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Virginia Department for Aging and Rehabilitative Services Brain Injury Report Out Day. Mitchell Callis, M.S.,Ed.,ATC,VATL Certified Athletic Trainer Children’s Hospital of the King’s Daughters Virginia Athletic Trainers Association
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Virginia Department for Aging and Rehabilitative ServicesBrain Injury Report Out Day Mitchell Callis, M.S.,Ed.,ATC,VATL Certified Athletic Trainer Children’s Hospital of the King’s Daughters Virginia Athletic Trainers Association Virginia High School League Sports Medicine Advisory Committee
Board of Education Guidelines • Local school divisions MUST establish concussion management policies by July 1, 2011 • Defines Appropriate Licensed Health Care Provider (ALHCP) • ATC, MD, DO, NP, PA, Neuropsychologist • Policies include: • Annual concussion education for parents and students • Removal from play if concussion suspected • No same day RTP nor until cleared by ALHCP • Must complete graduated RTP progression
What Have We Learned? • Anecdotal evidence says it’s working… • Increased awareness about concussion • Students, parents, coaches, school staff, etc • Increased utilization of concussion management best practices • On the sideline, in the office and in the classroom
What Have We Learned? • Education delivery mechanisms • Paper forms requiring signatures • Face-to-face meetings • Online • Most effective seems to be a combination of different methods • Different learning styles, technological limitations, repeated exposure to content
What Have We Learned? • Communication and collaboration are critical • Effective management is truly a team effort • Parents, medical professionals, teachers, school counselors • Cannot afford to underestimate academic consequences • Schools need to be ready and able to accommodate students with concussion
Summary and Agreement Statement of the International Conference on Concussion in Sport, Zurich (2012)andSCAT 3
Grading Scales of Concussions • Colorado • American Academy of Neurology • Cantu • Maroon • Hugenholz • Wilberger • Roberts • VNI • AMSSM • Ommaya & Gennarelli • Ommaya • Torg • Gersoff • Rugby Football league (UK) • Federation Internationale de Ski • Amateur Boxing Association • Auto Cycle Union (UK) • The Jockey Club • Rugby Union • Rugby League (Australia) • Schneider • Kulund • Kolb • Saal • Nelson • Parkinson NO MORE GRADES
Return to Play Criteria No signs or symptoms Normal neurological exam Normal balance Neuropsychological exam back to baseline And then… return to play progression
No activity Light aerobic exercise Return to Play Progression Sport specific exercise Non-contact training drills Full-contact practice Return to Play (Game) *24 hr minimum at each stage