Concussions
in High School Athletics
“Concussion is defined as a complex
pathophysiological process affecting the
brain, induced by traumatic
biomechanical forces”.
McCrory, P., Meeuwisse, W., Johnston, K. (2009). Consensus Statement on
Concussion in Sport: The 3rd International Conference on Concussion in Sport
Held in Zurich, November 2008. Journal of Athletic Training. 44(4):434–448
Campolindo Sports Medicine
Identification/Management of Concussions
•
A process that ensures a student-athlete who exhibits signs, symptoms or
behaviors consistent with a concussion shall be removed from athletics activities
(e.g., competition, practice, conditioning sessions) and evaluated by a medical staff
member (e.g., sports medicine staff, team physician) with experience in the
evaluation and management of concussions;
•
A policy that precludes a student-athlete diagnosed with a concussion from
returning to athletics activity (e.g., competition, practice, conditioning sessions) for
at least the remainder of that calendar day; and
•
A policy that requires medical clearance for a student-athlete diagnosed with a
concussion to return to the athletics activity (e.g., competition, practice,
conditioning sessions) as determined by a healthcare professional with specific
training and experience in the assessment and management of a concussion.
Concussion; Signs & Symptoms
Selected acute & delayed signs & symptoms suggestive of concussion
Cognitive
Somatic
Affective
Sleep
Disturbances
Confusion
Anterograde amnesia
Retrograde amnesia
Loss of consciousness
Disorientation
Feeling “in a fog”,
“zoned out”
Vacant stare
Inability to focus
Delayed verbal &
motor responses
Slurred/incoherent
speech
Excessive drowsiness
Headache
Dizziness
Balance
disruption
Nausea/vomiting
Visual
disturbances
(photophobia,
blurry/double
vision)
Phonophobia
Emotional
lability
Irritability
Fatigue
Anxiety
Sadness
Trouble falling
asleep
Sleeping more than
usual
Sleeping less than
usual
Nata.org
Concussion Education
• Any athlete suspected of having a concussion should be removed from
play and assessed by a licensed healthcare provider trained in the
evaluation and management of concussion.
• Recognition and initial assessment of concussion should be guided by a
symptom checklist, cognitive evaluation (including orientation, past
and immediate memory, new learning, and concentration), balance
tests, and further neurologic physical examination.
• While standardized tests are a useful framework for examination, the
sensitivity, specificity, validity, and reliability of these tests among
different age groups, cultural groups, and settings is largely undefined.
Their practical usefulness with or without an individual baseline test is
also largely unknown.
High School Athletics:
Coaching Education Program
AB 1451 (Hayashi) – January 1, 2013
•
This bill would require each high school sports coach taking or renewing his or her
first aid certification to take additional training that includes a basic understanding
of the signs, symptoms, and appropriate emergency action steps regarding
potentially catastrophic injuries, including, but not limited to, head and neck
injuries, concussions, second impact syndrome, asthma attacks, heat stroke, and
cardiac arrest. By requiring high school sports coaches to complete this additional
training, this bill would impose a state-mandated local program.
•
The California Constitution requires the state to reimburse local agencies and
school districts for certain costs mandated by the state. Statutory provisions
establish procedures for making that reimbursement.
•
This bill would provide that, if the Commission on State Mandates determines that
the bill contains costs mandated by the state, reimbursement for those costs shall
be made pursuant to these statutory provisions
Concussion
Management
Progression of Return to Play
•
Should be gradual and the time spent at each stage should be individualized and monitored
by a healthcare professional
• (from Vienna Guidelines ’01, Zurich ‘09)
Concussion Overview Presentation
Center for Disease Control: Heads Up
Concussion in High School Sports (10 min)
Concussion Management
Home Care Guidelines Following a Concussion
The Center for Disease Control provides information for
Caregivers dealing with concussions
•
www.cdc.gov/concussion
Additional Resources
Consensus Statement on Concussion in Sport
http://www.nata.org/sites/default/files/attr-44-04-434.pdf
Management of Sport Related Concussion
http://www.nata.org/sites/default/files/MgmtOfSportRelatedConcussion.pdf
American Medical Society for Sports Medicine Position Statement:
Concussion in Sport
http://journals.lww.com/cjsportsmed/Fulltext/2013/01000/American_Medic
al_Society_for_Sports_Medicine.1.aspx
Websites:
American Academy of Neurology
www.aan.com
National Athletic Training Association
www.nata.org
Center for Disease Control
www.cdc.gov