1. CONCUSSION

2. CONCUSSION
Common injury that is likely underreported in student athletes
Concussion can cause injury that interferes with school, social and family relationships
Recognition and education are paramount because despite protective measures, nothing is shown to prevent concussion
PA has a concussion law for interscholastic athletics, cheerleading and school based club sports.

3. WHAT IS A CONCUSSION?
A concussion is a mild traumatic brain injury (MTBI)
A concussion is a brain injury that:
Occurs when the head moves violently or is struck
Can change the way your brain normally works
Caused by a bump or blow to the head
Can happen even if there is no loss of consciousness
Mild traumatic brain injury is interchangeably with the term concussion
Even a “ding” or something that seems to be a mild bump or blow to the head can be serious.
Concussions range in significance from minor to major, but they all share a common factor– they temporarily interfere with the way your brain works– They can affect memory, judgment, reflexes, speech, balance and coordination.

4. WHAT IS A CONCUSSION ? (continued)
An “invisible” injury – more effect on the function of the brain and not a physical change in the brain
Cannot be seen on a CAT scan or traditional MRI
The severity of initial trauma does not always correlate with severity of injury
*Concussions can have a more significant effect on a young, developing brain. Recognition and response to initial injury can help facilitate recovery
You can not see a concussion
Signs and symptoms may not appear or be noticed until days or weeks after the injury

5. SYMPTOMS OF CONCUSSION (What does it look like?)
Confusion
Balance problems
Vomiting
Cannot recall events prior to and after injury
Dazed
Loss of consciousness
Forgetful
MIGHT APPEAR NORMAL
The two most common symptoms of a concussion are confusion and amnesia. The amnesia, which may or may not be preceded by a loss of consciousness, almost always involves the loss of memory of the impact that caused

6. SYMPTOMS OF CONCUSSION (What does it feel like?)
Headache
Nausea
Visual changes
Sensitivity to noise
Sensitivity to light
Sluggish, hazy, foggy or groggy
Fatigue
Difficulty paying attention
Dizziness

7. SYMPTOMS OF CONCUSSION
Irritable
Sad
Emotional lability
Nervous
Sleep disturbances

8. DANGER SIGNS Loss of consciousness Seizure Worsening headaches
Repeated vomiting
Slurred speech
Severe confusion
Significant irritability/behavior change
Numbness/weakness
2nd occurrence
These students should be sent for immediate evaluation
“Second Impact Syndrome” is when a person suffers a mild head injury and returns to play too soon and suffers another head injury before the brain is fully healed. This can lead to a rapid increase in pressure in the brain. The effects of Second Impact Syndrome include paralysis, ,mental disabilities and sometimes death.

9. POST CONCUSSIVE SYNDROME
Prolonged concussion symptoms may last up to a year (usually months)
Most frequent symptoms
-Headache Memory difficulty
-Fatigue Concentration difficulty
-Visual disturbances Sleep disturbance
-Balance disturbances Emotional problems

10. CONCUSSION CARE Sleep Avoid physical exertion No video games
No computer
No texting
Avoid loud noises and bright lights
NO SPORTS OF ANY KIND
The injury needs time to rest and heal properly
Concussions need to be treated as if they are a big deal– the brain is very important
“Second Impact Syndrome”

11. SUPPORT AT SCHOOL
Observe for continuing signs of symptoms of concussion
Coach, PE teacher, and/or athletic trainer aware of no return to activity/play until symptom-free both at rest and with exertion
Review and follow concussion action plan and district’s concussion policy
It is important to note symptoms that worsen and behaviors that seem to represent a change in the student– if a staff member has any questions or concerns at all about the signs and symptoms a student exhibits contact the school nurse or parent
Section 504 plan for prolonged symptoms (longer than several weeks) or permanent disability– that can affect the student’s performance in any manner– the accommodations may include environmental, curriculum, organizational and behavioral strategies

12. SUPPORT AT SCHOOL Time off from school/shortened day
Shortened classes (rest break during class)
Rest breaks during day
Allow extended time to complete assignments and tests
Reduced homework/class work load
No significant classroom or standardized testing at this time
Physicians and school personnel should monitor the students symptoms with cognitive exertion (mental effort such as concentration and studying) to evaluate the need and length of time supports

13. RETURN TO PLAY PLAN No physical activity
Low levels of physical activity
Moderate levels of physical activity (reduced time and/or weight from typical routine)
Heavy non-contact physical activity
Full contact in controlled practice
Full contact in game play
An individual should not return to sports/recreational activity while experiencing any lingering or persisting MTBI symptoms
Low levels of activity– (symptoms do not come back during or after activity) these activities include walking, light jogging, light weightlifting (lower weight , higher reps no bench no squats)
Moderate activity including moderate jogging, brief running-, stationary bike
Heavy activity- sprinting, running, high intensity stationary biking, high intensity weight lifting

14. PREVENTION
Educate athletes and parents about concussions before the first practice
Teach and practice safe playing techniques
Ensure that athletes wear the right protective gear for the activity
Ensure students practice good sportsmanship
Conduct pre-season baseline testing
Promote wearing seatbelts when riding in motor vehicle
Helmets, padding, and other protective equipment should fit properly, be well maintained, and worn consistently and correctly
Pre-season baseline testing are tests that assess brain function such as learning and memory skills, ability to pay attention or concentrate and how quickly someone can think and solve problems. These tests can be used during the season if an athlete has a concussion to help identify effects of the injury.

15. PA YOUTH CONCUSSION LAW
Establishes standards for managing concussions and head injury to student athletes
Form signed by students and parents regarding concussion information
Coaches to complete a concussion management certification training every year
Students with concussion symptoms must be removed from play
Penalties for coaches who fail to comply
Students must be cleared to return to play by an “appropriate medical professional”

16. RESOURCES www.cdc.gov/concussion
concussion-laws-pa-nj
(Sports Concussion Institute)
and-traumatic-brain-injury/sports-concussion-laws-new-jers