1. CONCUSSIONS The (not so) good, The bad, The UGLY Truth

2. CONCUSSION DEFINED Alteration to mental status Typically caused by a severe head trauma The brain moves violently within the skull Brain cells all fire at once, seizure-like Twisting motion of brain on brain step

3. AFFECTS ON BRAIN Attention span Working memory Sustained and selective attention time Inability to problem solve Reaction time

4. SYMPTOMS Early-minutes & hours Headache Dizziness or vertigo Lack of awareness of surroundings Nausea or vomiting Late days-weeks Persistent low grade headache Light-headedness Poor attention and concentration Memory dysfunction Easy fatigability Irritability and low frustration tolerance Intolerance of bright lights or difficulty focusing vision Intolerance of loud noises, sometimes ringing in the ears Anxiety and/or depressed mood Sleep disturbance

5. CONCUSSION GRADES Grade1 concussion symptoms last < 15’ There is no loss of consciousness. Grade 2 concussion symptoms are > 15’ There is no loss of consciousness. Grade 3 concussion loss of consciousness for ANY amount of time!

6. STATISTICS OF PREVELENCE 2001-2005: ages 5-18 years accounted for 2.4 million ER visits due to sports injury 6% (135,000) involved a concussion. Sports 2 nd leading cause of Traumatic Brain Injury for 15-24 year olds. 1 in 5 U.S. athletes in contact sport diagnosed with concussion yearly 3.5 million concussion REPORTED yearly At NPHS 17/22 sports are considered contact

7. Why aren’t concussion reported? 66% Did not think it was serious enough 41% Did not want to leave the game 36% Did not know it was a concussion 22% Did not want to let down their teammates

8. LONG TERM EFFECTS 1 in 1,000 chance for a man between the ages of 30-49 diagnosed with a memory related disease NFL retiree has a 1 in 53 chance

9. FIELD TESTING (EVALUATION) Orientation Time, Place, Situation Concentration Digits Backwards Memory Recall digits or patterns Physical Test Sprints & calisthenics Neurological Test Pupils Symmetry Coordination Finger to nose, tandem gait Sensation Romberg Test

10. RETURN TO PLAY Grade 1 if asymptomatic after 24 hours Grade 2 if asymptomatic for 1 week Grade 3 if asymptomatic for 2 weeks No repeat of symptoms after exertion Clearance from medical doctor or trained professional

11. CIF 2010 New Bylaw 313 - Concussion Protocol A student-athlete, who is suspected of sustaining a concussion or head injury in a practice or game, shall be removed from competition at that time for the remainder of the day. A student- athlete, who has been removed from play, may not return to action until the athlete is evaluated by a licensed health care provider trained in the evaluation and management of concussion and receives written clearance to return to play from that health care provider.