1. Concussion Protocol Dan Boivin OSZ President, Mont Ste Marie
This first slide could be read entirely.
We need to underline the great work of the majority while bringing the fact that we are seeing an increase number of weakness in our overall delivery.
October 29, 2016
FIS TD Update - TD Responsibilities

2. Concussion 2017
Coach Responsibilities – Coach has Duty of Care, Coach stands in shoes of parent for minors, Coach has total control over their athletes – training and competition, always err on side of being conservative.

3. Concussion Definition: Simple Definition:
Any direct or indirect force applied to the head or body that causes intracranial movement of the brain and results in complex vascular, neurochemical and processing injuries resulting in concussive symptoms.
Simple Definition:
Force Applied + Symptoms = Concussion

4. Concussion Statistics
May Be As Many As 1.9 Million Concussions For Children Under 18 In The US Yearly (AAP)
500% Increase In Diagnosis Of Concussion In Children And Young Adults Since (Under 22 y/o)
Boys Tend To Have A Higher Incidence Of Concussion Than Girls (Statistics Are Nearly Even In States With Certain Girls Sports Such As Field And Ice Hockey, Lacrosse and Soccer)

5. Concussion Statistics
Football, Soccer And Hockey Have Had A Greater Than 40% Increase In Reported Head Injuries From In Canada.
Up To 23% Of Adolescents In Canada Reported A Head Injury In The Last Year
1 In 5 Sports Related Injuries In Canada Is A Concussion
Among Ages Visiting A Canadian ER For A Sports Related Head Injury, 39% Were Diagnosed With Concussion. An Additional 24% Had Possible Concussion

6. Concussion Facts
Usually Last 1-4 Weeks (Vestibular-Ocular Symptoms 3-4 Weeks)
Symptoms Can Sometimes Last For Months To Years (Post Concussive Syndrome)
Can Be Catastrophic Resulting In Death Or Disability (Second Impact Syndrome)
Onset, Type And Severity Of Symptoms Can Vary Widely
No Two Are Alike, Therefore Treatment Should Be Individualized

7. Concussion May Not Be An Isolated or Mild Injury!
Need To Rule Out More Significant Traumatic Brain Injury – Urgent ER Evaluation?
Significant Association Of Neck Injuries With Concussion
Beware Of Distracting Injuries!
Loss Of Consciousness Is Not Required To Have A Significant Concussion (May Actually Predict Shorter Recovery Along With Vomiting)

8. Importance of Identification of Concussions
Athletes Are At Risk For Much More Severe Injury Or Prolonged Recovery If Not Treated Appropriately
Major Cause Of Both Short And Long Term Disability
Relationship To Dementia And Neurological Conditions Later In Life
May Cause Short And Long Term Psychological Changes

9. Importance of Identification of Concussions

10. Challenges of Identifying Concussions
Symptoms Can Be Subtle
The “Field Of Play” Can Be Chaotic/Busy
Athletes Report Only A Small Percentage Of Injuries
Overzealous Parents And Coaches
Lack Of Education In Officials, Coaches, Parents And Athletes
Lack Of Consistent Reporting To Sport’s Governing Body And Organizer’s Failure To Check Hold List

11. Sometimes Its Easy To See The Outward Signs

12. More Often It Is Not Moods of an Irish Setter by Gary Larson

13. Signs Observed In The Athlete By Others
Appears Dazed Or Stunned
Moves Clumsily
Answers Questions Slowly
Loses Consciousness (Even Briefly)
Shows Behavior Or Personality Changes
Can’t Recall Events Prior To Hit Or Fall
Can’t Recall Events After Hit Or Fall

14. Symptoms Reported By The Athlete
Headache Or Pressure In Head
Nausea Or Vomiting
Balance Problems Or Dizziness
Double Or Blurry Vision
Sensitivity To Light Or Noise
Feeling Sluggish, Hazy, Foggy Or Groggy
Concentration Or Memory Problems
Does Not Feel Right
Confusion

15. Symptoms Of Concussion Most Common Symptoms Reported In First 3 Days
Headache 71%
Feeling Slowed Down 58%
Difficulty Concentrating 57%
Dizziness 55%
Fogginess 53%
Fatigue 50%
Visual Symptoms 49%
Light Sensitivity 47%
Memory Dysfunction 43%
Balance Problems 43%

16. Can We Trust The Injured Athlete?
Answer: Some
Athletes Notoriously Under Report Concussion Injuries. Estimates Are Approximately 20% Will Self Report After Injury.
This Is Due To Both A Desire To Compete And A Desire To Please.
Hopefully Education And Awareness Of Athletes, Coaches, Officials, And Parents Can Improve Diagnosis And Prevent More Severe Or Long-Standing Consequences.

17. Management Guidelines Based on Four International Symposiums on Concussion in Sport
“When in Doubt, Sit Them Out”
No Athlete Should Play with Symptoms (either at rest or with exertion)
Neurocognitive Testing Should Return to Normal Before Being Cleared for Activity
A Youth Athlete Should Never be Returned to Sport the Same Day of Concussion No Matter How Brief the Duration of Symptoms
Every Injury and Athlete are Different and No Standard Timeline or Grading System Predicts Recovery

18. Checklist for Athlete Injury Specifically Concussion
The information below is to provide the competition Jury and LOC with suggested protocol in the event of a suspected concussion.
As a reminder it must be noted that the handling of suspected concussion should always be a shared responsibility between Officials, Coaches, Trainers, Parents and athlete.
At Team captains meeting
Upon completion of roll call for Jury / TD should ask if all athletes presently on the board are fit medically to participate in the event. A reminder that ski racing is a physically demanding sport.
DURING EVENT
A concussion should always be suspected if an athlete sustains a significant impact to the head, face, neck, or body and demonstrates ANY of the visual signs or reports to his/her peers ANY concussion symptoms. Athletes Team Captain should be made aware of the potential for a concussion arising from the reported or observed accident.
Normally, if a concussion is suspected medical treatment and intervention will be required.
Onsite Medical Treatment
In cases where an athlete loses consciousness or it is suspected an athlete might have a more severe
head or spine injury, Emergency Medical Assessment by emergency medical professionals should take
place immediately.
Even if the athlete did not lose consciousness but complains of dizziness, and other injury symptoms it is recommended that the athlete should undergo Sideline Medical Assessment or a Medical Assessment, depending on availability of a licensed healthcare professional present at the event.
SIDELINE ASSESSMENT
If a licensed Healthcare professional is present, a SCAT 5 assessment can be conducted. If a concussion is suspect from the SCAT 5 assessment the athlete should be removed from competition by his coach or team officials.
If a licensed healthcare professional is not present the athlete should be referred by his coach, team officials or parent to a licensed healthcare professional for assessment and determination before there is any return to competition . The Jury may wish to question any decision to return to play where there has been no intervention or independent assessment
Where an athlete is diagnosed with a concussion he/she should not return to play until the RETURN TO PLAY strategy as recommended by CSA/Alpine Canada has been followed and a MEDICAL CLEARANCE LETTER has been completed.
Note: Normally Athletes who have been provided with a Medical Clearance Letter may return to full sport activities as
Tolerated and as instructed by the Medical Healthcare Professional. If the athlete experiences any new concussion-like symptoms while returning to play, they should be instructed to stop playing immediately, notification provided to their parents, coaches, trainer or teachers, and undergo follow-up Medical Assessment.

19. Policies and Protocols ACA

20. Policies and Protocols ACA

21. Policies and Protocols ACA

22. Policies and Protocols ACA

23. Policies and Protocols ACA

24. Policies and Protocols ACA

25. Policies and Protocols ACA

26. Resources Canada
Parachute Canada: An organization in Canada dedicated to reducing preventable injuries including concussions
Alpine Canada Alpin
5th International Conference, Berlin 2016
SCAT 5 Protocols

27. Sideline Evaluation SCAT 5

28. Sideline Evaluation SCAT 5

29. Sideline Evaluation SCAT 5

30. Sideline Evaluation SCAT 5