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Texas A&M University Concussion Management Plan. David Weir, LAT,ATC Head Athletic Trainer for Football Texas A&M University. Basis. Consensus Statement on Concussion in Sport: 3 rd International Conference on Concussion in Sport Zurich November 2008. Basis. Health Care Providers

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Texas a m university concussion management plan

Texas A&M UniversityConcussion Management Plan

David Weir, LAT,ATC

Head Athletic Trainer for Football

Texas A&M University


Basis
Basis

  • Consensus Statement on Concussion in Sport:

  • 3rd International Conference on Concussion in Sport

    • Zurich

    • November 2008


Basis1
Basis

  • Health Care Providers

    • Team Physician

    • Athletic Trainers

  • Have unchallengeable authority to determine and manage the treatment and the return to play of any ill or injured athlete.

  • Return to play following a concussion will be made by the team physician or his/her designate.


Education
Education

  • Coaches must acknowledge that have been educated and they understand the concussion management plan.

    • They are presented education and they answer basic questions.

  • Athletes must receive documentation and sign an acknowledgement form.

  • Athletes must agree to report if they feel they have an injury or suspect someone else.


Baseline testing
Baseline Testing

  • Neurocognitive Testing

    • IMPACT Testing- a computer program in which symptoms checklist, concussion history and neuropsychological testing

    • Sports Tested for Baseline

      • baseball, basketball, diving, equestrian, football, pole vaulting, soccer, and softball


Mild traumatic brain injury mtbi
Mild Traumatic Brain Injury (MTBI)

  • Event occurs

    • Athletic Trainer Evaluates

      • Symptom Checklist

      • (+) Symptoms, Refer if Physician is present

  • Headache

  • Nausea

  • Vomiting

  • Balance Problems

  • Dizziness

  • Fatigue

  • Drowsiness

  • Visual Problems

  • Sensitivity to light

  • Sensitivity to noise

  • Irritable

  • Sadness

  • Nervousness

  • Numbness or Tingling

  • Feeling “foggy”

  • Difficulty in concentration


Evaluations
Evaluations

  • Short Term Memory Evaluation

    • How injury occurred

    • 3 word memory

  • Long Term Memory Evaluation

    • Day of Week

    • What did you eat for lunch

  • Processing Functions

    • Subtract from 100 by 7’s

    • Months of Year Backwards


Evaluations1
Evaluations

  • Balance Testing

    • Double Leg Stance

    • Single Leg Stance

    • Tandem or Heel to Toe


Decisions
Decisions

  • If Team Physician NOT present

    • Remove from all activities

  • If a concussion is suspected, do not return them that day!!!

    • Observe for minimum of 15 minutes

      • Athletic Trainer reevaluates

      • If athlete is:

        • COMPLETELY asymptomatic

        • Normal neurological exam including balance testing

        • Perform Functional Testing (Explained on next slide)

      • Still symptomatic

        • Athlete does not return that day and remains in observation

        • Arrange for physician evaluation


Functional testing
Functional Testing

  • Progressive

    • Walk

    • Jog

    • Sprint

  • Running Up/Downs

  • Bear Crawls

  • Observe for Symptoms

  • “Do you feel like normal _________ (name)?”

    • If Yes, allow return

    • If No, hold them


Diagnosed concussion
Diagnosed Concussion

  • Physician Evaluation ASAP

    • Sport Concussion Assessment Tool 2 (SCAT2)

      • Appropriate for persons Age 10 and above

    • Admitted or Released

    • Transportation Arranged

      • Athlete given Head injury Handout

      • Athlete instructed to follow-up with their staff athletic trainer daily


Immediate concussion treatment
Immediate Concussion Treatment

  • Tylenol only for pain

  • Refrain from:

    • Physical Activity

    • Texting and Emailing

    • Playing video games

    • Watching TV, Video

    • Consider excusing from all academics


Daily follow up
Daily Follow-up

  • Symptom Score

  • Determine athletes best interest depending on symptoms and academic demands

  • Refer to nutritionist to be placed on DHA Omega 3

    • Has been shown to aid the brain tissue

  • If symptom score is less than 10

    • Setup IMPACT testing


When do they become active
When do they become active?

  • At or near NO Symptoms

  • At or near Return to Baseline on IMPACT


Graduated return to play
Graduated Return-to-Play

  • Light Aerobic Exercise – Goal= Increase Heart Rate

    • Walking, Stationary Bike, Swimming -70% max

  • Sport Specific Exercise- Goal= Add Movement

    • Running Drills, jogging to sprinting

  • Training Drills- Goal= Add Coordination and Cognitive Function

    • Up/Downs, Bear Crawls, Pass Catching,


Final clearance
Final Clearance

  • Athlete is Completely Asymptomatic

  • Athlete Returns to Baseline on IMPACT

  • Athlete can accomplish all Return-to-Play activities with NO ONSET of SYMPTOMS

  • Athlete is referred by to physician for final clearance.


Ultimate return to play
Ultimate Return-to-Play

  • Upon Medical Clearance:

    • Athlete is released to coaches for normal training exercises including contact drills if appropriate to restore athletes confidence and to determine if athletes is ready to participate.


Norms
Norms

  • Typical recovery is 5-7 days (Simple)

    • Complex much longer Weeks to Years





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