotions  Vacant stare  Slow to respond

9.  Altered cellular metabolism causes decreased blood flow to the brain at a time the brain needs it most  The resulting “mismatch” increases the vulnerability of the brain to further injury.

10.  Traumatic brain injury is a common and potentially life-threatening injury  Possible long-term symptoms and disability  Important interventions prior to injury *Student athletes not reporting symptoms to ATC’s or team physicians puts them at higher risk for long term or permanent disability and possibly death.

11.  Use proper playing techniques.  Wear proper protective equipment and make sure equipment fits correctly.  Follow the rules and practice of good sportsmanship.

12. Don’t Hide It. - Tell a coach or athletic training if you or a teammate has symptoms! Report Symptoms. –The sooner you get checked out, the sooner you may be able to return to play Get checked out. –A concussion can affect your ability to perform everyday activities, your reaction time, balance, sleep, and classroom performance. Take time to recover. –You are more likely to have a repeat concussion when your brain is still healing! These concussions can lead to permanent brain damage or death - SECOND IMPACT SYNDROME

13.  You will not be allowed to return to play or attend class the day of your injury.  Your athletic trainer (AT) will ensure that you are sent home with instructions for you and your roommate(s)/parents in case signs and symptoms worsen.  Your AT will closely monitor your progression based on daily follow-ups.  Your parents will be contacted so long as consent is given.

14.  You will be withheld from all physical activity until otherwise instructed.  If needed, further classroom accommodations will be made. This will be done in combination with academic services and the DRC.  Once all signs and symptoms have resolved you will be tested before beginning return-to- play progression.

15.  All student athletes participating in high risk sports identified by the NCAA will do an initial Impact test prior to their first year.  A repeat test will be performed following their second year, prior to the start of the third. And..  If initial baseline is considered unacceptable  Following the recovery of a concussion

16.  Student athletes will be monitored daily. Once subjective symptoms have cleared and student athlete reports to be symptom free they will be evaluated by ATC or physician.  Student athletes will be evaluated using the SCAT3 test. This will need to be considered with in normal limits by ATC or physician before progressing.  A post-injury IMPACT test will be performed and compared to baseline*. Scores will need to have returned to the level of, or better than baseline scores.  *Student athletes participating in high risk sports identified by the NCAA will undergo a baseline IMPACT test prior to the start of their initial season, and following the completion of their second season.  All of the above must be considered with in normal limits prior to progress with the 6 day return progression.

17.  All steps require 24 hours in between.  You will be evaluated by a team physician between steps 4 and 5.  Student athletes have the right to seek evaluation and treatment by a personal physician at their own cost.  PSU physicians and ATC’s have final say in clearance process, and the most conservative treatment plan will be followed.

19.  Some injuries are worse than others  Some athletes are more vulnerable  Not everyone heals on the same timeline  Pre-injury risk factors combine with injury (modifiers)  # previous concussions, headache, ADHD, LD, mood  Other possible factors that influence recovery  Magnitude of force that is received  Location that force is received  Defensive position/ prep of individual receiving force  Size, speed factors

20.  40% of concussion resolve in about a weeks time.  70% of concussion resolve in about two weeks time.  Following two weeks, the recovery time slows down, and may last weeks, to months, to years. Student athletes need to be aware of the risk for prolonged recovery, and post-concussive symptoms.  Recovery is typically slower after suffering past concussions.

21. WEEK 1 WEEK 2 WEEK 3 WEEK 4 WEEK 5

22.  Resting the brain & getting good sleep  No or limited screen time (computers cell phones)  No alcohol  No additional forces to head / brain  Managing / facilitating physiological recovery  Avoid activities that produce symptoms  Not over-exerting body or brain Ways to over-exert  Physical  Emotional  Cognitive! (concentration, learning, memory)

23.  Following tens days of prolonged symptoms, or in case of severe concussion, rest may not be enough  Student athletes may be entered into a multidisciplinary concussion management program  Evaluation and recommendation for this treatment will be determined by treating physician

24.  Concussions are different for each athlete but ALL are a serious injury that should not be ignored.  Don’t hide it, report it, take time to recover  At anytime, don’t be afraid to ask ATC’s or team physician questions regarding concussions  Remember Max:  http://www.oregonlive.com/opinion/index.ssf/20 09/06/maxs_law_one_tragedy_that_need.html