Concussions Education:
Dangers You Should Be Aware Of
Video clip
The Problem
1. Concussions are a “invisible” injury.
2. Proper diagnosis depends on the
athlete to report “ALL” symptoms.
3. Athletes are not sure what they are
feeling when the have a concussion.
Concussions: What Can We Do?
 Prevent
 Proper Equipment and Technique
 Decrease the number of Head to Head hits.
 “Look” for Signs and Symptoms
 Parents, Coaches, Teammates, Teachers, and
Athletic Trainers should share this responsibility.
 All members should communicate in a “TEAM”
fashion.
 Obtain Baseline Cognitive Test
 Education
 Gfeller-Waller Concussion Awareness Act
Gfeller-Waller Concussion Awareness Act
• Mandatory Concussion Education For All
Coaches, Volunteers, School Nurses, Athletes,
and Parents.
▫ Should Include:
1. Written information detailing the recognition of
the signs and symptoms of concussions.
2. A description of the physiology and the potential
short term and long term effects of concussions.
3. The medical return to play protocol for postconcussion participation in interscholastic
activities.
Gfeller-Waller Concussion Awareness Act
• All coaches, school nurses, athletic directors,
first responders, volunteers, students who
participate in interscholastic activities and their
parents will receive a concussion and head
injury information sheet on an annual basis.
• The sheet must be signed and returned prior to
participation in any interscholastic activities,
including tryouts, practices, or competitions.
Gfeller-Waller Concussion Awareness Act
• Each school shall develop and maintain venue
specific emergency action plan.
• This plan must include:
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Delineation of roles.
Method of communication.
Emergency equipment available.
Access to and plan for emergency transport.
Emergency Action Plan
• Must be:
▫ In writing
▫ Reviewed by a licensed athletic trainer in
North Carolina.
▫ Approved by the principal of the school.
▫ Distributed to all appropriate personnel.
▫ Posted conspicuously at all venues.
▫ Reviewed and rehearsed annually by all
licensed athletic trainers, first responders,
coaches, school nurses, athletic directors and
volunteers.
What is a Concussion?
• Brain injury associated with a temporary loss
of brain function.
▫ Avoid terms such as “Ding” or “Bell Ringer”
▫ All concussions are different
• Causes
▫ A direct blow or force to the head.
 Head to Head
 Head to Ground
 Head to Object
▫ Impact occurs to another part of the body, but
the energy is transferred to the head.
Signs and Symptoms
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Headaches
“Pressure in Head”
Nausea or Vomiting
Balance Problems or Dizziness
Loss of Consciousness
Seizures or Convulsions
Blurred, Double, or “fuzzy
vision.
Sensitivity to light or noise
Confusion
Concentration Difficulty
Memory Difficulty
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Amnesia
“Don’t Feel Right”
Feeling foggy or groggy
Neck Pain
Fatigue or Low Energy
Drowsiness
Sadness
Nervousness or anxiety
Irritability
More Emotional Than Usual
Repeating
Change in Sleep Patterns
Feeling Sluggish or Slowed Down
Concussion Management
• Gfeller-Waller Concussion Awareness Act
• No Return the same day regardless of severity.
▫ If they have a mechanism of injury and symptoms,
they will be pulled from the event.
• Must be evaluated and receive written clearance by a
licensed physician or neuropsychologist.
▫ CANNOT be cleared by a chiropractor or emergency
room physician.
▫ Return to play must be supervised by a licensed
athletic trainer.
Return To Play
• Must be symptom free without medication for 24 hours.
▫ Day 1: Low level physical activity (light Jogging, Stationary
Bike, Walking)
▫ Day 2: Moderate Levels of Physical Activity (Weightlifting)
▫ Day 3: Heavy non-contact physical activity (Sports Specific
Drills)
▫ Day 4: Non-contact sports specific practice.
▫ Day 5: Full contact practice
▫ Day 6: Unrestricted return to activity or return to competition.
• Satisfactory Neuro-cognitive Scores Compared To Baseline
▫ No earlier than 48-72 hours post injury.
• May only move 1 step per day.
• Any symptoms require starting the RTP process over.
Why So Conservative?
• Second Impact Syndrome
▫ Occurs when an athlete sustains a direct or
indirect force to the head before recovering from
the last concussion.
• Dangers
▫ Long Term Morbidity
 100% of cases
▫ DEATH
 50% of the cases
Long Term Effects
• Decreased Decision Making Abilities
• Permanent Brain Dysfunction
• Depression
Suicide
• Early Onset of Dementia???
• Early Onset of Alzheimer's???
• Pre-mature DEATH
Resources of Interest
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http://www.nata.org/statements/#off
http://www.cdc.gov/ConcussionInYouthSports.com
http://impacttest.com/concussion/overview
http://tbicenter.unc.edu/MAG_Center/Home.html
• “Big Hits, Broken Dreams” based on Gfellar-Waller