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Concussion Management

Concussion or Traumatic Brain Injury (TBI)

What is a Concussion?

A concussion occurs when a blow to the head or body causes a disruption in normal brain function. An individual does not have to lose consciousness to suffer a concussion.

Causes

Anything that makes the brain bounce around and against the side of the skull can cause a concussion:

  • A blow or jolt to the head
  • Severe jarring or shaking
  • Abruptly coming to a stop

Risk Factors

Certain factors can increase your chances of developing a concussion:

  • Previous concussion or head injury
  • Contact/collusion sports, including football or boxing
  • Work environment: farming, logging, or construction
  • Traveling in a speeding vehicle
  • Alcohol consumption
  • Lack of sleep
  • Medications that cause drowsiness
  • Not wearing a helmet or safety gear when:
    • Riding a bike or motorcycle
    • Playing a contact sport like football, soccer, or hockey
    • Using skates, scooters, and skateboards
    • Catching, batting, or running bases in baseball or softball
    • Riding a horse
    • Skiing or snowboarding
  • Items, stairs causing slips or falls inside or outside of the home

What are the Signs and Symptoms Associated with a Concussion or (TBI)?


Signs

  • Vacant stare
  • Delayed verbal and/or motor responses
  • Confusion and/or inability to focus attention
  • Slurred or incoherent speech
  • Lack of coordination
  • Severe changes in emotions
  • Memory deficits or amnesia
  • Any loss of consciousness

Symptoms

  • Headache
  • Dizziness
  • Nausea or vomiting
  • Vision problems (blurred or double)
  • Hearing problems/Ringing in ears
  • "Foggy" or "slowed down" feeling
  • Drowsiness
  • Increased/Abnormal emotional responses
  • Difficulty concentrating
  • Confusion
  • Irritability
  • Sensitivity to light or noise
  • Difficulty remembering

How is a Concussion or TBI Managed?

The individual should be removed from play immediately and should not return to any activity until all signs and symptoms have been resolved. A re-injury – while still symptomatic – increases the chance of severe problems and complications, which may become life-threatening. A qualified medical provider should evaluate the individual as soon as possible.

Treatment

The goal of treatment is to allow the brain injury to heal. Treatment may include:

  • Rest: allow enough time for recovery
  • Avoid certain medicines: check with your doctor before taking medications, especially, aspirin, blood thinners, and medications that can cause drowsiness.
  • Avoid use of alcohol and illegal drugs
  • Prevent re-injury: avoid activities that might jolt or jar your head
    • Wait to return to a sports activity until your doctor has given you permission. Ask when it's safe to drive a car, ride a bike, work or play at heights, or use heavy equipment.
  • Include neuropsychological testing: check on the availability of concussion baseline screenings and post-concussion assessment tools

What is the Recovery Time for a Concussion or TBI?

Recovery from a concussion or TBI can take up to 10 days, sometimes even longer, depending on the severity. The longer the signs and symptoms are present, the more time is needed to ensure a full recovery. A qualified medical provider should be consulted before a concussed athlete returns to any activity. Under the guidance of that medical professional, the athlete can gradually be re-introduced into activities over several days before returning to sport. Any return of symptoms should trigger a follow up with the medical provider.


Wisconsin Interscholastic Athletic Association (WIAA) Return-to-Play Guidelines following a head injury

Wisconsin Interscholastic Athletic Association rules require a minimum of a five-day return-to-play progression. This progression begins when the individual is symptom free and cleared by a licensed health care professional. Each step requires a 24-hour window to ensure that the athlete is ready for the next level. If the athlete experiences a return of symptoms, activity should be stopped and his/her health care provider should be notified.

Step 1: About 15 minutes of stationary biking or jogging
Step 2: More strenuous running and sprinting in the gym or on field without equipment
Step 3: Begin non-contact drills in uniform; may resume weightlifting
Step 4: Full practice with contact
Step 5: Full game clearance


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