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Sports FitnessTreat all concussions seriously
By KOKO EATON © St. Petersburg Times, published August 30, 1998 At local high schools, colleges and the NFL, there are experienced trainers on the sideline who are able to evaluate an injured athlete and make an educated decision whether that athlete should return to the playing field. Unfortunately, in youth football there are no trained medical personnel on the sideline -- therefore there is no one available to evaluate a young athlete who may have sustained a concussion. There are three grades of concussions. . A Grade I is the mildest form. After the initial injury, there is no loss of consciousness. This is an important distinguishing feature of a mild versus severe concussion. The athlete may look dazed and confused, may even have some trouble walking, yet will be able to recall events after the injury (post-traumatic amnesia) and is able to recall events before the injury (retrograde amnesia). There might be a state of short-lived confusion, from five to 10 minutes. After that the athlete should be able to identify location, time and recognize the person asking the questions. The athlete's face should be evaluated for a glazed look. The athlete also should be asked about headache or dizziness. Another symptom of a head injury is irrational emotions or irritability. An athlete who exhibits any of these signs should not be allowed back on the playing field. Another way to evaluate the head-injured patient is with a series of jumping jacks. A player may return to the playing field under the observation of a certified trainer or team physician. If a trainer or team physician is not on the sideline, the player should be evaluated in the emergency room by a physician to make certain no permanent damage has occurred. With a Grade II concussion, the player may or may not have been unconscious. The player may not, however, be able to recall the events before the blow. In other words, the athlete has retrograde amnesia. The retrograde amnesia usually develops five to 10 minutes after the injury. The athlete may or may not remember the impact. The amnesia may last minutes, hours or days. The athlete is usually confused and disoriented. Players with this injury may not return to the playing field. The athlete needs to be asymptomatic for at least one week. The athlete should be examined in an emergency room and a CT scan or an MRI should be performed. A Grade III concussion is the classic "knocked out" player. The individual falls into a paralytic coma but usually recovers within minutes. This can be a life-threatening condition. Paramedics should be called and CPR may be needed if the player is not breathing. The player needs to be transported by emergency medical personnel on a backboard in case there has been a fracture to his neck. Also, coaches should have the means to remove the face mask without removing the helmet. This allows the emergency medical response team to initiate CPR without moving the head. After the brain has had the impact of its first concussion, it is easy to develop post-concussion syndrome. Once there has been initial injury to the brain, it takes less mpact to cause another, more serious, concussion. This is known as second-impact syndrome. It is because of second-impact syndrome that many professional football players have considered retirement. And because of second-impact syndrome all concussions need to be evaluated by a well-trained physician.
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ootball season is here, and unfortunately this means young, otherwise healthy, athletes going at each other at full speed, thinking that a piece of plastic reinforced with air pockets will protect their brain and neurologic function from permanent injury. Sadly, despite new helmets and greater protective gear, there are still a number of head injuries incurred from youth to the NFL.
