2012 concussion mgmtpossible concussion may return to us youth soccer play only aer release from a...
TRANSCRIPT
1
CONCUSSION MANAGEMENT
(Created by Don Bohnet, Region lll Risk Management Chairman)
2
Highlights
• Many of the following information come from an online education series posted by US Youth Soccer:
https://education.usyouthsoccer.org/courses/Centers-for-Disease-Control-and-Prevention/heads-up-concussion-in-sports-intro-course/
• Center for Disease Control (CDC) also has direct info available at: http://www.cdc.gov/concussion/sports/
Facts•Aconcussionisabraininjury.•Allconcussionsareserious.•Mostconcussionsoccurwithoutlossofconsciousness.•Concussionscanoccurinanysportorrecrea9onac9vity.•Recogni9onandproperresponsetoconcussionswhentheyfirstoccurcanhelppreventfurtherinjuryorevendeath.Abump,blow,orjolttotheheadcancauseaconcussion,atypeoftrauma9cbraininjury(TBI).Concussionscanalsooccurfromablowtothebodythatcausestheheadtomoverapidlybackandforth.Evena"ding,""geIngyourbellrung,"orwhatseemstobeamildbumporblowtotheheadcanbeserious.
3
RecognizingaPossibleConcussionTohelprecognizeaconcussion,youshouldwatchforandaskotherstoreportthefollowingtwothingsamongyourathletes:1.Aforcefulbump,blow,orjolttotheheadorbodythatresultsinrapidmovementofthehead.‐‐and‐‐2.Anychangeintheathlete’sbehavior,thinking,orphysicalfunc9oning.AthleteswhoexperienceoneormoreofthesignsandsymptomslistedbelowaQerabump,blow,orjolttotheheadorbodyshouldbekeptoutofplaythedayoftheinjuryandun9lahealthcareprofessional,experiencedinevalua9ngforconcussion,saystheyaresymptom‐freeandit’sOKtoreturntoplay.
SignsObservedbyCoachingStaff• Appearsdazedorstunned• Isconfusedaboutassignmentorposi9on• Forgetsaninstruc9on• Isunsureofgame,score,oropponent• Movesclumsily• Answersques9onsslowly• Losesconsciousness(evenbriefly)• Showsmood,behavior,orpersonalitychanges• Can’trecalleventspriortohitorfall
4
SymptomsReportedbyAthlete• Headacheor"pressure"inhead• Nauseaorvomi9ng• Balanceproblemsordizziness• Doubleorblurryvision• Sensi9vitytolight• Sensi9vitytonoise• Feelingsluggish,hazy,foggy,orgroggy• Concentra9onormemoryproblems• Confusion
USYouthSoccerConcussionIniAaAves• NewConcussionNo9fica9onForm• ConcussionProcedureandNo9fica9onForm
• ConcussionAwarenessintegratedintoCoachingEduca9on
• PartnershipwithAxonSportsforCogni9veBaselinetes9ng
5
ConcussionSigns,Symptoms,andManagementatTrainingandCompeAAonsStep1‐Didaconcussionoccur?Evaluatetheplayerandnoteifanyofthefollowingsignsand/orsymptomsare
present:1) Dazedlookorconfusionaboutwhathappened.2) Memorydifficul9es.3) Neckpain,headaches,nausea,vomi9ng,doublevision,blurriness,ringing
noiseorsensi9vetosounds.4) Shortaben9onspan.Can’tkeepfocused.5) Slowreac9on9me,slurredspeech,bodilymovementsarelagging,fa9gue,
andslowlyanswersques9onsorhasdifficultyansweringques9ons.6) Abnormalphysicaland/ormentalbehavior.7) Coordina9onskillsarebehind,ex:balancing,dizziness,clumsiness,reac9on
9me.
Step2‐Isemergencytreatmentneeded?
Thiswouldincludethefollowingscenarios:1) Spineorneckinjuryorpain.2) Behaviorpabernschange,unabletorecognizepeople/places,less
responsivethanusual.3) Lossofconsciousness.4) Headachesthatworsen5) Seizures6) Verydrowsy,can'tbeawakened7) Repeatedvomi9ng8) Increasingconfusionorirritability9) Weakness,numbnessinarmsandlegs
ConcussionSigns,Symptoms,andManagementatTrainingandCompeAAons
6
Step3‐Ifapossibleconcussionoccurred,butnoemergencytreatmentisneeded,whatshouldbedonenow?Focusontheseareasevery5‐10minforthenext1‐2hours,withoutreturningtoanyac9vi9es:1. Balance,movement.2. Speech.3. Memory,instruc9ons,andresponses.4. Aben9onontopics,details,confusion,abilitytoconcentrate.5. Stateofconsciousness6. Mood,behavior,andpersonality7. Headacheorpressureinhead8. Nauseaorvomi9ng9. Sensi9vitytolightandnoise
ConcussionSigns,Symptoms,andManagementatTrainingandCompeAAons
Playersshallnotre‐entercompe99on,training,orpartakeinanyac9vi9esforatleast24hours.EveniftherearenosignsorsymptomsaQer15‐20min,ac9vityshouldnotbetakenbytheplayer.
STEP4‐AplayerdiagnosedwithapossibleconcussionmayreturntoUSYouthSoccerplayonlyaQerreleasefromamedicaldoctorordoctorofosteopathyspecializinginconcussiontreatmentandmanagement.
STEP5‐Ifthereisapossibilityofaconcussion,dothefollowing:(1)TheabachedConcussionNo9fica9onFormistobefilledoutinduplicateandsignedbyateamofficialoftheplayer’steam.(2)Iftheplayerisabletodoso,havetheplayersignanddatetheForm.Iftheplayerisnotabletosign,noteontheplayer’ssignaturelineunavailable.
ConcussionSigns,Symptoms,andManagementatTrainingandCompeAAons
7
STEP5‐Con9nued(3)Ifaparent/legalguardianoftheplayerispresent,havetheparent/legalguardiansignanddatetheForm,andgivetheparent/legalguardianoneofthecopiesofthecompletedForm.Iftheparent/legalguardianisnotpresent,thentheteamofficialisresponsibleforno9fyingtheparent/legalguardianASAPbyphoneoremailandthensubmiIngtheFormtotheparent/legalguardianbyemailormail.Whentheparent/legalguardianisnotpresent,theteamofficialmustmakearecordofhowandwhentheparent/legalguardianwasno9fied.Theno9fica9onwillincludearequestfortheparent/legalguardiantoprovideconfirma9onandcomple9onoftheConcussionNo9fica9onFormwhetherinwri9ngorelectronically.
(4)Theteamofficialmustalsogettheplayeríspassfromthereferee,andabachittothecopyoftheFormretainedbytheteam.
ConcussionSigns,Symptoms,andManagementatTrainingandCompeAAons
2012 US Youth Soccer National Championship Series’
Injury & Treatment Recap (All Regional Championships
and the National Championships)
8
2012 NCS Injury & Treatment Recap Tournament USYSNC USYSNC USYSNC USYSNC USYSNC Total Count By %
# Regional/NC R I R II R III R IV NC
1 Concussion 10 22 12 6 50 16.23%
2 Joints/sprains of either knee, ankle, shoulder 1 25 17 43 13.96%
3 Contusions 18 6 7 31 10.06%
4 Muscle strains 8 3 8 9 28 9.09%
5 Fractures 6 15 5 26 8.44%
6 Lacerations of either the face, eye or body 10 7 3 3 23 7.47%
7 Knee injuries 8 8 2 18 5.84%
8 Cervical Strains 11 11 3.57%
9 Heat related 1 1 3 6 11 3.57%
10 Ankle Injuries 1 9 10 3.25%
11 Bruise 8 8 2.60%
12 Shoulder / Clavicle 1 2 5 8 2.60%
13 Forearms/Wrist 2 5 7 2.27%
14 Blister 4 4 1.30%
15 Finger 1 3 4 1.30%
16 Hip 1 2 3 0.97%
17 Anxiety 2 2 0.65%
18 Lower Back 2 2 0.65%
19 Cramp 2 2 0.65%
20 Infection 2 2 0.65%
21 Seisure/Sickness fainting 1 1 2 0.65%
22 Wrist/hand 2 2 0.65%
23 Asthma 1 1 0.32%
24 Bee Sting 1 1 0.32%
25 Bronchitis 1 1 0.32%
26 Cardiac related incident 1 1 0.32%
27 Dislocation 1 1 0.32%
28 Eye 1 1 0.32%
29 Jaw 1 1 0.32%
30 Lip 1 1 0.32%
31 Nose 1 1 0.32%
32 Rash 1 1 0.32%
33 Toe 1 1 0.32%
# Incidents 2 79 79 80 68 308 100.00%
USYouthSoccerRiskManagement
SOCCERGOALSAFETY
Anoverview
USYouthSoccerRiskManagementCommibee 2012
9
GoalPostAnchoring
Anchoring/Securing/CounterweighAngGuidelinesfromConsumerProductSafetyCommission
hbp://www.cpsc.gov/cpscpub/pubs/326.html
Aproperlyanchored/counterweightedmovablesoccergoalismuchlesslikelyto9pover.Remembertosecurethegoaltotheground(preferablyattherearofthegoal),makingsuretheanchorsareflushwiththegroundandclearlyvisible.ItisIMPERATIVEthatALLmovablesoccergoalsarealwaysanchoredproperly.Thereareseveraldifferentwaystosecureyoursoccergoal.Thenumberandtypeofanchorstobeusedwilldependonanumberoffactors,suchassoiltype,soilmoisturecontent,andtotalgoalweight.
*AugerstyleThisstyleanchoris"helical"shapedandisscrewedintotheground.Aflange
isposi9onedoverthegroundshoes(bar)andreargroundshoe(bar)tosecurethemtotheground.Aminimumoftwoauger‐styleanchors(oneoneachsideofthegoal)arerecommended.Moremayberequired,depending
onthemanufacturersspecifica9ons,theweightofthegoal,andsoilcondi9ons.
GoalPostAnchoring
10
GoalPostAnchoring*Semi‐permanent
Thisanchortypeisusuallycomprisedoftwoormorefunc9onalcomponents.Themainsupportrequiresapermanentlysecuredbasethatisburied
underground.Onetypeofsemi‐permanentanchorconnectstheundergroundbasetothesoccergoalbymeansof2tethers.Anotherdesignu9lizesaburiedanchortubewithathreadedopeningatgroundlevel.Thegoalisposi9onedovertheburiedtubeandtheboltispassedthroughthegoalgroundshoes(bar)andreargroundshoe(bar)andscrewedintothethreadedholeofthe
buriedtube.
GoalPostAnchoring*PegorStakestyle(varyinglengths)
Typicallytwotofourpegsorstakesareusedpergoal(moreforheaviergoals).Thenormallengthofapegorstakeisapproximately10inches(250mm).Careshouldbetakenwheninstallingpegsorstakes.Pegsorstakesshouldbedrivenintothegroundwithasledge‐hammerasfaraspossibleandatanangleifpossible,throughavailableholesinthegroundshoes(bar)andreargroundshoe(bar)tosecurethemtotheground.Ifthepegorstakeisnotflushwiththeground,itshouldbeclearlyvisibletopersonsplayingnearthesoccergoal.
Stakeswithlargerdiametersortexturedsurfaceshavegreaterholdingcapacity.
11
GoalPostAnchoring*J‐HookShapedStakestyle
Thisstyleisusedwhenholesarenotpre‐drilledintothegroundshoes(bars)orreargroundshoe(bar)ofthegoal.Similartothepegorstakestyle,thisanchorishammered,atanangleifpossible,directlyintotheearth.The
curved(top)por9onofthisanchorfitsoverthegoalmembertosecureittotheground.Typically,twotofourstakesofthistypearerecommended(pergoal),dependingonstakestructure,manufacturersspecifica9ons,weightofgoal,andsoilcondi9ons.Stakeswithlargerdiametersortexturedsurfaces
havegreaterholdingcapacity.
*Sandbags/CounterweightsSandbagsorothercounterweightscouldbeaneffec9vealterna9veonhardsurfaces,suchasar9ficialturf,wherethesurfacecannotbepenetratedbyaconven9onalanchor(i.e.,anindoorprac9cefacility).Thenumberofbagsorweightsneededwillvaryandmustbeadequateforthesizeandtotalweight
ofthegoalbeingsupported.
GoalPostAnchoring
12
AnchorandLabelExamplesSummary(CPSC,1995)
Semi‐permanentAnchorexamples
PegorStakeStyleAnchorexamples AugurStyleAnchor
PortableGoalSafety
Prac9ceGoalsrequireappropriatestoragewhennotinuse–ensurebasesarestoredawayfromanyfieldsandkeepbase
stakesideprotected.
13
GoalPostAnchoring
*NetPegsThesetapered,metalstakesshouldbeusedtosecureonlytheNETtotheground.NetpegsshouldNOTbeusedtoanchorthemovablesoccergoal.
GoalStorageExamples
Whengoalsarenotbeingusedalways:a)Removethenet.b)Takeappropriatestepstosecuregoalssuchas:
1)Placethegoalframesfacetofaceandsecurethemateachgoalpostwithalockandchain,2)Lockandchaintoasuitablefixedstructuresuchasapermanentfence,3)LockunusedgoalsinasecurestorageroomaQereachuse,4)Ifapplicable,fullydisassemblethegoalsforseasonalstorage,or5)Ifapplicable,foldthefaceofthegoaldownandlockittoitsbase.
GuidelinesforGoalStorageorSecuringWhenGoalisNotinUse.Themajorityoftheincidentsinves9gatedbyCPSCdidnotoccurduringasoccermatch.Mostoftheincidentsoccurredwhenthegoalswereunabended.Therefore,itisimpera9vethatallgoalsarestoredproperlywhennotbeingused.
(CPSC,1995)
14
ForMoreInformaAon:
hXp://www.cpsc.gov/CPSCPUB/PUBS/Soccer.pdf