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Concussion Management and Awareness Act

Concussion Management and Awareness Act. Dave Boyland, PT, DPT, SCS, ATC Maggie Reinhard, PT, DPT, ATC Goldwyn & Boyland Physical Therapy. The Law.

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Concussion Management and Awareness Act

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  1. Concussion Management and Awareness Act Dave Boyland, PT, DPT, SCS, ATC Maggie Reinhard, PT, DPT, ATC Goldwyn & Boyland Physical Therapy

  2. The Law • A student diagnosed with a concussion is not to be returned to athletic activities until at least 24 hours have passed without symptoms and the student has been assessed and cleared by a medical provider to begin a graduated return to activities.

  3. The 3rd International Conference on Concussion in Sport • Panel of Sports Medicine Physicians, Neurologists, Psychologists, Athletic Trainers, Researchers, Athletes, Coaches, etc. • Endorsed by FIFA, IOC, IRB, IIHF

  4. The 3rd International Conference on Concussion in Sport • Concussion is defined as a complex pathophysiological process affecting the brain, induced by traumatic biomechanical forces. • Eliminated the terms “complex” and “simple” concussion • Established Return to Play (RTP) Guidelines

  5. Direct/Indirect Observation • Any student suspected of having a concussion either based on the disclosure of a head injury, observed or reported symptoms, or by sustaining a significant blow to the head or body must be removed from athletic/physical activity and observed until an evaluation can be completed by a medical provider.

  6. The Team • Medical Director • School Nurse • Certified Athletic Trainer • Director of Physical Education/Athletics • School Administrator • Teacher • Coach • Student • Parent/Guardian

  7. Training Course • NYSED approved training course • Heads up to Clinicians (CDC) • Every 2 years

  8. Who Must Take the Course? • School Nurse • Certified Athletic Trainer • Physical Education Teacher • Coach

  9. Neurocognitive Computerized Testing • Impact • CogSport • Headminders • ANAM (Automated Neuropsychological Assessment Metrics)

  10. Identification • Amnesia • Confusion • Headache • LOC • Balance Difficulty/Dizziness • Double or Blurred Vision • Sensitivity to Light and/or Sound • Nausea/Vomiting/Loss of Appetite

  11. Identification • Irritability/Sadness/Changes in Personality • Feeling Sluggish or Light-headed • Concentration or focusing problems • Slowed Reaction Times • Fatigue/Sleep Issues

  12. Immediate Referral • Headache that Worsens • Seizures • Looks drowsy or cannot be awakened • Repeated Vomiting • Slurred Speech • Unable to recognize people or places • Weakness or Numbness • Unsteady Gait • Dilated or Pinpoint Pupils

  13. Sideline Assessment Tools • SCAT 2 • SAC • BESS

  14. SAC

  15. Diagnosis • Licensed Physician • Nurse Practitioner • Physician Assistant

  16. Post-concussion Management • Cognitive Rest • Avoidance of participation or exposure to: • Computer and Video Games • Television Viewing • Texting • Reading or Writing • Studying or Homework • Taking a Test or Completing a Significant Project • Loud Music • Bright Lights

  17. School Responsibility • Providing Accommodations • Shorter School Day • Rest Periods • Peer Note Takers • Extended Time for Tests and Assignments

  18. Post-concussion Management • Physical Rest • Adequate Sleep • Taking Frequent Rest Periods and Naps • Avoiding Exertion

  19. Post-concussion Management • 24 Hours SYMPTOM FREE • Clearance for Return to Activity • Private Medical Provider • Medical Director

  20. Return to Activity • Phase 1 • Low impact, non-strenuous light aerobic activity • Phase 2 • Higher impact, higher exertion, moderate aerobic activity • Phase 3 • Sport specific, non-contact activity, low resistance weight training • Phase 4 • Sport specific, non-contact activity, higher resistance weight training • Phase 5 • Full contact training drills, intense aerobic activity

  21. Return to Activity • Phase 6 • Return to full activity without restrictions • Determined by Medical Director

  22. Second Impact Syndrome (SIS) • A Severe, Life Threatening Condition That Causes Irreversible Brain Damage, Hemorrhage, And Cerebral Edema • Almost Exclusively In Individuals Under Age 25

  23. References • http://www.nysphsaa.org/safety/pdf/NYSEDGuidelinesforConcussionManagement.pdf • http://preventingconcussions.org • McCrory P, Meeuwisse W, Johnston K etal. Consensus Statement on Concussion in Sport: The 3rd International Conference on Concussion in Sport Held in Zurich, November 2008. J Ath Training. 2009;44:434-448. • Wojtys EM, Hovda D, Landry G et al. Concussion in Sports. Am J Sports Med. 1999;27:676-687.

  24. Questions?

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