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Coaches Understanding Sports-Related Concussion. Safe Concussion Outcome, Recovery & Education (SCORE) Program Children’s National Medical Center Washington, DC. USA Hockey Foundation Project. Goal of Project:

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coaches understanding sports related concussion

Coaches Understanding Sports-Related Concussion

Safe Concussion Outcome, Recovery & Education (SCORE) Program

Children’s National Medical Center

Washington, DC

usa hockey foundation project
USA Hockey Foundation Project

Goal of Project:

Maximize safety of youth hockey players, specifically as it relates to the prevention and management of concussion.

usa hockey foundation project1
USA Hockey Foundation Project
  • Completed with support from USA Hockey Foundation (Heads Up Hockey)
  • In collaboration with Gardens Ice House and Montgomery Youth Hockey Association
  • Modeled after NHL Concussion Program
    • Education, Baseline Testing, Post-Concussion Evaluation & Gradual Return-To-Play
slide4

1997

  • NHL REQUIRES BASELINE
  • TESTING FOR ALL ATHLETES
  • Over 3800 athletes tested
  • 800 concussion evaluations
  • Player and league supported
  • Post-Concussion Evaluation
  • Gradual Return-To-Play

Eric Lindros

(8 reported concussions)

four part concussion education management program
Four-Part Concussion Education & Management Program
  • Education: Increase knowledge of signs, symptoms, and risks associated with concussion
  • Baseline: Establish pre-season baseline levels of concussion symptoms
  • Early ID of concussion: Promote effective, early identification of concussions
  • Return to play: Implement safe return-to-play (RTP) protocol
key starting points
Key Starting Points
  • Concussions can occur in any sport
  • Ice hockey is a safe sport
    • Concussions are relatively infrequent
    • Concussions vary with the level, skill & intensity of the play.
    • Individual’s likely vary in their susceptibility to concussion.
  • Proper management of a suspected concussion significantly reduces the chances of a bad outcome.
slide7

Four-Part Concussion Education & Management Program

  • Education: Increase knowledge of signs, symptoms, and risks associated with concussion
  • Baseline: Establish pre-season baseline levels of concussion symptoms
  • Early ID of concussion: Promote effective, early identification of concussions
  • Return to play: Implement safe return-to-play (RTP) protocol
what is a concussion
What is a Concussion?

A concussion is an injury to the brain that:

  • Is caused by a bump, blow or jolt to the head.
  • Can change the way the brain normally works.
  • Can range from mild to severe.
  • Can occur during practices or games in any sport.
what are the symptoms of a concussion
What are the Symptoms of a Concussion?

3 symptom types

  • Physical: Headache, nausea, balance problems, double/fuzzy vision, sensitivity to light or noise, feel sluggish, dizziness
  • Thinking: Poor concentration, memory, trouble following conversation, fogginess, confusion
  • Emotions: irritable, more emotional, sadness
do you need to lose consciousness with a concussion
Do you need to lose consciousness with a concussion?

NO!

  • You may or may not have a loss of consciousness
  • Only a small % do (approx 10)!
  • Can happen even if you haven’t been knocked out.
  • Can be serious even if you’ve just been “dinged” or had your “bell rung.”
incidence
Incidence
  • Traumatic brain injury (TBI) is among the most common injuries in children
  • Annually, more than one million children sustain a TBI; 80-90% “ mild”
  • Concussion = Mild TBI
  • Estimated 300,000 sports-related concussions per year (likely an underestimate by 3-8x)
how do you know if a player has had a concussion
How do you know if a player has had a Concussion?
  • After a blow, something seems different.
  • You might notice some symptoms right away (confusion, loss of balance, fogginess, memory).
  • Player is not following the game or the plays.
  • BUT - Other symptoms may take hours, days, or weeks (headache, irritability, poor concentration).
  • Later on, difficulties with schoolwork,

completing everyday tasks, irritability.

what parents coaches teammates see signs
What Parents/ Coaches/ Teammates See (Signs)
  • Appears dazed, stunned, glassy
  • Confused about tasks, game assignment
  • Forgetful, repeating same questions
  • Unsure of game, score, opponent
  • Moves clumsily
  • Answers questions slowly
  • Shows behavior or personality changes
  • Can’t recall events before hit or after hit
  • Loses consciousness
symptoms the player may report
Symptoms The Player May Report
  • Headache
  • Nausea
  • Balance problems, dizziness
  • Double or fuzzy vision
  • Sensitivity to light or noise
  • Feeling sluggish or slowed down
  • Feeling foggy or groggy
  • Concentration or memory problems
  • Confusion
what to do if your player has a concussion
What to do if your player has a Concussion
  • Initial Assessment - Do NOT ignore a blow or jolt to the head. Observe the player for signs and symptoms.
  • If a Concussion is suspected, implement the ACTION PLAN.
  • When in doubt, sit them out.
basic assessment
Basic Assessment
  • Observe player for signs & symptoms
    • Check Concussion Card or clipboard
  • Questions to Ask:
    • Score of game, Who playing, Last Play, Current Period
    • What happened right before hit
    • What happened right after hit
    • Symptom list (card/ clipboard)
  • Questions Not to Ask (not useful)
    • Name of self or others
    • Day, date, time, where they are (orientation)
    • How many fingers
action plan
ACTION PLAN
  • Do NOT allow the player to play with symptoms.
  • Remove the player from the game/ practice.
  • Inform the parents.
  • Encourage a medical checkup. Obtain a proper evaluation by sports concussion expert.
  • Allow return to play only with permission from an appropriate health care professional.
what if i have questions about a possible concussion
What if I Have Questions about a possible Concussion?

If Coach, Parent, or Player has any question:

  • Call the SCORE Information Hotline to discuss with a Concussion consultant
  • SCORE Hotline #: 240-426-8057
  • SCORE Hotline Hours:
    • Mon-Fri 8am-9pm
    • Sat-Sun 10am-9pm
treatment of a concussion
Treatment of a Concussion
  • Give yourself time to recover. REST!
    • Your brain needs to heal.
    • If not healed, your brain is more likely to be injured again - and worse.
    • Recovery can take several days or weeks.
    • Manage physicial (e.g., running, weightlifting) and cognitive (e.g., schoolwork, homework) exertion
what could happen if nothing is done
What could happen if nothing is done?
  • Player is more likely to be re-injured.
  • Second/ third... injuries:
    • are more likely to be more severe
    • could cause permanent brain damage
    • can take longer to recover from.
  • The player is put in greater danger.
  • The player is not helping their team or teammates.
  • Teammates must help their fellow teammates!
after a concussion when can the player return to play
After a Concussion, When Can the Player Return to Play?
  • No longer have symptoms
    • No longer need medicine to control symptoms.
  • Cognitive/ thinking skills back to “normal.”
  • Cleared by medical professional.
after a concussion gradual return to play protocol
After a ConcussionGradual Return to Play Protocol

After rest and gradual activity (exertion)

  • Light aerobic exercise such as walking or stationary cycling.
  • Sport specific training.
  • Non-contact training drills.
  • Full contact training.
  • Game play.
how can concussions be prevented
How Can Concussions be Prevented?
  • Follow the sport’s safety rules (especially checking, rough play).
  • Good sportsmanship.
  • Use proper equipment.
    • Right equipment for the sport and position.
  • Use equipment properly.
    • Properly fitted.
    • Use it every time you play.
  • Do not ignore a blow or jolt to the head.
key ending points
Key Ending Points
  • Know what a concussion is and its symptoms.
    • Dings and bell-ringers count!
    • 3 types of symptoms: physical, thinking, emotional
  • Don’t Ignore. Observe the players, tell parents.
    • Encourage teammates to watch out for their friends.
  • When in doubt, consult with SCORE.
  • Give TIME to recover. REST!
  • Follow the sports’ rules safely.
  • Use the equipment properly.

Play Hard! Play Safe! Play Smart!

four part concussion education and management program
Four-Part Concussion Education and Management Program
  • Education: Increase knowledge of signs, symptoms, and risks associated with concussion
  • Baseline: Establish pre-season baseline levels of concussion symptoms
  • Early ID of concussion: Promote effective, early identification of concussions
  • Return to play: Implement safe return-to-play (RTP) protocol
pre season symptom baseline
Pre-Season Symptom Baseline
  • Assess presence of any “symptoms” prior to any injury
  • Allows for comparison following an injury
    • Identify number and degree of symptoms
  • After an injury, symptoms are monitored until return to pre-injury levels
  • Assist in guiding a safe return to play
pre season symptom baseline1
Pre-Season Symptom Baseline
  • With parental permission, complete baseline assessment by both parent and athlete
  • Copies of baseline assessments collected by SCORE staff; will be returned to parents for their records
  • Letter to pediatrician indicating that baseline has been completed, should a concussion occur
slide29

0= Not a problem

2= Moderate problem

4= Severe problem

four part concussion education and management program1
Four-Part Concussion Education and Management Program
  • Education: Increase knowledge of signs, symptoms, and risks associated with concussion
  • Baseline: Establish pre-season baseline levels of concussion symptoms
  • Early ID of concussion: Promote effective, early identification of concussions
  • Return to play: Implement safe return-to-play (RTP) protocol
concussion identification and return to play
Concussion Identification and Return to Play
  • Implement the ACTION PLAN
  • Should an injury occur, SCORE staff can provide consultation and evaluation, in collaboration with athlete’s physician
  • Return to Play: Ideally, conducted by certified athletic trainer.
safe concussion outcome recovery and education score program
Safe Concussion Outcome, Recovery, and Education (SCORE) Program
  • Staff includes neuropsychologists, sports medicine physician, and athletic trainer
  • Symptom monitoring and concussion-specific neuropsychological testing
    • Computerized testing (ImPACT) assessing attention, memory, and processing speed/ reaction time
safe concussion outcome recovery and education score program1
Safe Concussion Outcome, Recovery, and Education (SCORE) Program
  • Provide consultation to coaches and trainers regarding safe return to play
  • Provide consultation to schools regarding academic issues
score hotline
SCORE Hotline

If Coach, Parent, or Player has any question:

  • Call the SCORE Hotline to discuss with a Concussion consultant
  • SCORE Hotline #: 240-426-8057
  • SCORE Hotline Hours:
    • Mon-Fri 8am-9pm
    • Sat-Sun 10am-9pm