”Woodsy’s Trainers Page”
September 29th Entry

This week we will discuss a MAJOR injury that happens way to often to hockey players : CONCUSSIONS
 
A violent shaking or jarring action of the brain resulting in immediate or transient impairment of neurological function.
Concussions are broken up into 3 grades (MILD, MODERATE and SEVERE)
 
Grade 1 MILD  Concussion
- no loss of consciousness
- this is the concussion that is most common but most difficult to recognize
- momentary confusion - poor concentration, inability to process info or sequence tasks
- athlete reports "having their bell rung"
- symptoms usually resolve in less than 15 minutes
- remove from activity and reevaluate every 5 minutes
 
MANAGEMENT OF GRADE 1 Mild Concussion
- remove from activity
- examine immediately and then every 15 minutes
- if continued activity continues discontinue activity

Signs and symptoms of POST CONCUSSION SYNDROME would include:
- vertigo- unsteady balance
- headaches,nausea,sensitivity of light ---ANY OF THESE SIGNS WOULD DISQUALIFY ATHLETE
 
If player is symptom free for 15 minutes they may reenter ACTIVITY
IF THE PLAYER SUFFERS A SECOND MILD CONCUSSION IN THE SAME GAME OR EXPERIENCES SYMPTOMS, THEY ARE DONE FOR THE REST OF THE GAME AND MUST BE SYMPTOM FREE FOR 1 WEEK BEFORE RETURN TO ACTIVITY IS ALLOWED!
 
GRADE 2 MODERATE  Concussion
- Moderate Dizziness
- Unsteady balance or gait while walking
- Blurred vision
- TINNITUS (Ringing in the ear)
- Headache
 
- Loss of consciousness for less than 5 minutes
- Confusion but no obvious loss of consciousness
- Poor concentration
- Loss of memory
IMMEDIATELY PRECEDING EVENT - RETROGRADE AMNESIA
                   OR FOLLOWING INJURY - POST GRADE AMNESIA
 
MANAGEMENT OF GRADE 2 Concussion
- Removal from activity not allowed to return today
- May develop post concussion; this can last for weeks
- Must be reevaluated by a doctor the next day
- Must be symptom free at rest and exercise for 1 week before return to activity
  IF SYMPTOMS PERSIST PAST 1 WEEK; MUST UNDERGO A CT SCAN OR MRI
  - 2ND GRADE 2 CONCUSSION ATHLETE MUST WAIT 2 WEEKS OF BEING SYSTEM FREE BEFORE RETURN TO ACTIVITY
 
GRADE 3 SEVERE Concussion
 - Loss of consciousness for more than 5 minutes either BRIEF - seconds and PROLONGED - minutes
- Problems with legs, arms, elbows and wrists are present
- Convulsions may be present
 
MANAGEMENT OF GRADE 3  Concussion
- Definitely discontinue activity
- Through a NEUROLOGICAL EXAM
- 2 Weeks symptom free at rest, exercise or exertion
- 2 GRADE 3 CONCUSSIONS - Athlete is kept out at least 1 month
  ANY PROBLEMS WITH THE CT SCAN AND OR MRI -  ATHLETE IS DONE FOR THE SEASON
 
OBSERVED FEATURES OF CONCUSSIONS
- Vacant stare - befuddled facial expression
- Delayed verbal and motor response (slow to answer)
- Confusion (inability to focus)
- Disoriented, walking in wrong direction, unaware of time, date and place
- Slurred or incoherent speech
- Gross observation in coordination, stumbling
- Emotions are out of proportion
- Distraught, crying
- Memory deficits
- Asks the same questions over and over
- Any loss of consciousness
 
************************************SYMPTOMS OF CONCUSSION**************************************
EARLY - Headaches, dizziness or vertigo (unsteady balance), lack of awareness, nausea or vomiting
LATER - Occurring days or week later POST EVENT
- Persistent low grade headaches
- Lightheadedness
- Poor attention and concentration
- Memory problems
- Easily tired or fatigues quickly
- Anxiety or depressed
- Sleep problems
 
NO MATTER HOW OLD THE ATHLETE IS CONCUSSIONS ALWAYS NEED TO BE A CONCERN WITH ANY HIT TO THE HEAD OR FALLING AND HITTING THE HEAD OR THE HEAD HITTING A OBJECT
 
NEVER TAKE CHANCES CHECK  FOR SIGNS AND SYMPTOMS
 
IF SYMPTOMS PERSIST FOR A SECOND DAY GET CHECKED BY A DOCTOR
 
ATHLETES IF YOU EXPERIENCE ANY OF THESE SIGNS OR SYMPTOMS REPORT THEM TO COACHES, TEAM TRAINER
OR PARENTS IMMEDIATELY - DO NOT TRY TO PLAY THROUGH IT - THIS DOES NOT HELP YOU OR YOUR TEAM!!!
 
HAVE A GREAT WEEK AND REMEMBER, YOU HAVE ANY QUESTIONS, NEED ANY TIPS OR GUIDELINES
...PLEASE LET ME KNOW OR E-MAIL ME

DONNY WOODS ATC EMT LMT - DWoods@DurhamHockeyInstitute.com