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Community Experience Ann l. Engelland, MD Harrison and Mamaroneck school districts Barnard college health service. What we thought then…. Run them around following head injury Awaken patient every two hours Shine bright light in eyes to check for ?? RTP often in same game

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Community ExperienceAnn l. Engelland, MDHarrison and Mamaroneck school districtsBarnard college health service

What we thought then
What we thought then….

  • Run them around following head injury

  • Awaken patient every two hours

  • Shine bright light in eyes to check for ??

  • RTP often in same game

    (dings and bell ringers)

What we think we know now
What we think we know now…

  • Rest is mainstay

  • Sleep is therapy

  • Recognize photophobia

  • Sit out ‘til symptom-free

  • When eight-year-olds are hitting each other-in tackle practice—with roughly the same G-forces as college players, what’s badly needed is a paradigm shift, a universal up-draft in thinking.”

    “This is your brain on football”

    by Paul Solotaroff

    Rolling Stone Magazine, January 2013

How to make policy changes
How to make policy changes


NOT JUST by inducement from the Attorney General


sometimes one at a time

W e can listen to dr atul gawande and others
We can listen to Dr. AtulGawande and others

My experience
My experience

  • 5 schools:

    • 4 public school districts

    • 1 college

  • Private practice

  • Policy-making in four settings

  • Book writingand blog

  • Twitter, Facebook

  • Google alerts

Ways to teach
Ways to Teach

  • Faculty meetings

  • Staff in-services (health, athletics, guidance, social work, psych)

  • Correct errors diplomatically

  • Make it easy and use checklists



Student:________________________ Grade:_______ Today’s Date:________

Date of Injury:_______________ Notified by:______________________

Description of injury:_______________________________________________

Current Sport:_____________ Counselor:___________________


_____ Concussion package mailed/given & discussed with parent.

_____ Add information on Database & PE alert list

_____ Signed parental consent received

_____ Email teachers/counselors alerting of concussion or head injury

_____ Incident report if injury occurred on school property

_____ Baseline/Prior Impact on file? If yes then have student re-test when symptom free Part C or consult School MD to determine when to Impact

_____ Check medical chart for previous concussions: List Concussion Hx dates:_________________

_____ If medical note necessary for school attendance – then advise Counselor need for Concussion Team Meeting

______ Completed Part C returned – check w/ counselor to see how student is doing academically before sending School MD paperwork

_____ Email School MD Post MTBI & medical paperwork & advise School MD of Information in Bold below & feedback from counselor/teachers RTL



More ways to teach
More ways to teach

  • Website development

  • School newsletter

  • Medical resources in community

  • Psychiatric and Neuropsych resources

  • Resource for the injured with guide to recovery

Films to view and show
Films to view and show

  • Head Games

  • The Smartest Team

  • Crash Reel

  • United States of Football ?

What needs emphasizing
What needs emphasizing

  • Non-sports injuries are prevalent

What needs emphasizing1
What needs emphasizing

  • Prevention starts in pre-season

What needs emphasizing2
What needs emphasizing


What to emphasize
What to emphasize

  • Exercise and Fitness, Team sports are important to a healthy childhood

What needs emphasizing3
What needs emphasizing

  • Holistic and individualized approach

    to each injury is required

What needs emphasizing4
What needs emphasizing

  • College level: no NCAA umbrella rules!

What not to emphasize
What NOT to emphasize

  • New helmets, bells and whistles

  • Different equipment

  • ImPACT testing unless very experienced

  • Long term disability risk ?

  • Beware of snake oil salespeople

Now promise me you will all be very careful
Now promise me you will all be very careful.”

It s all in your head everyone s guide to managing concussions

Ann Engelland, MD

It’s All in Your Head:Everyone’s Guide to managing Concussions