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Sports Concussion: Sideline and Initial Management

Sports Concussion: Sideline and Initial Management. Jim Fiechtl, MD Assistant Professor: Depts. Of EM and Orthopedics Vanderbilt Bone and Joint Clinic. Vanderbilt Bone & Joint. Disclosures. Unfortunately, I have no financial disclosures to make, but I am always willing to listen.

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Sports Concussion: Sideline and Initial Management

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  1. Sports Concussion:Sideline and Initial Management Jim Fiechtl, MD Assistant Professor: Depts. Of EM and Orthopedics Vanderbilt Bone and Joint Clinic Vanderbilt Bone & Joint

  2. Disclosures • Unfortunately, I have no financial disclosures to make, but I am always willing to listen. Vanderbilt Bone & Joint

  3. Objectives • How to recognize? • What we are doing on the sideline? • Who goes to the ER Vanderbilt Bone & Joint

  4. Who is concussed? http://i.cdn.turner.com/si/multimedia/photo_gallery/0910/cfb.impact.injuries/images/tim-tebow.3.jpg Vanderbilt Bone & Joint

  5. Who is concussed? http://www.cbssports.com/mcc/blogs/entry/24156338/29747154 Vanderbilt Bone & Joint

  6. Who is concussed? http://theother87.files.wordpress.com/2011/05/youth-soccer.jpg Vanderbilt Bone & Joint

  7. Who does the evaluation? • Anyone trained • Means someone has been trained • Coach • Certified Athletic Trainer • Physician • Team Parent http://www.trophies2go.com/team-mom-trophy Vanderbilt Bone & Joint

  8. What are we looking for? • Lying on the ground/slow to get up • Are they unconscious? • Unsteady or wobbly • Grabbing their head • Dazed, blank look • Confused, running wrong plays Pocket Concussion Recognition Tool™ Vanderbilt Bone & Joint

  9. Lying Motionless • If unconscious, assume a cervical spine injury • C-spine control • Activate Emergency Action Plan • Take your time – ensure safety • Needs to go to Emergency Department http://mnhopper1s.files.wordpress.com/2011/10/spine.jpg?w=420&h=337 Vanderbilt Bone & Joint

  10. Able to Move • Take your time – ensure safety • Move them to a ‘quiet’ area on the sideline • Give the player a few minutes to catch breath • Observe Vanderbilt Bone & Joint

  11. Sideline Assessment • Maddocks’ Questions • What city and stadium? • Opponent? • Month and day? • Remember being injured, score of the game, the play, etc • Memory and Cognition • Months, 3 objects, numbers backwards Vanderbilt Bone & Joint

  12. Sideline Assessment • Brief Neuro Exam • Cranial nerves • Strength • Balance • Cerebellar Vanderbilt Bone & Joint

  13. When can they go back in? They’re done for the day. Vanderbilt Bone & Joint

  14. Who needs a trip to the ER? • Worsening headache or symptoms • Drowsy, hard to awaken • Repeated vomiting • Unusual behavior • Seizures • Weakness or numbness in arms or legs • Slurred speech, unsteady walking Putukian. BJSM 2013;47:285-8. http://ia.media-imdb.com/images/M/MV5BMjA0NjI0ODgzNF5BMl5BanBnXkFtZTcwMDAxNDUyMQ@@._V1_SY317_CR20,0,214,317_.jpg Vanderbilt Bone & Joint

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