Presentation by Travis Francis, manager of the Via Christi Sports Medicine Clinic, about identifying and treating concussions.

1. Via Christi Sports Medicine
Presented by:
Travis Francis, MS LAT ATC
Manager – Sports Medicine

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Concussions
A concussion is the most common form of
head injury suffered by athletes. It is a
form of traumatic brain injury that occurs
when the brain is violently jarred back and
forth or rotated inside the skull as a result
of a blow to the head or body. This can
"stun" the brain cells or even result in their
death.
You do not need to lose consciousness to
suffer a concussion.

3. Concussions, cont…
Any athlete in motion is at risk for a
concussion.
This may occur in any sport, to boys and
girls alike.
Symptoms may appear immediately or
develop over several days.
They may last a few days to several months
and interfere with schoolwork and social
life.
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4. 4
Concussions, cont…
Common Features:
1. Caused by direct blow with impulsive force transmission.
2. Rapid onset of short lived impairment.
3. Functional disturbance rather than a structural injury.
4. Graded clinical symptoms; resolution follows sequential course.
5. No neurological imaging abnormalities. (MRI, CT, etc..)

5. Concussion: Quick Facts
Quick Facts
• Always remove athlete immediately after suspecting a
concussion. Do NOT allow return to play the same day
with a concussion.
• Athletes do NOT have to be knocked out to have a
concussion. 90% of concussions occur without a loss of
consciousness.
• CT scans don‟t diagnose concussions. Everyone with a
concussion has a normal CT scan.
• It is OK to let someone fall asleep after being hit in the
head. With careful monitoring, rest and sleep will be
helpful.
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6. Concussion: Quick Facts cont…
• “Warm Up for Return” is a graded process that requires a
minimum of five days.
• 9 out of 10 athletes will be back to normal within two weeks.
They may miss a few games.
• Kansas law requires a physician‟s signature (MD/DO) to
"Return to Play."
• Athletes who return to full contact too early risk Second
Impact Syndrome, a rare but devastating brain injury that
may result in death.
• Concussions can affect driving, school work, sleep, emotions,
relationships and self worth.
• The “game plan” is not just about returning an athlete to their
sport, it is about returning the person back to their life.
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7. Concussion: Quick Facts cont….
Adult vs. Adolescent Brain
• Adolescent brain more likely to have:
 Diffuse Injury
 Prolonged Brain Swelling
 Slower recovery
 Neurological deficits following re-injury
• Adult brain is supported by mature skull
development and mature muscle development
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8. Concussion: Quick Facts cont….
Male versus Female
Females are:
 More likely to report sleep disturbances and
headaches
 More likely to have post-concussive syndrome
at one, three and six months post-injury
2011 Study
 Girls twice as likely to sustain concussion
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9. Concussion
Signs and Symptoms
Signs Observed Reported By
Others:
• Appears dazed or stunned
• Is confused about assignment
• Forgets plays
• Is unsure of game, score or
opponent
• Moves clumsily or has slurred
speech
• Answers questions slowly
• Loses consciousness
• Shows behavior or personality
changes
• Cannot recall events prior to hit
• Cannot recall events after hit
Signs Reported by Athlete:
• Headache
• Nausea or vomiting
• Balance problems or dizziness
• Double or fuzzy vision
• Sensitivity to light or noise
• Feeling sluggish or drowsy
• Feeling foggy or groggy
• Concentration or memory
problems
• Confusion
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10. Concussion: Management
Once a concussion is diagnosed OR perceived:
• Remove from activity IMMEDIATELY
• Assess physical, emotional and cognitive
symptoms (see Score Card #1)
• Determine if advanced medical attention is
warranted: LOC, symptoms worsening, drainage
from ears or nose, fracture….
• Assess memory, balance, and concentration:
(Score Card #2)
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11. Concussion: Management
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12. Concussion: Management
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13. Concussion: Management
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14. Concussion: Management
• Refer to physician for further evaluation and
treatment; all student-athletes must be evaluated
AND cleared by a physician to practice medicine
and/or surgery (MD or DO)
•Rest!!
• Physical
• Cognitive
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15. Concussion:
When to call EMS or see a physician immediately?
Symptoms that need immediate referral:
• LOC – Loss Of Consciousness
• Vomiting
• Headache that worsens over time
• Slurred speech or other changes in speech
• Pupils are unequal or dilated
• Blood or other discharge from ears or nose
• Seizure
• Any signs of amnesia either pre or post injury
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16. Concussion:
Return to „Learn‟ and Return to „Play‟
Return to Learn
•Assess symptoms that affect
learning (concentration, light
sensitivity, headache, etc..)
•If trouble with basic functions, take a
few days off of school
•Limit activities that rely on „heavy‟
brain function (texting, watching TV,
playing video games, etc..)
•Allow time for rest throughout the
day; utilize PE and recess times
•NO TESTING!!
Return to Play
•Don‟t begin until fully returned to
school
•Day 1: Increase heart rate; stationary
bike (5-10 minutes)
•Day 2: light activities that may
include: (15-20 minutes)
• Jogging: do 2 or 3 laps around the gym
with 1 to 2 minute rest periods
•Day 3: increase activity duration,
moderate intensity; no contact
opportunities; may lift weights, sprint,
any conditioning
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17. Concussion:
Return to „Play‟ cont..
Return to Play
•Day 4:
• Full activity with no restrictions
• Follow up testing with „Score
Card‟
•Day 5:
• Released to full activity both in
school and other activities
When to STOP RTP
•At any time during the
progression, if symptoms
worsen.
•If you stop progression,
take next day off and take
one step back on
progression to resume.
•If you have to stop
progression multiple times;
refer to physician
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18. THANKS!!
QUESTIONS??
Kansas Sports Concussion Partnership
• www.kansasconcussion.org
Center for Disease Control
• www.cdc.gov/Concussion
Safe Kids Worldwide
• www.safekids.org
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