CONCUSSIONS: WHAT YOU NEED

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1 CONCUSSIONS: WHAT YOU NEED TO KNOW! 11/5/2011 Kayt Zundel OHSU ThinkFirst Oregon Program Director Community Outreach Coordinator

2 BRAIN AND SPINAL CORD INJURY PREVENTION Concussion Quiz What is a Concussion? How concussions occur Signs and symptoms of concussions Recovery from concussions Current Oregon Law Available free online concussion training from CDC Online concussion resources

3 THINKFIRST OREGON Who We Are: ThinkFirst Oregon is a Brain and spinal cord Injury Prevention Program. Located at Oregon Health & Science University, ThinkFirst participates in injury prevention programs and community events throughout the state of Oregon. Mission: The OHSU ThinkFirst Oregon Mission is to reduce the incidence of brain, spinal cord, and other traumatic injuries and fatalities by providing education to youth, parents, and community members throughout Oregon. ThinkFirst Oregon is a chapter of ThinkFirst National Injury Prevention Foundation.

4 QUIZ YOURSELF Mark each of the following statements as True (T) or False (F) A concussion is not a traumatic brain injury. A concussion is a bruise on the brain. Concussions can occur in any organized or unorganized recreational sport or activity. Concussions can be caused by a fall, bump, or blow to the head or body. Concussions only happen if a person has been knocked out or lost consciousness. If you suspect someone may have a concussion it is important to keep that person from sleeping. To have a concussion you only need to exhibit one symptom.

5 QUIZ ANSWERS A concussion is not a traumatic brain injury. FALSE A concussion is a bruise on the brain. FALSE Concussions can occur in any organized or unorganized recreational sport or activity. TRUE Concussions can be caused by a fall, bump, or blow to the head or body. TRUE Concussions only happen if a person has been knocked out or lost consciousness. FALSE If you suspect someone may have a concussion it is important to keep that person from sleeping. FALSE To have a concussion you only need to exhibit one symptom. TRUE

6 CONCUSSION FACTS A concussion is a traumatic brain injury All concussions should be taken seriously Head injuries are often not physically obvious and have been referred to as invisible 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

7 TRAUMATIC BRAIN INJURY A Traumatic Brain Injury (TBI) is a blow or jolt to the head or penetrating brain injury that disrupts the function of the brain (CDC) Concussions are referred to as Mild Traumatic Brain Injuries but we have learned that the word mild does not describe the life changing ramifications of a concussion.

8 CONSEQUENCES OF TBI WHICH INCLUDES CONCUSSIONS Cognitive Functions Affected Memory Loss Impaired Judgment Difficulty Concentrating and Completing Tasks Difficulty Communicating Decreased Neurophysical Ability Seizures Loss of Smell, Taste, or Vision Speech Impairments Headaches Fatigue Loss of Balance

9 WHAT IS A CONCUSSION? Simple explanation A concussion is a type of traumatic brain injury or TBI caused by a bump, blow, or jolt to the head or by a hit to the body that causes the head and brain to move rapidly back and forth. A concussion is a disruption to the normal functioning of the brain. It changes the way your brain normally functions. It is not a bruise to the brain. Because it is a disruption of how the brain works (functional) brain CAT scans and MRIs results are normal with most concussions.

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11 WHAT IS A CONCUSSION? A concussion is typically caused by a severe head trauma during which the brain moves violently within the skull. The brain cells all fire at once, much like a seizure. Some studies show that patients who suffer a concussion appear to have the brain activity of people in a coma. A concussion can also be structural. A study by researchers at the University of Illinois at Chicago College of Medicine reported finding structural changes in the white matter of the brains of patients with head injuries. These structural changes correlate to cognitive deficits in thinking, memory and attention.

12 White Matter & Gray Matter Your Brain So another reason concussions may be hard to diagnose without specialized equipment is because concussions often take place deep inside the white matter of the brain. Gray matter The brain s gray matter is made up of neurons, which gather and transmit signals. White matter The white matter is made up of dendrites and axons, which create the network by which neurons send their signals.

13 Concussion Symptoms Athletes Signs Observed by Coaching Staff Symptoms Reported by Athlete Appears dazed or stunned Headache or pressure in head Is confused about assignment or position Forgets an instruction Is unsure of game, score, or opponent Moves clumsily Answers questions slowly Loses consciousness (even briefly) Shows mood, behavior, or personality changes Can t recall events prior to hit or fall Can t recall events after hit or fall Nausea or vomiting Balance problems or dizziness Double or blurry vision Sensitivity to light Sensitivity to noise Feeling sluggish, hazy, foggy, or groggy Concentration or memory problems Confusion Does not feel right or is feeling down

14 CONCUSSION SYMPTOMS Some symptoms of concussions may be immediate or delayed in onset by hours or days after injury: Concentration and memory complaints Irritability and other personality changes Sensitivity to light and noise Sleep disturbances Psychological adjustment problems and depression Disorders of taste and smell

15 CONCUSSION SYMPTOMS IN CHILDREN Symptoms can be hard to spot in young kids Listlessness, tiring easily Irritability, crankiness Change in eating or sleeping patterns Lack of interest in favorite toys Loss of balance, unsteady walking

16 RECOVERY FROM CONCUSSIONS Having the child get plenty of rest. Keep a regular sleep schedule, including no late nights and no sleepovers. Making sure the child avoids high-risk/ high-speed activities such as riding a bicycle, playing sports, or climbing playground equipment, roller coasters or rides that could result in another bump, blow, or jolt to the head or body. Children should not return to these types of activities until their health care professional says they are well enough. Giving the child only those drugs that are approved by the pediatrician or family physician. Talking with their health care professional about when the child should return to school and other activities and how the parent or caregiver can help the child deal with the challenges that the child may face. For example, your child may need to spend fewer hours at school, rest often, or require more time to take tests. Sharing information about concussion with parents, siblings, teachers, counselors, babysitters, coaches, and others who interact with the child helps them understand what has happened and how to meet the child s needs.

17 RECOVERY FROM CONCUSSIONS Get plenty of sleep at night, and rest during the day. Avoid activities that are physically demanding or require a lot of concentration.they can make your symptoms worse and slow your recovery. Avoid activities, such as contact or recreational sports, that could lead to another concussion. Avoid sustained computer use, including computer/video games early in the recovery process. When your health care professional says you are well enough, return to your normal activities gradually, not all at once. Because your ability to react may be slower after a concussion, ask your health care professional when you can safely drive a car, ride a bike, or operate heavy equipment. Consider talking with your employer or school about returning to work or school gradually and until you recover Do not drink alcoholic beverages until your health care professional says you are well enough. Alcohol and other drugs may slow your recovery and put you at risk of further injury. Consult with family members or close friends when making important decisions.

18 PREVENTION

19 SIGNIFICANT PROBLEM More than 50 percent of concussions occurring at the adolescent and high-school level are never even recognized and diagnosed by the team coach, trainer or physician. If a concussion is suspected, the first action is to remove the athlete from play. The most reliable testing to diagnose concussion is neurocognitive testing which can help to objectively evaluate the concussed athlete s post-injury condition and track recovery for safe return to play.

20 MAX S STORY ORG/ MAXS- LAW- OARS/ OAR In the fall of 2001, high-school quarterback Max Conradt, 17, sustained a concussion during a game. With no medical confirmation that his first concussion had cleared, Max started in the next game. He collapsed at halftime due to massive bleeding in his brain even though no remarkable hits were observed. Three critical brain surgeries saved his life, but he continued in a coma for three months. Once he became physically stable, Max began a long period of rehabilitation in several institutions. He now lives in a group home for individuals with brain injuries in Salem. The Max s Law Implementation Guide is dedicated to Max Conradt and to all Oregon students who play sports.

21 MAX S LAW RECOGNIZE: All coaches must receive annual training in recognizing the symptoms of concussion. REMOVE: Students suspected of sustaining of having a concussion must be removed from play. REFER: A concussion must be evaluated by a properly trained medical professional. RETURN: A student may return to play when all symptoms have resolved, at least one day has elapsed since the injury, and a medical release has been obtained

22 WHAT YOU CAN DO

23 HELMETS

24 HELMETS Skateboarding and rollerblading requires a multi-impact helmet. Bicycle helmets are single-impact helmets. They are not designed for trick skating, freeform skating, half-pipe skating, hot dogging, roller hockey and other radical skating styles where falls are frequent and a multi-impact helmet is required.

25 RAISE AWARENESS Know the signs for concussion Raise awareness in your organization, community, or school Educate kids and teens to take hits to the head seriously Wear safety helmets Provide CDC concussion kits to your coach or school

26 FREE ONLINE TRAINING CDC Free online training is offered on the CDC website Heads Up Online Concussion Training Course In my opinion it is Great training for nurses, doctors, teachers, coaches, parents, and even teens Heads up for Coaches: Heads up for Clinicians: html

27 CAUSES OF TRAUMATIC BRAIN INJURY IN IN THE U.S. D ATA S OURCE: U.S. DEPARTMENT OF H EALTH AND H UMAN S ERVICES, 2010 Assault 10% Struck By or Against 17% Other/ Unknown 21% Motor Vehicle Crashes 17% Falls 35%

28 CAUSES OF TBI IN CHILDREN AGES % Falls 25% Struck by or hit against an object 17% Motor Vehicle Crashes-Traffic Crashes 3% Assault 5% Other

29 CONCUSSION MANAGEMENT RESOURCES OHSU SPORTS MEDICINE CONCUSSION MANAGEMENT CDC OCAMP Concussion Management

30 QUESTIONS?

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