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Concussion Awareness


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Concussion Awareness

  2. 2. CONCUSSIONS ARE TBIS  We’ve all done it -- accidentally knocked our head against something and wondered whether it was serious. It’s human nature to check for bleeding and, usually finding none, we rub the spot that hurts and carry on. But that’s the insidious nature of concussions – if there is any bleeding or swelling, it’s internal.  Concussions are so pervasive that it has been estimated that three- quarters of all Americans will experience at least one in their lifetime. Concussions are a type of traumatic brain injury (TBI), which is a major cause of disability and death in the United States.  TBIs contribute to more than 50,000 deaths in this country every year and are a diagnosis in more than 280,000 hospitalizations and 2.2 million emergency department visits. The leading causes of concussions seen in EDs across the country include vehicle wrecks, sports, slips/falls, unintentional blunt force traumas, and assaults.
  3. 3. HOW SERIOUS IS IT? By their very nature, concussions are significant injuries. Experts stress that there is no such thing as a minor concussion and that a loss of consciousness is not required for there to be a critical problem. Concussions typically come in three grades.  Mild/Grade 1: A Grade 1 concussion is the least serious, occurring when the brain is injured but the person does not lose consciousness and the degree of disorientation is low. The confusion lasts for only a short time.  Moderate/Grade 2: With a Grade 2 concussion, the degree of disorientation is higher and lasts longer than 15 minutes. It also may involve a person’s not being able to recall certain details, such as incurring the injury (post-traumatic stress amnesia).  Severe/Grade 3: A Grade 3 event causes unconsciousness (usually for only a brief period of time) or amnesia regarding a larger range of details – such as what occurred just before or just after the injury.
  4. 4. COMMON SYMPTOMS Common emotional symptoms include:  Anxiety  Irritability  Depression  Feeling overstimulated. Common physical symptoms include:  Headaches  Fatigue  Nausea  Blurry vision  Weakness Common cognitive symptoms include problems with:  Memory  Judgment  Speech  Reflexes The brain is a complicated organ, controlling the body’s functions and performing an incredible number of tasks. It is hardwired to protect itself from injury, so oftentimes concussion symptoms might not be noticed for several days or weeks, if it all. Because each person’s brain is unique, no two concussions are the same.  Numbness  Dizziness  Loss of smell or taste  Tinnitus  Sensitivity to light or noise.  Balance  Concentration  Coordination  Sleep.
  5. 5. VEHICLE ACCIDENTS  On average, there are 5.4 million non-fatal car collisions every year in the United States. In 2012, more than 24,000 of those vehicle wrecks were on Kentucky roads, resulting in just about every injury imaginable. Although concussions can be the only injury received in a traffic accident, more often than not they are suffered along with more obvious bodily wounds such as broken bones, burns, or paralysis. Even if you feel alright after an accident, it is always a good idea to seek medical care. Brain injuries may take a delayed path, initially having no symptoms or mild ones that worsen over time.
  6. 6. HOW CONCUSSIONS RESULT FROM WRECKS  Even without a direct hit to the head, a car accident can still jolt the brain enough to result in a concussion. While few of us think about our high school lessons on Newton’s laws of motion, those laws are always at work, and they are the reason that a sudden deceleration can result in a brain injury.  To simplify the science behind it, just imagine yourself riding in a car. If the car suddenly stops, your body continues to move forward at the same speed as the speed the car was traveling before it was stopped until some external force stops it. In the best scenario, you were wearing your seatbelt and that acts to stop your body from hitting the dashboard or windshield.  But your brain doesn’t have its own seatbelt, so it continues at the same speed as the car until it hits the inside of your skull.  The impact of a traffic accident causes the soft tissue of a driver’s or passenger’s brain to crash back and forth against the skull’s inner wall, causing bruising, bleeding, and tearing of nerve fibers.
  7. 7. CONCUSSIONS IN SPORTS: THE NUMBERS  Concussions can happen in any sport, at any experience level. The University of Pittsburgh’s Brain Trauma Research Center estimates that more than 300,000 sports-related concussions occur in the U.S. every year and that the likelihood of suffering a concussion while playing a contact sport is as high as 19 percent per year of play.  The National Federation of State High School Associations estimates that about 140,000 high school athletes suffer concussions every year, although many go unreported.  The CDC reports that among the 38 million youths who participate in organized sports in the United States, concussion is the most common injury and has risen 57 percent among children (age 19 or younger).
  8. 8. LOOKING OUT FOR YOUNG ATHLETES It’s important to recognize that, for many players, it can be hard to admit they are injured and be pulled from the game. Young athletes especially may hide or downplay their symptoms because, among other reasons, they:  Don’t fully appreciate the health threats posed by concussions  Are eager to play  Don’t want to disappoint their teammates  Think they can push through it. Given the severity of the possible consequences, the American Academy of Neurology recommends that any athlete suspected of having experienced a concussion should be removed from play immediately, and the process of returning should be gradual. Far too many players feel the pressure to return prematurely instead of allowing themselves the time necessary for a full recovery.
  9. 9. CONCUSSION RISKS IN YOUTH BASKETBALL  Basketball is the country’s most popular youth sport, played by one million children each academic year. Contrary to many first impressions, it is also a contact sport. Collisions are common – ball to head, player to player, even head to floor.  About 375,000 children and teenagers are treated in hospital emergency rooms each year for basketball-related injuries, and the proportion related to head trauma is on the rise.  A report in Official Journal of the American Academy of Pediatrics determined that basketball accounted for more than nine percent of athletic concussions among 8- to 19-year-olds, placing it second among youth sports, behind only football (22 percent).  Other researchers who examined ER visits for 5- to 19-year-olds found that traumatic brain injuries associated with playing basketball, predominantly in the form of concussion, had spiked 70 percent between 1997 and 2007.
  10. 10. TODAY’S NCAA PLAYERS & HEAD INJURIES  Today’s basketball players are bigger and stronger than they used to be. For example, the number of Division I players 6 feet 9 inches or taller increased from 649 in the 2000-1 season to 681 in the 2008-9 season. This extra force and mass means physical collisions are more likely to result in injury -- specifically concussions -- because players don’t wear head protection. While no helmet is concussion-proof, wearing one can help protect athletes from serious brain injuries. The NCAA has begun treating concussions as a priority and now requires its member institutions to have a concussion- management plan outlining a return-to-play protocol for their student- athletes.
  11. 11. CONCUSSIONS AT FOOTBALL PRACTICES & GAMES  According to the NCAA Injury Surveillance Center, ten percent of all college football players sustain brain injuries, which is an average of 1,364 per year. The growing awareness that concussions can have serious long-term effects has led the NCAA Football Rules Committee to adopt harsher penalties for targeting on the field, and every school is required to have a concussion-management plan. Of course, football is a collision sport, with large bodies forcefully knocking into one another.  Football is the most popular sport in the nation for high school boys, according to the National Federation of State High School Associations, with 1.1 million boys playing. All those athletes need to practice their skills, and perhaps because practices happen more often than games, there are more opportunities to get hurt.  Whatever the reason, high school and college football players are more likely to suffer a concussion during practices than in a game (58 percent vs. 42 percent). Overall, college students had the highest rate of concussions during games, with 3.74 per 1,000 games compared to 2.01 for those in high school and 2.38 for youths. High school students had the highest rates during practices.
  12. 12. THE NFL’S REPETITIVE HEAD TRAUMA CRISIS  Recently, a settlement was finally reached in a 2013 lawsuit brought by more than 4,500 ex-professional players against the NFL claiming that it failed to protect them adequately against concussions and head injuries. The NFL agreed to pay $765 million to settle the claims, which is good news for the former players who have developed health problems linked to repeated blows to the head sustained on the football field.  The crisis has raised some concerns about the sport’s future. Though a majority of Americans polled said they expect football to be just as popular in 20 years, 50 percent said they would not want their son to play the game.
  13. 13. NFL’S CONCUSSION PROTOCOL  The NFL and the NFL Players Association have now agreed to follow guidelines designed to probe and punish teams that violate the league's game-day concussion protocol. Discipline for violations involve hefty fines and loss of draft picks. Among other rules, a player who has signs of a concussion on the field and does not require transport for more serious injury must be removed and evaluated by the Club medical team. The evaluation must include a sideline and/or locker room exam using the NFL Sideline Concussion Assessment Tool and must be entered into the player’s medical record. If a concussion is diagnosed, same-day return to practice or play is strictly prohibited.
  14. 14. SLIPS & FALLS IN THE ELDERLY  While young adults are often involved in serious car wrecks or suffer sports injuries, it’s the elderly that are prone to slips and falls. The CDC reports that falls were the primary reason that people age 65 and older visited the emergency room from 2006 to 2010, accounting for almost 82 percent of their TBI-related visits. And because concussions are often missed or misdiagnosed, it’s important to be especially alert if you know that an older adult has fallen or has a fall-related injury such as a broken hip. Older people often take anticoagulant medication to prevent blood clots, which makes them extremely vulnerable to the effects of a bump or blow to the head. Furthermore, concussions that happen to seniors usually take more time to heal.
  15. 15. LINK BETWEEN CONCUSSIONS & DEMENTIA?  Of further concern is the increased risk of dementia in those who experience a concussion at age 65 or older. Some researchers have found that there is about a 26 percent increased chance that an older adult will get dementia if they’ve fallen and had a mild concussion, as opposed to an injury elsewhere on their body, such as a broken arm or leg. As for those who suffer more than one traumatic injury to the brain, dementia risk more than doubles. However, it is not yet known whether concussions actually cause or accelerate degeneration of the brain.
  16. 16. FALL PREVENTION FOR THE ELDERLY Common sense tips for reducing fall risk include these:  Make sure your glasses are the right prescription.  Wear shoes inside as well as outside.  Get moderate exercise to help improve balance.  Don’t get up too quickly.  Remove throw-rugs in your house.  Install grab bars in your bathroom.  Keep your stairs free of clutter.
  17. 17. MULTIPLE CONCUSSIONS ARE DANGEROUS  Once someone has had a concussion, it becomes easier for them to have a second concussion. Every additional concussion that occurs will increase the chances of a future concussion, and just as age can increase recovery times, so can a history of concussions. A teenager with a fourth concussion may actually recover more slowly than a 65-year-old with a first concussion.  Furthermore, people who get repeated head injuries can have permanent brain damage if they try to resume their normal routine too quickly after a concussion. A second concussion soon after the first does not have to be very strong for its effects to be permanently disabling or even deadly.  Brain swelling that occurs when a second concussion is sustained before a previous concussion is completely healed is known as second-impact syndrome, and it can be fatal.
  18. 18. TREATMENT  If someone is still suffering from concussion-like symptoms and they continue to be active, they could make their injury even worse. This is why it’s so critical that people who experience a concussion not resume normal activities (especially sports) until they have completely recovered. Rest means avoiding general physical exertion as well as limiting activities that require thinking and mental concentration. The best treatment is to allow time for the brain to heal.