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Head and Neck Injuries

Head and Neck Injuries. The Worst injuries in sport!. Head and Neck Injuries. Potentially severe and life threatening Very Preventable (choice of activity, equipment, techniques) Initial Management can make all the difference!. Skull. Jewel Box – encases the brain.

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Head and Neck Injuries

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  1. Head and Neck Injuries The Worst injuries in sport!

  2. Head and Neck Injuries • Potentially severe and life threatening • Very Preventable (choice of activity, equipment, techniques) • Initial Management can make all the difference!

  3. Skull • Jewel Box – encases the brain

  4. Meninges and Cerebral Spinal Fluid • The lining outside of the Central Nervous System, encases and surrounds the brain • Three Layers of Meninges (Dura mater, Arachnoid mater, Pia mater) • Veins are mostly subdural and arteries are mostly epidural

  5. Mechanisms of Injury • Injuries to the head and or neck can occur by mechanical overload of the brain or brain stem. This would include any load or trauma to the head or neck! • The Skull along with the CSF and Meninges protect the brain from mechanical overload. This is why we do not get permanent damage after landing from a jump, or banging our head into a cabinet

  6. Protecting ourselves from injury • Our entire body absorbs the energy from the ground to the point where the head should move as little as possible. When landing properly, we should cushion our landing by bending as many joints as we can so that the energy is dispersed as much as possible! (motorcycle landing)

  7. Trauma • Blunt trauma is the acceleration or deceleration of the head that exceeds the ability of the meninges to absorb the energy • Direct loading (blow to skull) such as a direct shoulder or elbow to the head • Indirect loading (through the neck) such as whiplash caused by a car accident. This hurts twice acceleration and deceleration! • Sharp trauma (direct laceration of neural tissue by angular acceleration or deceleration of the brain, or bullets, knives or broken bones). Injury to brain tissue (axons)

  8. Other Injuries • Scalp injuries – not as severe but often result in lots of bleeding • Fractures to the skull • Vascular injuries – are very dangerous because the slow bleeding against the brain will cause increased pressure and can lead to brain damage, coma or death • Concussions – Shaking of the brain caused by direct and or indirect trauma to the brain.

  9. Concussions cont… • “shaking of the brain” which causes elastic deformation of the brain, brain contusion, or diffuse axonal injury (this could be very severe depending on the acceleration and how many axons are severed) • Temporary neurological deficit caused by mechanical trauma or over load to the nervous system….can range from a few minutes or hours to days weeks or months!

  10. Signs of Concussions • Change of mental state (ability to concentrate, incoherent speach, short and long term memory, delayed responses) • Headache • Nausea • Visual or sensory disturbance (seeing dots, vacant stare) • Motor disturbance (trouble walking, slurred or speech) • LOC

  11. First Response • Suspect catastrophe • Stabilize the head and neck • ***Never exercise after a concussion because it will lead to increased blood pressure and thus increase bleeding!

  12. First Aid Cont…How do you determine concussion • If LOC then you know it is severe no need for the following, but if no LOC then… • Ask them questions like: person, place, time, situation • Short term memory test: Give them a phrase or license plate number to remember and then go on to… • Concentration tasks (count down from 100 by 2 or 5) • Be sure to seek medical attention regardless after any hit to the head

  13. Grades of Concussion • There are different grades or degrees of severity but it is important to note that concussions are not black and white they are more of a GREY MATTER! • Grade 1 (mild) –No LOC, symptoms last less than 15min • Grade 2 (moderate) – No LOC, symptoms last longer than 15min • Grade 3 (severe) – LOC, symptoms last greater than 15 min (often days or weeks)

  14. Return to play • Must be determined by a health care professional • Usually no exercise for 24 hours after symptoms disappear • No risk of contact for twice the time of the symptoms plus 24 hours • LOC is automatic 3 weeks but if symptoms persist could be longer still!

  15. Reaction time tests • Tests such as these can be used for baseline testing. • http://getyourwebsitehere.com/jswb/rttest01.html • http://www.topendsports.com/testing/reaction-timer.htm • http://www.exploratorium.edu/baseball/reactiontime.html

  16. Ruler Drop Test • Objective • The objective of this test is to monitor the athlete's reaction time. • Required Resources • To undertake this test you will require: • Metre ruler • Assistant • How to conduct the test • The ruler is held by the assistant between the outstretched index finger and thumb of the athlete's dominant hand, so that the top of the athlete's thumb is level with the zero centimetre line on the ruler • The assistant instructs the athlete to catch the ruler as soon as possible after it has been released • The assistant releases the ruler and the athlete catches the ruler between their index finger and thumb as quick as possible • The assistant is to record distance between the bottom of the ruler and the top of the athlete's thumb where the ruler has been caught. • The test is repeated 2 more times and the average value used in the

  17. Cont… • Calculations are based on the normative data table • The algorithm to calculate the reaction speed is d = vt + ½at² where • d = distance in metres • v = initial velocity = 0 • a = acceleration due to gravity = 9.81m/s² • t = time in seconds • We need to manipulate d = vt + ½at² to give us an algorithm for t • As v = 0 then vt = 0 therefore the algorithm is t = Sqrt(2d/a) • Example • d = 9cm • t = sqrt(2 × 0.09 ÷ 9.81) • t = sqrt(0.01835) • t = 0.135 seconds • Excellent Above Average Average Below Average Poor • <7.5cm 7.5 - 15.9cm 15.9 - 20.4cm 20.4 - 28cm >28cm

  18. Videos • http://www.youtube.com/watch?v=D5haG28ZnfQ • http://www.youtube.com/watch?v=7U7jUbKQYdw • http://www.youtube.com/watch?v=r8TFHGKgpzA

  19. Hockey Issues • Direct hits to the head • Blindside hits (indirect trauma) • Equipment is different today vs. 20 years ago • Players’ size today vs. 20 years ago (players are faster and stronger) • Recent rule changes and concussions (2 line pass and others)

  20. Boxing and other contact sports • Various medical associations have recommended a ban on full contact fighting sports • The Goal of boxing is to leave the opponent with brain damage • The magnitude of victory is judged by the degree of brain injury that a boxer inflict on his opponent

  21. Videos • http://www.youtube.com/watch?v=JHnL7wqtQLs • http://www.youtube.com/watch?v=yf0nTy4nSEo

  22. Combat sports debate • Boxing and MMA are barbaric Sports that should be banned! The ultimate goal is delivering a concussion or injury to the opponent, we need to get rid of it! Agree or disagree……take one of the following points of view and argue this…..Debate will be tomorrow! • Parent perspective • Government • Educators • Ave. Joe • Educated student • **Be sure to have plenty of references to support your arguments!...you have to back up your point of view will facts/stats!

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