Concussion: A View from the Sidelines
- 1. Gregory A. Elkins, MD
- 3. What we AREN’T Going to Talk About Return to Play Protocols Return to Learn Second Impact Syndrome CTE
- 4. What we ARE going to talk about (Learning objectives) Preseason Prep Pregame Prep In-Game Duties Postgame
- 5. Preseason Prep Pre-participation Exams HISTORY!!!! - Previous Concussions - Migraines
- 6. Preseason Prep Baseline Neurocognitive Testing Time Cost ? 2 Sets of Tests
- 7. Pregame Prep Evaluation of Previously Injured Players “Don’t make decisions when the stands are full and the band is playing”
- 8. Pregame Prep Emergency Action Plans All Sports All Venues
- 9. Pregame Prep Pregame Sports Medicine Timeout Who? How? Where?
- 10. In-Game Duties What are the people tasked with dealing with concussions doing?
- 11. In-Game Duties Dealing with ALL injuries Evaluation and treatment of musculoskeletal injuries Icing, taping, re-taping and bracing Monitoring heat (including water breaks, etc.) Sudden Cardiac Death, etc., etc., etc.
- 12. In-Game Duties Dealing with Coaches (and parents)
- 13. In-Game Duties Observing the Field
- 14. Evaluating Possible Concussions Presentation Evaluation
- 16. Presentation Athlete who presents to Sports Med with Symptoms
- 17. Presentation Athlete sent to sideline by Official
- 18. Presentation Athlete brought or pointed out by Coach or Teammate
- 19. Presentation Athlete with abnormal activity observed by Sports Med
- 20. Evaluation A little different than in the Clinic, Office or ER Elkins Law of Down Athlete- “If there is one mud puddle on the field that is where the player goes down.”
- 21. Evaluation General Observation Mental Status LOC
- 22. Evaluation History! History!! History!!!
- 24. Evaluation Specific Neuro Pysch Sideline Tools Remember these are TOOLS, Concussion is a Clinical Diagnosis!
- 25. Evaluation When in doubt, sit them out!
- 26. Evaluation Transport? Unstable or deteriorating neurological status
- 27. Monitoring Watch the concussed athlete Reevaluate at regular intervals Make sure they do not re-enter-TAKE AWAY THE HELMET!!!
- 28. Postgame The Sports Med team is usually the last to leave
- 29. Postgame More potential Evaluations Athletes pointed out by teammates, coaches or parents Athletes with symptoms Athletes noted to have extreme emotional lability (crying or laughing inappropriately, etc.)
- 30. Postgame Plan for what is next for the athlete with concussion Follow up Return to Play/Learn OK I mentioned them. Are you happy?
- 31. Postgame Communicate with Parents Written documents Online resources (smart phones) http://www.nfhs.org/media/1014739/parents_ guardians_guide_to_concussion_final_2016. pdf Parents may not be present
- 32. Postgame Now we get to the stuff everyone wants to hear about; RTP, RTL, CTE! But that’s another talk
- 33. Other Important Considerations This talk focused on a football game in an ideal situation with an NATA Certified Athletic Trainer and maybe a Sports Medicine Physician. What if it’s a girls soccer practice or an away volleyball game?
- 34. Other Important Considerations Emergency Action Plans are important, but our student athletes deserve NATA Certified Athletic Trainers!
- 35. Recap Learning Objectives Preseason Prep Pregame prep In Game Duties Postgame Duties