Winter is Here Again, Play Safely

We're nearing the end of 2013 and I can hardly believe it.  We're all scrambling around making last minute purchases and celebration plans (or maybe it's just me).  The weather in San Diego has been particularly rainy this winter and it seems that snow has been falling by the foot instead of by the inch in many places around the country.  Winter is definitely here and holiday break is just around the corner, if it hasn't started already.

While I don't have a new topic for you this week I was flipping through the archives and thought this week would be a good time to refresh your memory on some of the topics I have posted about previously.  I can't say much to help with the rain in San Diego other than to invest in some good rain gear, but for those who love the snow I can offer some tips on how to avoid cold injuries.

Whether you're using a snow day to build a snow man or you're looking forward to some sledding fun you should always be prepared for the cold weather. School break may mean plans for a ski/snowboard trip that could be quickly ruined by frostbite or hypothermia.  I always preach prevention and this week is no different.  So take a look at a few previous posts I made regarding environmental cold injuries and don't forget to protect yourself.

Read more about Environmental Cold Injury Prevention.

Read more about different types of Environmental Cold Injuries.

Submitted by Heather L. Clemons, MS, MBA, ATC

Recognizing Bacterial Meningitis

Given recent outbreaks in California and New Jersey and Aaron Loy’s continuing recovery meningitis has been a topic on the minds of college students and their families around the country.  For those in San Diego interested in the progress of Aaron Loy a coming post will help answer some of your questions.  Our thoughts and prayers go out to Aaron and his family, hoping that he makes a speedy recovery.  For others, the questions become how do I avoid contracting meningitis?  How do I recognize someone who is suffering from the condition?  Today’s post will be an effort to help you understand 1) what meningitis is, 2) how to prevent meningitis, and 3) what to do if you believe someone has meningitis.

Meningitis is the inflammation of the coverings of the brain and spinal cord, usually the result of bacteria in the cerebrospinal fluid.  The severity of the condition and necessary treatment are dependent on the cause of meningitis.  Meningitis can result because of a bacterial infection, a viral infection, parasitic infection, fungal infection or certain cancers, drugs or head injuries (non-infectious).  Parasitic meningitis is uncommon in more developed nations.  The Centers for Disease Control (CDC) has collected a variety of resources to answer your many questions including this podcast and FAQ sheet.  For those of you who like videos, check out this one:

To read more about the signs and symptoms associated with bacterial meningitis click HERE.  The most important things to understand about bacterial meningitis include risk factors, how to prevent it and knowing when to seek treatment.  The condition can progress quickly and become catastrophic if antibiotics are not administered in a timely fashion so it is important to recognize it quickly.

• College students are most often at risk for meningitis because of the community setting (dormitories) that many of them live in.  Living in close quarters and coming into close contact with friends (who could be sick) is the easiest way to spread meningitis.
  
• The easiest way to prevent meningitis is to complete the vaccine schedule.    

• The most common signs and symptoms are sudden onset of a fever, severe headache and a stiff neck.  Others include nausea, vomiting and altered mental status.

• If you suspect someone has meningitis transport them immediately to the hospital.  Typically antibiotics will be administered once a diagnosis is confirmed.

Knowing there is a current outbreak of meningitis at two universities around the nation can be unnerving, but educating yourself and your family and minimizing your risk can help set you at ease.  I have taken the time to list more resources below for those that would like to learn more.

OTHER RESOURCES:

Meningitis:   WebMD

Understanding Meningitis:  Meningitis Foundation of America

Understanding Meningitis:  Meningitis Research Foundation

Submitted by Heather L. Clemons, MS, MBA, ATC

Influencing Concussion Reporting Behaviors in High School Athletes

“Be Honest.  Speak Up.”  This phrase is repeated throughout the concussion portion of every ASA™ Program.  Every effort is made to encourage athletes in attendance to be truthful about their concussion symptoms or those of their teammates.  Research has shown that returning to play while still suffering concussion symptoms can lead to more severe and potentially catastrophic head/brain injuries, yet there are still occasions where high school athletes return to play with lingering concussion symptoms.  The question remains, “Why?” 

A recent study in the Journal of Athletic Training attempts to better understand factors that influence concussion reporting in high school athletes.  The researchers hypothesized that improved concussion knowledge and a positive attitude are motivational factors that should increase concussion reporting.  Over a two-year period (2008 – 2010) high school athletes across six sports were asked to complete a survey (167 athletes participated) regarding their knowledge, attitudes, and beliefs about concussions.  Participants were also asked to document previous concussions and concussion-like symptoms and whether or not they reported them to a coach or medical personnel. 

Results of the study show that concussion still continue to be under-reported by student-athletes because of a lack of recognition of concussion signs and symptoms and a negative attitude toward reporting potential concussions.  Specifically, the following was noted:

• Of the 167 athletes who completed the survey 89 reported having at least one concussion or "bell ringer."  Of these 89 athletes only 15 (~17%) reported ALL signs and symptoms to a coach or medical personnel.

• These 89 athletes went on to describe 84 concussions (48% were reported for evaluation) and 584 “ bell ringers” (only 12% were reported for evaluation) demonstrating a significant gap in understanding of what a concussion is.

• In order of most to least cited, the top five reasons for not reporting concussion or concussion-like symptoms included:  1) not believing signs and symptoms were serious enough to report; 2) did not want to be removed from the game; 3) did not want to let down teammates; 4) did not want to let down coaches; and 5) not knowing event was a concussion.

• Athletes still demonstrate a gap in understanding signs and symptoms associated with potential concussions, especially those that are less common or could indicate another condition such as nausea. 

• A majority of athletes still do not believe concussion are serious.  Additionally, they feel the need to down play their symptoms and struggle with feelings of embarrassment when deciding whether or not to report a potential concussion.

For m,e this study bring two major points to light that must continue to be reinforced during concussion education for athletes, parents and coaches.  First, the term “bell ringer” must be removed from the conversation when discussing concussions.  A concussion is a concussion, period.  If an athlete is having concussion-like symptoms s/he should report it and evaluated for a potential concussion.  Coaches, parents and medical professional should not use the term “bell ringer” when talking about concussions or performing clinical evaluations.  It is obvious that the term takes away from the seriousness of a brain injury and students may continue to compete despite their symptoms.  Concussion are serious injuries and this should be emphasized with all parties.

Secondly, the study demonstrates that with increased knowledge around signs and symptoms of concussion students are more likely to realize they may be suffering from a concussion and report it.  Creating an environment where it is expected that symptoms will be reported and taken seriously will minimize the likelihood that student-athletes will downplay their symptoms due to feelings of embarrassment.  Coaches and parents can be most influential in this area and should pay extra attention to the culture they create around toughness and injuries.  It should be very clear that concussions are not injuries that can be “played through.”

Anecdotal personal reports and data collected by A4IA shows that the ASA™ is helping to increase concussion reporting among high school athletes.  Most recently two athletes at Torrey Pines High School reported concussion symptoms to their athletic trainer for evaluation a week after completing the ASA™ curriculum.  Basic analysis of pre-/post- ASA™ Program testing show that students are unaware of many of the signs and symptoms of concussion (similar to those cited in the highlighted study), but also believe you must lose consciousness to suffer a concussion.  Finally, many did not realize that exercise can cause the return of concussion symptoms and that returning to play while still suffering from a concussion can lead to prolonged concussion symptoms or even second impact syndrome (SIS).  ASA emphasizes all signs and symptoms of concussion, the seriousness of these injuries and the potentially catastrophic consequences of participating with concussion.  Following the completion of the ASA™ Program athletes demonstrate a more clear understanding of concussions based on the available post-test data.  They understand that you only lose consciousness in 10% of concussions, can describe second impact syndrome (SIS) and know the importance of a gradual return to play program.  Most of all, they know it is critical to report their symptoms and be evaluated.

It’s a small step, but an impactful one.  As the number of athletes who have completed the ASA™ training grows the gap in concussion knowledge decreases.  Ideally concussion reporting will increase and studies that currently demonstrate concussion under-reporting rates ranging from 40% – 50% will be a thing of the past.  It is important to be sure that concussions are being reported more consistently whether or not there is an athletic trainer available, parents and coaches must continue to educate themselves in concussion recognition and management too.  Be familiar with the available resources and if you have questions ask someone trained in concussion recognition and management.

Submitted by Heather L. Clemons, MS, MBA, ATC

A4IA Looks to Take ASA Program East

The ASA™ Program is familiar to many in San Diego with over 1500 athletes who have completed the program since its inception.  A4IA is looking to expand the ASA™ Program's impact by taking it to other cities around the country.  As a first step A4IA has selected Community Health Network’s Sports Medicine Program in Indianapolis, Indiana and the New Hampshire Musculoskeletal Institute (NHMI) in Manchester, New Hampshire as the locations for upcoming ASA™ programs.  A4IA would like to take time today to introduce you to the athletic trainers behind these two organizations that have been instrumental in bringing ASA™ to their area.  Meet, DeAnne Green, ATC (Community Health Network) and Laura Decoster, ATC (NHMI).  I recently had an opportunity to connect with these athletic trainers and find out why bringing ASA™ to their community was so important to them.

DEANNE GREEN 

DeAnne is a professional athletic trainer who manages Community Health Network’s Sports Medicine Program.  The program is responsible for improving sports medicine health care for athletes in the Indianapolis area.  This includes athletic training coverage for several local high schools and an Indy Car racing team.  There are also a variety of injury clinics/screenings and educational events.  Check out their website for more information!

DeAnne had the pleasure of connecting with Beth through former NATA President, Marjorie Albohm.  Once connected with Beth, the value of the ASA™ Program to Community Health Network’s Sports Medicine mission was immediately obvious.  Community Sports Medicine is already working to educate parents, coaches and athletes to improve their overall well-being and the ASA™ Program’s focus on youth sport safety is one of the key areas for Community’s Sports Medicine. 

DeAnne is most excited about how ASA™ empowers athletes to help each other in a time of need.  In most situations, teammates are often the first one to an injured athlete.  Knowing what to do can be powerful for all athletes on the field.  DeAnne says, “It has been my pleasure to work with Beth, Tommy and A4IA.  Their support of athletic trainers and youth sports safety is awe-inspiring, heart-felt and truly special.  I am proud and honored to share this program in the Indianapolis area.”

LAURA DECOSTER

Laura is a professional athletic trainer who is the Executive Director of the New Hampshire Musculoskeletal Institute (NHMI). NHMI’s largest program, the Safe Sports Network (SSN) focuses on all aspects of youth sport safety for athletes in the Greater Manchester area.  The program provides athletic trainer coverage for seven high schools in the area and runs a drop-in injury clinic in downtown Manchester.  SSN also provides concussion management for youth leagues, including baseline and follow-up cognitive testing.  NHMI also provides extensive opportunities for research and professional development for athletic trainers, physicians and other allied health professionals.  Check out SSN to find out more!

Laura became aware of A4IA when she was working on a video for the SSN and she came across Tommy’s video on YouTube when searching for examples.  Shortly thereafter she met Beth at the Youth Sports Safety Alliance Meeting in Washington, DC (February 2013).  Given NHMI’s focus on youth sport safety through the SSN, ASA™ seemed like a logical addition to what was already being offered.

Laura believes there is value in the ASA™ Program for schools that have an athletic trainer as well as those who do not.  Just like DeAnne, Laura is aware that most often, even when an athletic trainer is on the sidelines it is a teammate that will likely reach an injured athlete first.  Knowing what to do can be the difference between a full recovery and a potential catastrophe.  Empowering athletes to help themselves is the first step in expanding sports medicine coverage for all athletes.  Laura says, “When I heard about ASA, I thought it was brilliant.  I hope that every potentially catastrophic outcome that could be prevented, is prevented.”

The ASA™ Program has already had a tangible impact here in San Diego, with two ASA Ambassadors using their hands-only CPR skills to save a life.  ASA™ has also given over 1500 San Diego athletes the ability to help their teammates in an emergency.  A4IA looks forward to taking their ASA™ and their “What you know may help save someone you know” message on the road.

Submitted by Heather L. Clemons. MS, MBA, ATC

Return to Learning Guidelines Following Concussion

At the end of October the American Academy of Pediatrics (AAP) published a series of guidelines to assist in returning young people to learning following a concussion.  I published a link to the full article on the A4IA Facebook Page shortly thereafter, but I wanted to take the time to introduce the statement to you today.  As we learn more and more about concussions, how to recognize them and how to manage them the idea of cognitive rest along with physical rest has become an increasingly popular concept. 

The concept was even discussed in the guidelines published following the 4^th International Conference on Concussion in Sport held in Zurich last November.  The resulting consensus statement from this conference did not lead to specific guidelines on how to return to learning (RTL).  The AAP has since tackled that project and developed some key concepts that pediatricians, parents and school administrators, staff and teachers should be familiar with.  The intended audience is pediatricians, but I found these guidelines very helpful as an athletic trainer and believe parents and schools will think the same.

You can review the full statement, HERE.

Following my own review of the statement I have the following recommendations for parents who are dealing with a young child or adolescent who has suffered a concussion and returning to learning:

• Remember, everyone’s recovery from a concussion is different.  The rate at which symptoms start to dissipate will vary from person to person and concussion to concussion.  Be flexible and adjust your child’s rest needs based on their symptoms and not “cookbook” recommendations.

• Read the AAP’s entire statement on RTL and be sure your child’s pediatrician is familiar the statement and is willing to work with you and your child’s school to facilitate your child’s recovery and return to school.  Most students will recover within 1-3 weeks and help will only be needed for a short period of time.

• Become familiar with education jargon relative to the various types of academic adjustments that are available so you can communicate clearly with your child’s pediatrician and school (the statement can help with this).

• Become familiar with the resources available at your child’s school from both a health and academic perspective and communicate with appropriate parties as needed while your child is returning to school.  This should be a team effort.  For example, who is the school nurse, school psychologist, athletic trainer, special education contact?

• If your child suffers prolonged post-concussion syndrome it is important to consider further follow up with a neuropsychologist (or other specialist) who is familiar with pediatric concussions.

• Remember, students should be at their academic “baseline” BEFORE returning to sports.

• The statement provides additional concussion resources at the conclusion of the statement and while they were likely intended for pediatricians I believe they may be useful in answering additional questions for parents and others.

Just as returning to sport too soon after a concussion can prolong symptom, it is believed that returning to school too soon can do the same.  It is important to know that research is still being done to continue to clarify RTL guidelines, but based on what we know it appears that the same graded return process that is used for physical exertion is also a useful process when considering cognitive exertion.  In the end, as I always seem to say, be prepared and have a plan.  It’s a team effort to return a child to school and sport following a concussion and the more you know, the more the team will know.

Submitted by Heather L. Clemons, MS, MBA, ATC

ASA Program Key Component of Sportsmanship Summit

Students from Torrey Pines High School and La Costa Canyon High School participated in a sportsmanship summit on October 28^th at San Dieguito Academy.  Athletes Saving Athletes™ was part of this summit in an effort to teach students potential life-saving information and improve cooperation among the students.  The hope was to create student leaders who could reinvigorate a positive competitive spirit among the athletes and their fans.

According to published reports the summit focused on improving leadership skills and sportsmanship between athletes at the schools because of a growing number of incidents at LCC vs. TPHS events.  The most cited event was the boy’s lacrosse championship game last May and thenegative fan behaviors and post-game actions.  While students involved in the rivalry say it is typically healthy competition on the field the number of negative actions of spectators has become increasingly more common.  The rivalry has been ever present given the quality of the athletic programs at LCC and TPHS, but sportsmanship has waned in recent months.

The summit included guest speakers, often alumni of either LCC or TPHS along with the ASA™ program.  The ASA™ program presented its typical “head, heat, heart” program along with teaching Hands-Only CPR™ and how to use an AED.  The program creates student leaders, ASA Ambassadors, who are expected to go back to their teams and share what they learned.  The program also provided hands-on opportunities for students from each school to work together.  The ASA™ program was a key addition to the summit because of its ability to empower students with potential life-saving information, irrespective of team/school affiliation.   

Beth Mallon, Advocates for Injured Athletes founder and CEO was originally contacted by Kari Digiulio, Athletic Director at LLC to help “restore the relationship between the LCC and TP communities.”  Those involved thought it was important to start with the athletes themselves and the ASA™ program seemed the perfect fit, as LCC already had 70 athletes who went through the program last spring.  Additionally, the Athletic Trainers, Sam Villa (LCC) and Christina Scherr (TPHS) taught the curriculum as an example of cooperation between the communities.

Each school nominated and selected 100 athletes to attend the summit. The summit was held at a neutral location (San Dieguito Academy) in an effort to promote a sense of common ground.  Athlete safety is a concern for everyone and knowing how to recognize potentially catastrophic conditions and where to locate AEDs on campus is important for all athletes whether they are teammates or opponents. 

Beth Mallon made the following statement regarding the experience:

“We were honored to participate. We hope the program has a lasting positive impact in the lives of the athletes. We hope the athletes see each other as competitors, but also as the one who might need to step up someday and save a life. Our motto is "What you know may save someone you know".

The group of athletes was AMAZING honestly, I was extremely impressed with the students attending the program. They were polite, respectful, engaged and attentive. It was truly a very special group of young men and women. They should feel very proud they were selected by their coaches and their administration to attend the summit and represent their school.  We are proud as an organization that they represent ASA.”

Submitted by Heather L. Clemons, MS, MBA, ATC

Halloween Safety Tips

Halloween is just around the corner.  Costumes, party plans and trick-or-treating routes are all in the works. Although Halloween is not technically a sport (although I bet if I looked hard enough I could find someone who says it is) safety is still important.  When kids knock on the door and yell, “trick or treat!” we’re all assuming it’s going to be a treat, not a trick.  Just like any other event, safety should always be a first priority.  Thanks to several organizations there a tons of resources out there to help you and your family have a safe and fun Halloween.  My goal here today is to summarize some of the key points for you and link you to the major groups that have published important safety recommendations.

COSTUME RECOMMENDATIONS

• Costumes should be bright or contain reflective materials; shoes should fit well
• Avoid wearing masks as they limit visibility; use non-toxic make-up or well-fitting hats instead
• Be sure costumes parts (wigs, hats, etc.) are flame resistant
• Be sure swords, sticks, canes are soft, flexible and not sharp
• Avoid wearing colored contact lenses that are not prescription, and something you normally wear

PUMPKIN CARVING RECOMMENDATIONS

• Allow small children to draw on pumpkins and have the adult do the cutting
• Consider using flashlights or glow sticks to light pumpkins instead of candles
• Never leave lit candles unattended and be sure to place on flat, sturdy surface

PREPPING YOUR HOUSE FOR TRICK-OR-TREATERS

• Be sure your porch/doorway is well lit
• Area is clean, free of trip hazards and debris
• Keep your pets safely restrained

TRICK-OR-TREATING SAFELY

• Young children should always be accompanied by an adult
• Older children should stick to a pre-agreed upon route and return home at the agreed upon time
• Have a flashlight with fresh batteries
• Have a fully charged cell phone for communication; be sure children know how to access 9-1-1 or the local emergency number
• Go in groups and stay together
• Walk only on the sidewalks or in cross walks, carefully obey all pedestrian laws
• Children should be sure to make eye contact with any drivers before crossing the street (be sure they see you)
• Never enter a home or car for a treat

DRIVING SAFELY

• Exit and enter all driveways, alleys and cross walks slowly, some pedestrians may be difficult to see
• Pay extra attention to pedestrians on curbs and corners to be sure they are not darting into the street
• Drive with caution, particularly in residential neighborhoods
• The most popular trick-or-treating hours are between 5:30p – 9:30p, so take extra precautions during this time

This list is a combination of recommendations from the American Academy of Pediatrics, the Centers for Disease Control, and Safe Kids Worldwide.  There is also a Spanish version of the Safe Kids Worldwide tip sheet and CDC “SAFE HALLOWEEN” mnemonic.  Each list has a slightly different focus so I encourage you to take a look at them all.  As a final reminder, at the end of the night be sure to look through the candy you’ve collected to remove any choking hazards and check for tampering.  For a healthier Halloween be sure to ration candy over several days following all the trick-or-treating fun.

In the end, Halloween should be about having fun with friends, but remember prevention is the best medicine.  So… pick out your best rubber sword, flame resistant wig and well-fitting pirate boots.  Get ready to hit the town to collect your candy booty.  Just don’t forget to pack your flashlight, your cell phone, and your route plan.  Grab your captain and meet your crew to trick-or-treat the whole night through!  

HAPPY HALLOWEEN!

Submitted by Heather L. Clemons, MS, MBA, ATC

Recognizing and Referring Athletes with Psychological Concerns

Most weeks when writing this blog I usually focus on providing you information on how to recognize signs and symptoms of potentially dangerous injuries and illnesses.  I’ve also advocated for having emergency action plans in place and an athletic trainer on site at all times.  When thinking sport safety I think we can all get a little caught up in the physical injury and illness side of things, but this week is a reminder that we need to be on the lookout for signs of mental health concerns as well.

Back in September the National Athletic Trainers’ Association published an executive summary for a coming inter-association taskforce position statement titled, “Inter-Association Recommendations for Developing a Plan to Recognize and Refer Student-Athletes with Psychological Concerns at the Collegiate Level.”  The primary goal of the statement is to help colleges develop an evidence-based action plan for recognizing, referring and managing student-athletes who may be suffering from mental illness.    According to statistics published in the statement 1 in 4-5 youths meet the criteria for a mental health disorder and experience a severe level of impairment across a lifetime.  Based on a 2012 study, 45.9 million adults 18 years or older experienced mental illness during 2010.  Of those 46 million, the 18 – 25 year olds comprised 29.9% of the total group experiencing mental illness.  Mental health issues are a growing concern, but especially in the 18-25 year old age group. 

Athletic trainers are taught to recognize and refer athletes who they believe may be suffering from mental health issues, however overall care for the athlete must be a team effort.  Colleges need to have an action plan for how mental health issues will be addressed and it should involve the team physician, athletic trainer, and university and community counseling services.  If you have a child in college and playing sports do you know what the action plan is should they need care regarding a mental health issue?    Did their pre-participation physical examination questionnaire include questions about their mental health history?  Do you what types of physical conditions can predispose someone to mental health issues? 

The executive summary provided by the NATA provides some of the basic answers to the questions I have posed and the full position statement will be published for public viewing shortly.  I recommend that you take a look at the statement and do the work to become aware of the resources available to your college-aged children (whether they’re athletes or not).  It’s always better to be prepared and know what to do before mental health referral is needed than to scramble for answers once you realize there is a concern.  As always, be prepared and plan ahead for the best results.

Moving forward, based on feedback from readers I am happy to discuss/review specific mental health concerns.  To suggest a topic you would like me to blog about you can send an email to Heather Clemons or tweet me @AlfredSB10.

Submitted by Heather L. Clemons, MS, MBA, ATC

October is Sudden Cardiac Awareness Month

For many of us October is a month of two colors:  orange and pink.  Orange in all its variations seems to be the standard color for fall and the upcoming Halloween festivities.  Pink is the standard color of National Breast Cancer Awareness Month.  It’s the time of year for walks and other fundraising and awareness events; even your favorite NFL players can be seen wearing pink every Sunday.  I’d like to add another color to the October repertoire:  red.  October is also recognized as National Sudden Cardiac Arrest Awareness Month.  Organizations such as the Heart Rhythm Society are beefing up efforts to improve awareness and education around sudden cardiac arrest (SCA) and all those affected. 

Those of you who follow A4IA know that SCA is one of the primary conditions that can affect athletes, even at a young age.  The ASA™ program spends time teaching student-athletes to recognize SCA and report it accordingly.  Student-athletes are also taught how to perform hands-only CPR and used an Automated External Defibrillator (AED) to respond as directed.  The ASA™ program focuses on this condition in young athletes, but SCA can strike at any age.  Understanding the basics about SCA and having the skills to respond could save someone’s life.

KEY POINTS ABOUT SCA:

• 350,000 deaths occur annually due to SCA (more than breast cancer, lung cancer, AIDS)
• Claims a life about every 90 seconds
• Is NOT a heart attack (it is an electrical problem, not a blood flow problem)
• 95% of people who experience SCA die
• Can often occur without any warning signs (approximately in 2/3 of all cases)
• Risk factors include a low ejection fraction (EF), family history of sudden death, unexplained episodes of fainting, heart attack, abnormal heart rhythm

SCA TREATMENT:

Time is of the essence when treating SCA.  If you suspect SCA you should call 911 immediately and begin treatment.  Using an AED is the preferred treatment for SCA, if available. Treatment with an AED within 4-6 minutes of suffering SCA increases survival rates. If an AED is not available, begin CPR until emergency personnel arrives.

SCA:  CAN YOU RECOGNIZE IT?

Some of the most interesting information I found on the HRS website relates to recent research data that was collected relative to awareness of SCA in the general public and among physicians.  Some of the more interesting finding include:

• 1 in 4 people can correctly identify SCA
• 65% of people believe SCA is the same as a heart attack
• 90% of people underestimate the number of people who die from SCA
• Consumers who suffer heart-related symptoms are more likely NOT to see a physician regarding their symptoms, even if they are at risk for heart disease

SCA RESOURCES/EVENTS:

The American Heart Association has devoted a significant portion of their web resources to better understanding SCA.  Click HERE to learn more.

Eric Paredes Save A Life Foundation is sponsoring another heart screening event on October 20, 2013 at Patrick Henry High School.  To learn more or register for this event, click HERE.

Heart Rhythm Society (HRS) provides a variety of fact sheets and resources regarding SCA, atrial fibrillation and other related topics.  For more information click, HERE and check out the left-sided menu.  If you have the time I would encourage you explore even more of the website as there is a wealth of information and resources available here for consumers and physicians.

Korey Stringer Institute provides SCA recognition and treatment guidelines.  If you love to read the research you should check out KSI’s research publications database, simply scroll down to cardiac conditions.  If you’d like to learn more about AEDs click HERE.

The Sudden Cardiac Arrest Association is devoted entirely to SCA.  

Submitted by Heather L. Clemons, MS, MBA, ATC

Recent Concussion Bylines

As many of you know I like to periodically scan the news and research publications to update you on what is happening in the world of sport-related concussions.  Given the recent release of post-concussion syndrome treatment guidelines and the start of the new NFL season concussions still remain a common topic of discussion.  Below you find links to recent research studies, personal stories and injury reports relating to concussions.  This information is posted for your review and critical analysis.  I will provide a brief description of the links I have posted to give you a better starting point for what you’re about to read.

NFL CONCUSSION COUNTS:

It seems if you read the sports section of any newspaper on Monday it is littered with reports of who was diagnosed with a concussion, who returned after a concussion on who didn’t.  Ever wonder how many concussions happen in the NFL in a given week and ultimately over the season?  If so, here are some links you can follow to track that information for yourself:

The Concussion Blog

Frontline’s Concussion Watch Project

RECENT RESEARCH RESULTS:

There is always a regular stream of concussion research being published.  The topics range from understanding the forces that cause concussions, understanding diagnostic tools, recommendations on how to manage concussions and the role of equipment in concussion prevention.  As I scan the various outlets some of the more interesting research publications that have caught my attention are the following:

Guidelines for Mild Traumatic Brain Injury and Persistent Symptoms.  Published by the Ontario Neurotrauma Foundation these guidelines focus on how to manage treatment in patients that are suffering from post-concussion syndrome (PCS).  It is important to note that the recommendations are based on the broader topic of mTBI, not just sports-related concussions.  The statement does take the time to speak to sports-related concussions specifically, while also addressing a variety of common PCS symptoms such as persistent headache and mood changes (anxiety, depression).

Post-exertion neurocognitive test failure among student-athletes following concussion.  The author’s in this study show that athletes who passed a neurocognitive exam (like imPACT) at rest, often failed if the same test if performing physical exertion prior to completing the exam.  Authors advocate for post-concussion neurocognitive testing to include an exam following physical exertion as part of the return-to-play protocol.

Sport-Related Concussion:  How Many is Too Many?  Is a review article where authors review available current research in an effort to systematically answer the question, “How many is too many?”

Time Interval between Concussion and Symptom Duration.  Authors attempt to understand the impact of previous concussion history has on the duration of symptoms of additional concussions.  Authors state that children with a previous history of concussion (especially repeat concussions) are at higher risk for prolonged symptoms following a concussion.

NCAA Concussion Education in Ice Hockey:Authors systematically review the materials and methods used by the NCAA to provide concussion education to its member institution athletes (specifically in ice hockey) and found the materials and techniques did not significantly change athlete’s reporting behavior. 

OTHER INTERESTING STORIES:

Is the iOS 7 Making You Sick?  Here’s Why… I first saw this piece linked on The Knockout Project, but apparently a lot of people are having a tough time with this one, especially those with PCS or a previous history of concussions.

ER Visits, Hospital Admissions for Children with Concussion Skyrocketing.  Recent research shows a growing number of children being seen in the ER for concussions.

The NFL and Concussions:  Knowing What We Knew.  An interesting read regarding concussion management and the role sport culture (particularly as promoted by coaches) plays in under reporting and returning to play too soon.

League of Denial:  The NFL's Concussion Crisis:  The book becomes available Tuesday while the 2-part documentary starts next week.

Pink Concussions:  A resource focused on the concussion experience in girls and women.  They are currently seeking girls to participate in a research study who have a history of concussion.

This is just a smattering of the most recent information that is out there.  There is so much more.  As always I encourage you to do your own research and reading on topics that interest you.  There are a variety of digital search tools out there that can help you do your searches systematically.  If you'd like to learn more about how to do this just drop me a line and I'd be happy to help!

Submitted by Heather L. Clemons, MS, MBA, ATC