1. Peter T. Hurley, M.D. Hickory Orthopaedic Center

2. Evaluation on the Field  Rule Out Neck Injury  Neurologic deficits? Signs & Symptoms of Concussions  Most common symptoms Confusion and amnesia

3. Others… Headache, dizziness, ringing in ears, nausea or vomiting, slurred speech, fatigue, light intolerance, inappropriate affect, irritability, balance problems, blurry vision, double vision.

4. Sidelines Evaluation  Amnesia Retrograde, antegrade  Affect, Appropriate?  Eyes pupil evaluation and light tolerance  Balance  Motor strength

5. Grading Systems 41+ systems with little agreement

6. American Academy of Neurology  Grade I – Confusion, symptoms less than 15 minutes, NO loss of consciousness  Grade II – Symptoms greater than 15 minutes, NO loss of consciousness  Grade III – Loss of consciousness

7. Recommends NO return to play or practice on the day of concussion, grading not needed. North Carolina High School Association

8. What does the coach want to know?

9. If L.O.C.-(loss of consciousness) Athlete is out.

10. No L.O.C., mild symptoms, symptoms resolve in less than 15 minutes player might resume play. Reevaluate, do symptoms return with exertion?

11. No L.O.C., greater than 15 minutes of symptoms athlete is done for the night.

12. No L.O.C., symptoms greater than 15 minutes Controversy exists for when to return to play.

13. Symptoms of concussions can persist for days – weeks – months

14. Objective Evaluation would be helpful.