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CONCUSSION MANAGEMENT

(Created by Don Bohnet, Region lll Risk Management Chairman)

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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.

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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

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SymptomsReportedbyAthlete• Headacheor"pressure"inhead• Nauseaorvomi9ng• Balanceproblemsordizziness• Doubleorblurryvision• Sensi9vitytolight• Sensi9vitytonoise• Feelingsluggish,hazy,foggy,orgroggy• Concentra9onormemoryproblems• Confusion

USYouthSoccerConcussionIniAaAves•  NewConcussionNo9fica9onForm•  ConcussionProcedureandNo9fica9onForm

•  ConcussionAwarenessintegratedintoCoachingEduca9on

•  PartnershipwithAxonSportsforCogni9veBaselinetes9ng

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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

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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

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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)

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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

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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

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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.

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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

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AnchorandLabelExamplesSummary(CPSC,1995)

Semi‐permanentAnchorexamples

PegorStakeStyleAnchorexamples AugurStyleAnchor

PortableGoalSafety

Prac9ceGoalsrequireappropriatestoragewhennotinuse–ensurebasesarestoredawayfromanyfieldsandkeepbase

stakesideprotected.

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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)

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ForMoreInformaAon:

hXp://www.cpsc.gov/CPSCPUB/PUBS/Soccer.pdf