Podcasts about scat5

  March means two things in the world of sports medicine, not counting March Madness. The first is National Athletic Training Month. The second is Brain Injury Awareness Month. In the world of sport-related concussions, it's an ideal time to continue to bring awareness about concussions, which are a mild traumatic brain injury. I thought for this year, I'd try to go through the SCAT, or the Sport Concussion Assessment Tool and talk about what we know from an evidence-based standpoint how each of the components function. Today we are going to tackle the Maddocks questions. It's time to buckle up as we dive into the SCAT.    Connect with The Host! Subscribe to This Podcast Now!       The ultimate success for every podcaster – is FEEDBACK! Be sure to take just a few minutes to tell the hosts of this podcast what YOU think over at Apple Podcasts! It takes only a few minutes but helps the hosts of this program pave the way to future greatness! Not an Apple Podcasts user? No problem! Be sure to check out any of the other many growing podcast directories online to find this and many other podcasts via The Podcaster Matrix!     Housekeeping -- Get the whole story about Dr. Mark and his launch into this program, by listing to his "101" episode that'll get you educated, caught up and in tune with the Doctor that's in the podcast house! Listen Now! -- Interested in being a Guest on The Pediatric Sports Medicine Podcast? Connect with Mark today!   Links from this Episode: -- Dr. Mark Halstead: On the Web -- On X   -- Maddocks DL, Dicker GD, Saling MM. The assessment of orientation following concussion in athletes. Clin J Sport Med. 1995;5(1):32-5. doi: 10.1097/00042752-199501000-00006. PMID: 7614078. https://pubmed.ncbi.nlm.nih.gov/7614078/ -- Perry Maddocks Trollope Lawyers https://www.pmtl.com.au/ -- Hohmann E, Bloomfield P, Dvorak J, Echemendia R, Frank RM, Ganda J, Gordon L, Holtzhausen L, Kourie A, Mampane J, Makdissi M, Patricios J, Pieroth E, Putukian M, Janse van Rensburg DC, Viviers P, Williams V, de Wilde J. On-Field and Pitch-Side (Sideline) Assessment of Sports Concussion in Collision Sports: An Expert Consensus Statement Using the Modified Delphi Technique. Arthroscopy. 2024 Feb;40(2):449-459.e4. doi: 10.1016/j.arthro.2023.06.026. Epub 2023 Jun 28. PMID: 37391103. https://pubmed.ncbi.nlm.nih.gov/37391103/ -- Iverson GL, Gaudet CE, Kissinger-Knox A, Gardner AJ. Examining Whether Loss of Consciousness Is Associated With Worse Performance on the SCAT5 and Slower Clinical Recovery After Concussion in Professional Athletes. J Neurotrauma. 2023 Nov;40(21-22):2330-2340. doi: 10.1089/neu.2022.0043. Epub 2023 Feb 8. PMID: 36541353. https://pubmed.ncbi.nlm.nih.gov/36541353/ -- Gardner AJ, Wojtowicz M, Terry DP, Levi CR, Zafonte R, Iverson GL. Video and clinical screening of national rugby league players suspected of sustaining concussion. Brain Inj. 2017;31(13-14):1918-1924. doi: 10.1080/02699052.2017.1358399. Epub 2017 Sep 5. PMID: 28872354. https://pubmed.ncbi.nlm.nih.gov/28872354/ -- Iverson GL, Van Patten R, Gardner AJ. Examining Whether Onfield Motor Incoordination Is Associated With Worse Performance on the SCAT5 and Slower Clinical Recovery Following Concussion. Front Neurol. 2021 Mar 1;11:620872. doi: 10.3389/fneur.2020.620872. PMID: 33732202; PMCID: PMC7956999. https://pubmed.ncbi.nlm.nih.gov/33732202/   Calls to the Audience Inside this Episode: -- Be sure to interact with the host, send detailed feedback via our customized form and connect via ALL of our social media platforms! Do that over here now! -- Interested in being a guest inside The Pediatric Sports Medicine Podcast with Dr. Mark? Tell us now! -- Ready to share your business, organization or efforts message with Dr. Mark's focused audience? Let's have a chat! -- Do you have feedback you'd like to share with Dr. Mark from this episode?

BJSM's Dr. Liam West talks to internationally renowned Sports Neuropsychologist Dr. Ruben Echemendia about the new concussion assessment tool - the SCAT6 and SCOAT6. They discuss areas that were highlighted as requiring improvement from the implementation of the SCAT5, how these were addressed and how best to use the SCAT6. The differences between the SCAT6 and SCOAT6 are discussed as well as top tips for those looking to diagnose and manage concussions. SCAT6 Paper: https://bjsm.bmj.com/content/57/11/722

В тестовом 28 выпуске подкаста Hardtalk анестезиолог-реаниматолог Сергей Симбирцев в одиночестве рассказывает про гаджеты, перфекционизм и сотрясение мозга. 01:24 три чпока: темы выпуска 01:56 про спортивные браслеты и активность 05:31 про перфекционизм в спорте 08:25 про отбитый мозг 08:50 про протокол SCAT5 Яндекс.Музыка https://music.yandex.ru/album/10955666 YouTube https://www.youtube.com/channel/UCvsLdAoHfJU2MkR6Qbqx5Gg VK https://vk.com/hardcorerunning Apple Podcasts https://podcasts.apple.com/ru/podcast/hardtalk/id1509066889 Почта: hardtalkpodcast@yandex.ru

To help prepare you for your PM&R Board Exams, we're bringing you a podcast series dedicated to current practices and core knowledge. Main Learning Objectives: • Review definition of mild TBI • Be able to list common signs and symptoms that may accompany mild TBI • Understand when to use SCAT5 vs ACE • Recap return to play guidelines • Understand significance of Second Impact Syndrome Credits: This episode was written and recorded by: Jospeh Tessler, MD & Kari Rezac, DO This episode was reviewed for accuracy by: Rebecca Dutton, MD & Lawrence Horn, MD This podcast series is directed by: Margaret Beckwith, MD & Benjamin Gill, DO, MBA Please send feedback to aapdigitaloutreach@gmail.com so we can best suit your learning needs!

In this episode we review concussion, a large and nuanced topic. There are 200,000 concussions annually in Canada, making concussion knowledge required for coverage of all sports.To gain an understanding of sport related concussions refer to the consensus statement on concussion in sport (the 5th international conference on concussion in sport held in Berlin, October 2016)It is helpful to think of concussion management in 3 phases: acute, subacute and chronicIn the acute phase, a sideline evaluation must include screening for red flags. Review the CT Head Rules, C-Spine Rules and SCAT5 including what these tools assess, when to use them, and their common limitations. Always remember, when in doubt, sit them out!In the subacute phase, listen to your patient. Ask them about their most bothersome symptoms, track their progress and evaluate their symptom evolution with consistent criteria (ex. vestibular ocular motor screening assessment, neck exam, neurological exam, symptom questionnaires). Encourage early return to movement, emphasizing sub symptom threshold aerobic exercise as a safe and effective treatment for sport related concussions.Education and counselling are paramount for a good prognosis. Provide return to learn and return to play protocols with handouts. For example:1.     http://www.fowlerkennedy.com/patient-resources/sport-concussion/2.     SCHOOLFirst: Enabling successful return-to-school for Canadian youth following a concussion3.     https://www.parachutecanada.org/en/professional-resource/concussion-collection/canadian-guideline-on-concussion-in-sport/10% of concussion patients will have persistent symptoms. It is important to fully understand the patient’s entire medical journey - track the their progression from the initial event to the current assessment. Ensure a multidisciplinary team is involved, if not already (PT/OT/VOR PT/SLP/Neuro-optometry/Psychology). And remember, counselling is essential! Concussion can have a large impact on a patient’s mental health and wellness. Ask about the patient’s social support network. Assess underlying mood or anxiety disorders that may have worsened from baseline since the concussion. If needed, consider pharmacotherapy or refer to a therapist or psychiatrist.Additional Resources:https://cjsmblog.com/category/concussion-in-sport/https://www.reframehealthlab.com/concussion-management/https://abinetwork.ca/individuals-families/concussions/concussion-resources/http://concussionsontario.orghttp://obia.ca/concussion-resources/

Concussion is a confusing, somewhat misunderstood diagnosis that impacts many individuals every day. We have an in-depth conversation about Concussion, to discuss what it is, what happens to individuals who have one and what kinds of things help to cure concussion. One intervention that can really make a difference for those who suffer concussion is Vision Therapy, and the growing field of Behavioural Optometry. We discuss how athletes who play sports with high risk of concussion can be assessed by a Behavioural Optometrist to see how well their visual systems and movement systems are coordinated, before an injury happens. This may indicate concussion suseptibility and may help to decrease the impact of a concussion on this individual. BIO: Dr. Meuller is an Optometrist in Vision Development and Rehabilitation. She is the founder of NeuroVision Clinic, which uses neuro-optometric assessment, optometric vision therapy, and NeuroDevelopmental Movement. She is a Fellow with the College of Optometrists in Vision Development and Board Certified in Rehabilitative Optometric Vision Therapy. She is a Clinical Associate with the Optometric Extension Program Foundation, Neuro Optometric Rehab Association, and a member of Vision Therapy Canada. Dr. Mueller completed her Doctor of Optometry with Honours from the University of Waterloo in 2001. In 1997 she graduated from the University of Western Ontario with an Honours Bachelor of Science, double major in Physiology and Psychology, with Distinction. Throughout her university career she was involved in vision research.Discover Dr. Mueller online:Neurovisiontherapy.comFacebook: NeuroVision TherapyInstagram: @neurovisiontherapyDiscover more about Concussions and Screening Concussions here: cattonline.comDiscover Small Conversations on Social MediaInstagramFacebookTwitterFind Susannah Steers at www.movingspirit.ca and on social media @themovingspirit.Find Gillian McCormick at https://physiogillian.com/ and on social media @physiogillian

This podcast presents, Dr. Ron Tarrel, a Neurologist with Noran Neurological Clinic, who talks about brain injuries, specifically concussions, including symptoms and when follow-up is needed. Enjoy the podcast! Objectives:     Upon completion of this podcast, participants should be able to: Identify and discuss the types of concussive injury. Explain the basic pathology of brain injury. Diagnose concussion based on history and examination findings. Determine appropriate evaluation and treatment recommendations and safe return to sport/daily living activities, etc. CME credit is only offered to Ridgeview Providers & Allied Health Staff for this podcast activity. Complete and submit the online evaluation form, after viewing the activity.  Upon successful completion of the evaluation, you will be e-mailed a certificate of completion within approximately 2 weeks.  You may contact the accredited provider with questions regarding this program at  rmccredentialing@ridgeviewmedical.org. Click on the following link for your CME credit: CME Evaluation: "If I Only Had A Brain: TBI/Concussions" (**If you are listening to the podcasts through iTunes on your laptop or desktop, it is not possible to link directly with the CME Evaluation for unclear reasons. We are trying to remedy this. You can, however, link to the survey through the Podcasts app on your Apple and other smart devices, as well as through Spotify, Stitcher and other podcast directory apps and on your computer browser at these websites. We apologize for the inconvenience.)  DISCLOSURE ANNOUNCEMENT  The information provided through this and all Ridgeview podcasts as well as any and all accompanying files, images, videos and documents is/are for CME/CE and other institutional learning and communication purposes only and is/are not meant to substitute for the independent medical judgment of a physician, healthcare provider or other healthcare personnel relative to diagnostic and treatment options of a specific patient's medical condition; and are property/rights of Ridgeview Medical Center & Clinics.  Any re-reproduction of any of the materials presented would be infringement of copyright laws.  It is Ridgeview's intent that any potential conflict should be identified openly so that the listeners may form their own judgments about the presentation with the full disclosure of the facts. It is not assumed any potential conflicts will have an adverse impact on these presentations. It remains for the audience to determine whether the speaker’s outside interest may reflect a possible bias, either the exposition or the conclusions presented. Ridgeview's CME planning committee members and presenter(s) have disclosed they have no significant financial relationship with a pharmaceutical company and have disclosed that no conflict of interest exists with the presentation/educational event. SHOW NOTES: CHAPTER 1:  Mechanisms, Pathophysiology, and Testing.When we define concussion or brain injury, it's not only about the physical damage, but interruption of the physiologic process of the brain. Unfortunately, there is not a nice, neat set of symptoms and the phrase traumatic brain injury seems to be a catchall phrase.  Different mechanisms will affect our brains differently, but not uniformly. Whiplash can cause myofascial tissue damage in the cervical spine, affecting proprioception and balance. There are blunt trauma mechanisms causing fractures and or penetrating injuries to the brain. In addition to high energy explosions, causing thermal injury as well as particulate projectile injuries; and there are shearing injuries. Briefly the different types of mechanisms/forces that lead to injury were discussed, including a deeper dive into ballistic, penetrating blunt force, blast/explosive wave, energy/thermal and shear injuries. Additionally, Dr. Tarrel discusses items that occur on the cellular level, however per TBI outline provides a more comprehensive list of metabolic dysregulation - such as: CPP, metabolic dysfunction, inflammation, apoptosis, axonal injury. There is a variety of cognitive tests mentioned in this podcast, including the Slums exam, the mini mental status, sac, and the Skat 5 tests. Many are used in the field for assessment and represent a quick look at a singular moment in time. These tests help diagnose injury, but have limitations in terms of prognosis. The same can be said for impact testing for kids. These tests can provide a good baseline prior to an injury which helps in future diagnosis, but does not predict risk for injury. Is there utility for lab workup in this patient population? Currently, the community is investigating Tau proteins, which are a brain derived neurotrophic factor. These trophic proteins have to do with inflammation and breakdown of normal homeostatic tissue. It has not been determined what is actually happening when a Tau protein is released. This continues to be an ongoing area of research. CHAPTER 2:  Symptoms...so let's say we have this patient... Symptoms we are looking to investigate would be penetrating injury, skull fracture, loss of neurologic function, weakness, etc. Does the patient exhibit ataxia or disequilibrium? Are symptoms progressing? What is the level of awareness or consciousness? Signs of increased ICP or focal deficits. This patient would require an initial head CT and possibly an MRI. When is discharge appropriate for these patients? Sometimes patients aren't able to give you specific information to look for the problem. Their complaints are generalized, and vague. You have to pay attention to these symptoms, but you might have to wait for the dust to settle and patient remains asymptomatic continue to observe for signs and symptoms. Patients that have a loss of awareness or even vague changes should have a follow-up visit. Upon return if they are symptom free and have a negative neuro exam, further imaging would not be necessary. However, if there are symptoms, even some that seem vague like an imbalance, or "just not feeling right". Then further work up would be beneficial. A key takeaway here is that vague symptoms can challenge clinicians, but it's important to take these patients at face value. Does follow up have to be with a neurologist? There are many neurologists that do not treat concussions. Head injuries have been a mainstay of the neurosurgery field, but also orthopedists are often sideline physicians that can specialize in concussions and would be appropriate for follow up. CHAPTER 3:  Societal Pressure and Treatments. There's a certain pressure to clear concussions early and allow individuals to resume their regular activities. However, concussion protocols call for a gradual return to activity post event. Returning too fast and trying to force the brain to work only promotes "misfires" in the brain. Treatment starts with reduced activities; low light stimulus, decreased physical activity, and limited, if any, screen time. Then, slowly, activities can be reintroduced, one at a time like steps on a ladder. If the patient tolerates the dark room, turn on the tv and watch nonsense. If that goes well, eat dinner with family, walk around the block. Slowly add in activities. If symptoms return, the patient takes a step back down the ladder, returning to the previous activity they were able to tolerate. The length of this process all depends on the individual, their symptoms, and their personal rate of recovery. Other important aspects of recovery include a normal sleep wake cycle and adequate pain control. In a normal sleep wake cycle with adequate sleep, CSF is turned over twice as fast as nonopioid treatment. Opioids are good pain relievers, but also serve as a mood and energy suppressants. They are good medications when used appropriately. Non-opioid medications include, Tylenol, aspirin, if bleeding risk is low, and gabapentin. Gabapentin has been found to be a good baseline medication for TBI patients. There is a mental health component to traumatic brain injuries. Those with underlying depression are more likely to develop severe symptoms post a TBI event. Additional TBI Information Traumatic Brain Injury: Brain Dysfunction resulting from some external force  Prevalence/Incidence:      - Incidence rates of 1/6 to 3.8 million in sports in the US annually. Causes:--As you might imagine, there is a lot of physics and chemistry behind our understanding of concussion and the forces that lead to head injury. - BALLISTIC:  Ballistic injury generally refers to projectiles and their flight. Factors that influence the severity of ballistic injury include force speed and the direction of impact. - PENTRATING INJURY:  Penetrating injury is just that. An injury that pierces and enters the skull directly causing direct tissue destruction along with the penetrating forces. - BLUNT FORCE INJURY: Blunt force injury is also direct physical force to the skull/head but without penetration Impact of any kind not only triggers direct forces on the brain tissue itself, but there are complex cellular and molecular processes that lead to further dysfunction, neuronal dysfunction and cell death. There are multiple factors that contribute to this severity of injury that go beyond the initial impact. The generally accepted formula for concussion is that it takes 90-100G's; the force of a object accelerating with gravity to cause brain/axonal injury. That can be equated to hitting a wall at approximately 20 miles/per hour. However, that does not determine the severity of injury of which multiple other factors play into. 1. Is "whiplash" a common culprit in concussion? Yes, to the idea that whiplash can cause concussive like symptoms. 100's and 100's of patients who suffered mechanical whiplash injuries who developed other changes including cognitive changes that would not necessarily relate to simple cervical spinal or spinal muscular injury. That is where the notion of shearing injury comes in and I will come back to that in a moment but I can also tell you that it works both ways. Patients with myofascial injury often develop a sense of dizziness or imbalance or vertigo. You can often tell the difference between true vestibular dysfunction, vertigo, and the feeling of dysequilibrium (some people use words like rafting or floating, etc.) or the sense of uncontrollable movement within their environment. There is a myofascial syndrome in which the normal resting length of muscles is affected related directly to, for instance, the neck injury. We have proprioceptive information from our spinal column to our brain which, based on normal resting length of muscle and muscle tension, provides information to our brain telling us when we are safe and stable within our environment. With soft tissue injury, specifically myofascial injury, injury to the muscle tissue and the fascial tissues which surround muscles individually and in groups, the resting length of muscle and fascial tension can change related to microscopic tearing or shearing of muscle fibers, inflammation and the body's own protective response which is for muscles to splint or spasm, or tighten up around an area of injury. This then leads to different proprioceptive information registered by the brain and one can get the feeling that he/she are off balance, floating, rafting, whatever because the normal resting length of our muscles in various positions has been altered in response to the injury and based on that, your brain believes your neck is in a position that is not. And the individual feels "off" in whatever way. That same kind of shearing injury that we discussed affecting the spinal column, muscular and myofascial tissues also affects the brain and specifically the white matter or nerve tracts of the brain. Neurons have 2 specific components to them in regards to the delivery of information. First there are the dendrites which are nerve tracts that bring electrical signals to the nerve cell body and then long tails known as axons that take information away from the cell body, all in the white matter of our brain, not the thinking controlling cortical gray matter. These axons and dendrites live in a sort of ground substance in the brain and when forces are exerted on the brain tissue itself, just like the muscles and connective tissues around the spine, you can have a shearing injury that causes stretch and tearing to those tissues. This will necessarily affect normal transmission of electrical information from our cortex down to the spinal cord and information coming in from the body to the brain. So in other words, our thoughts and our commands coming out of our brain as well as how we register information coming into our brain is distorted because there is literally derailing of the information traveling in either direction. Obviously, how our brain interprets our world around us, our position in it, and how our brain organizes thoughts and responses to information can all be affected. This is believed the level of injury that causes some of the more subtle yet more confusing and difficult-to-treat symptoms that occur with a complex head injury. - DESTRUCTIVE WAVEFORCE Blast/Explosive wave,   energy/thermal,    There are different mechanisms of blast injury created by the release of energy that can involve a wave of energy or heat and sometimes objects. One type of explosive device releases a "blast wave" causing the sudden release of expanding force emitting a pressurized energy impulse traveling out in all directions from the explosive center. These types of bombs affect air and fluid filled tissues especially, causing these tissues to burse (like a balloon filling up too fast). Thermal blasts will dramatically overheat objects in its wake (living and not). Finally, bombs can contain particles (e.g. shrapnel or nails, etc.) that can cause penetrating injury throughout a large circumferential area. PHYSIOLOGY - Cellular and molecular changes - Vascular autoregulation - CPP - Metabolic dysfunction - Inflammation - Apoptosis - Axonal injury The pathophysiologic changes introduced by traumatic forces into a living organ, specifically the brain, then cause secondary changes in the autoregulatory mechanisms in the brain that support maintenance of blood flow, intracranial pressure, perfusion pressure, oxygenation and energy availability and utilization. Brain injury triggers a cascade of cellular processes and disruption of that homeostasis, which leads to neural dysfunction and death and are the secondary forms of injury after trauma. Our brains thrive on a very exacting and delicate balance of energy and information going in and energy and information going out And if you introduce anything that alters that balance, it will lead to further brain dysfunction. SYMPTOMS - Thought/memory/concentration/reasoning - Psychological changes - Perceptual disturbance - Alteration of sleep/wake cycles - Headache - Proprioception - Sensory disturbances - Nausea/vomiting - Environmental sensitivities PHYSICAL EXAM/DIAGNOSTIC TESTING - Diagnostic Imaging - CT or MRI initial image modality of choice - Laboratory Testing - Theoretical biomarkers but nothing that has been borne out. - Cognitive Testing 1. Standardized evaluation tools such as the SAC, SCAT5, Westmead, ImPACT for concussion may have limited validity, especially if there is no baseline test. Thorough Neurologic Examination Although generally there are no hard findings. TREATMENT/MANAGEMENT - Activity Restrictions - Medications - Functional Retraining - Conditioning/Endurance PROGNOSIS - Return to ADL's - Return to work - Return to sport 1. This is a BIG one. According to a paper in Pediatrics 2015 by Thomas et al, there was no added benefit in strict rest after concussion. This was a small study. Are there other papers or ongoing research to support prolonged rest? 2. In the McCrory P. et al. Consensus statement on concussion in sport—the 5th international conference on concussion in sport held in Berlin, October 2016. Br J Sports Med. 2017; 51 : 838-847 advocates for a 6 step progressive re-introduction with 24 hours in between RISKS OF RECURRENCE - Recurrent injuries = cumulative and more permanent TREATMENT - Pain management, sleep, psych, light exercise, etc. SEQUELA - Parkinsonism - Dementia - Seizure - CTE PREVENTION - STATE HIGH SCHOOL SPORT ASSOCIATIONS - NCAA - NFL/CFL - FIFA - ABA/WBA - UFC REFERENCES 1) Centers for Disease Control and Prevention Guideline on the Diagnosis and Management of Mild Traumatic Brain Injury Among Children JAMA Pediatr. 2018 November 01 2)Blast-Related Traumatic Brain Injury: Current Concepts and Research Considerations Daniel W Bryden, Jessica I Tilghman, and Sidney R Hinds, II 3) A Review of the Molecular Mechanisms of Traumatic Brain Injury Asma Akbar Ladak, Syed Ather Enam, Muhammad Talal Ibrahim 4) Management of acute moderate and severe traumatic brain injury UpToDate 5) Concussion Diagnosis and Management Best Practices NCAA Sport Science Institute 6) NFLPA Concussion Game Day Checklist Return-To-Participation Protocol 7) Traumatic Brain Injury Information Page National Institute of Health 8) Management of Concussion and Mild Traumatic Brain Injury: A Synthesis of Practice Guidelines Archives of Physical Medicine and Rehabilitation 9) Prevalence and Epidemiology of Combat Blast Injuries from the Military Cohort 2001 - 2014 NCBI Bookshelf 10) Pathophysiology of Traumatic Brain Injury Physiopedia Thanks for listening.

Dette er tredje episode fra Dansk Selskab for Sportsfysioterapi omhandlende den nye opdatering af det faglige katalog for hjernerystelse i sport.I dagens episode har vi talt med fysioterapeut og kandidat i fysioterapi Lisbeth Lund Pedersen. Lisbeth er forfatter på opdateringen og sidder i bestyrelsen i DSSF. Det faglige katalogDIFs side om hjernerystelse Hjernerystelsesgenkenderen SCAT5 på engelsk SCAT5 på dansk Centers for Disease Control and Prevention Guideline on the Diagnosis and Management of Mild Traumatic Brain Injury Among Children Reducing musculoskeletal injury and concussion risk in schoolboy rugby players with a pre-activity movement control exercise programme: a cluster randomised controlled trialEfficacy of a movement control injury prevention programme in adult men's community rugby union: a cluster randomised controlled trial.

Show Notes Dr. Susan Kirelik, a concussion specialist and emergency medicine physician, discusses the key points of concussion diagnosis and management from the perspective of the emergency medicine clinician. The topics covered include: The signs and symptoms of concussion and how it is diagnosed in the ED The initial evaluation of a patient presenting with a head injury, including tools for determining when neuroimaging is indicated Screening tools for the evaluation of patients with suspected concussion, such as the VOMS examination and the SCAT5 and Child SCAT5 tools Management of patients in the ED after making a concussion diagnosis and the role of rest, antiemetics, and acute pain management for these patients The importance of aftercare instructions when discharging concussed patients, in the context of new guidelines for concussion recovery The risk factors for prolonged recovery from concussion and resources for concussion recovery Patients seeking concussion clearance in the ED Addressing patient or parent questions about the long-term complications of concussion, such as second impact syndrome, the potential for cumulative effects of multiple concussions, and risk for CTE (chronic traumatic encephalopathy) Susan B. Kirelik is the Medical Director of the Rocky Mountain Pediatric OrthoONE Center for Concussion and is an attending pediatric emergency medicine physician at the Rocky Mountain Hospital for Children in Denver, Colorado. Read the article: Concussion in the Emergency Department: A Review of Current Guidelines - Trauma EXTRA Supplement (Trauma CME) References McCrory P, Meeuwisse W, Dvorak J, et al. Consensus statement on concussion in sport-the 5(th) international conference on concussion in sport held in Berlin, October 2016. Br J Sports Med. 2017;51(11):838- 847. (Consensus statement) Meeuwisse WH, Schneider KJ, Dvorak J, et al. The Berlin 2016 process: a summary of methodology for the 5th International Consensus Conference on Concussion in Sport. Br J Sports Med. 2017;51(11):873-876. (Conference summary) Kuppermann N, Holmes JF, Dayan PS, et al. Identification of children at very low risk of clinically-important brain injuries after head trauma: a prospective cohort study. Lancet. 2009;374(9696):1160-1170. (Prospective cohort study; 42,412 patients) Stiell IG, Wells GA, Vandemheen K, et al. The Canadian CT Head Rule for patients with minor head injury. Lancet. 2001;357(9266):1391-1396. (Prospective cohort study; 3121 patients) Mucha A, Collins MW, Elbin RJ, et al. A brief vestibular/ocular motor screening (VOMS) assessment to evaluate concussions: preliminary findings. Am J Sports Med. 2014;42(10):2479-2486. (Cross-sectional study; 64 patients) Links to tools and publications mentioned in the podcast: PECARN Pediatric Head Trauma: Official Visual Decision Aid for Clinicians Vestibular/Ocular-Motor Screening (VOMS) for Concussion SCAT5 tool Child SCAT5 tool REAP concussion management (NOTE: this is the new URL for “center4concussion.com,” which is mentioned in the podcast) Tip sheets for educators, parents, and healthcare providers on managing concussion recovery in the classroom

Show Notes Dr. Susan Kirelik, a concussion specialist and emergency medicine physician, discusses the key points of concussion diagnosis and management from the perspective of the emergency medicine clinician. The topics covered include: The signs and symptoms of concussion and how it is diagnosed in the ED The initial evaluation of a patient presenting with a head injury, including tools for determining when neuroimaging is indicated Screening tools for the evaluation of patients with suspected concussion, such as the VOMS examination and the SCAT5 and Child SCAT5 tools Management of patients in the ED after making a concussion diagnosis and the role of rest, antiemetics, and acute pain management for these patients The importance of aftercare instructions when discharging concussed patients, in the context of new guidelines for concussion recovery The risk factors for prolonged recovery from concussion and resources for concussion recovery Patients seeking concussion clearance in the ED Addressing patient or parent questions about the long-term complications of concussion, such as second impact syndrome, the potential for cumulative effects of multiple concussions, and risk for CTE (chronic traumatic encephalopathy) Susan B. Kirelik is the Medical Director of the Rocky Mountain Pediatric OrthoONE Center for Concussion and is an attending pediatric emergency medicine physician at the Rocky Mountain Hospital for Children in Denver, Colorado. Read the article: Concussion in the Emergency Department: A Review of Current Guidelines - Trauma EXTRA Supplement (Trauma CME) References McCrory P, Meeuwisse W, Dvorak J, et al. Consensus statement on concussion in sport-the 5(th) international conference on concussion in sport held in Berlin, October 2016. Br J Sports Med. 2017;51(11):838- 847. (Consensus statement) Meeuwisse WH, Schneider KJ, Dvorak J, et al. The Berlin 2016 process: a summary of methodology for the 5th International Consensus Conference on Concussion in Sport. Br J Sports Med. 2017;51(11):873-876. (Conference summary) Kuppermann N, Holmes JF, Dayan PS, et al. Identification of children at very low risk of clinically-important brain injuries after head trauma: a prospective cohort study. Lancet. 2009;374(9696):1160-1170. (Prospective cohort study; 42,412 patients) Stiell IG, Wells GA, Vandemheen K, et al. The Canadian CT Head Rule for patients with minor head injury. Lancet. 2001;357(9266):1391-1396. (Prospective cohort study; 3121 patients) Mucha A, Collins MW, Elbin RJ, et al. A brief vestibular/ocular motor screening (VOMS) assessment to evaluate concussions: preliminary findings. Am J Sports Med. 2014;42(10):2479-2486. (Cross-sectional study; 64 patients) Links to tools and publications mentioned in the podcast: PECARN Pediatric Head Trauma: Official Visual Decision Aid for Clinicians Vestibular/Ocular-Motor Screening (VOMS) for Concussion SCAT5 tool Child SCAT5 tool REAP concussion management (NOTE: this is the new URL for “center4concussion.com,” which is mentioned in the podcast) Tip sheets for educators, parents, and healthcare providers on managing concussion recovery in the classroom

Today, September 26, 2018, is the FIRST EVER Rowan’s Law Day in Ontario. It’s a day to remind us that concussions are important, and together we need to continue to raise awareness and education to improve the management of these injuries. It is also National Coaches Week in Canada. We’re saying #ThanksCoach by offering our coach and trainer concussion sideline course for FREE. Check out the details below. During Episode 22, we answered questions submitted by viewers: 1. If someone has increased symptoms and is positive with every VOMS test, would you give them rehab for every aspect? 2. Is there a ‘gold standard’ graded exercise test? 3. How is the child SCAT5 used? Access our coach and trainer coach for FREE until Oct. 2, 2018. Use the link below and the code: thankscoach2018 https://courses.completeconcussions.com/concussion-sideline-course-coaches-trainers-school-teachers/ For previous podcast episodes, visit: http://bit.ly/concussionpodcast CONCUSSION EDUCATION PROGRAMS: Healthcare Practitioners: http://bit.ly/joinCCMI Coaches/Trainers/Teachers: http://bit.ly/concussionprograms http://completeconcussions.com https://www.instagram.com/completeconcussions https://www.facebook.com/completeconcussions https://twitter.com/ccmconcussions

How do we make the diagnosis? What now?   Concussion in Sport Group Guidelines Concussion Recognition Tool (for coaches, trainers on field) Child Sports Concussion Assessment Tool, 5th Ed. (Child SCAT); Ages 5-12 Sports Concussion Assessment Tool, 5th Ed. (SCAT5); Ages 13 and Up This post and podcast are dedicated to the great K Kay Moody, DO, MPH for her stalwart effort to care for both patient and doctor. Thank you for all that you do to help us to be our best and for promoting #FOAMed #FOAMped and #MedEd. References Churchill NW et al. The first week after concussion: Blood flow, brain function and white matter microstructure. Neuroimage Clin. 2017; 14: 480–489. Ellis MJ et al. Psychiatric outcomes after pediatric sports-related concussion. J Neurosurg Pediatr. 2015; 16:709-718. Graham R et al. and the Committee on Sports-Related Concussions in Youth; Board on Children, Youth, and Families; Institute of Medicine; National Research Council. Sports-Related Concussions in Youth: Improving the Science, Changing the Culture. Washington (DC): National Academies Press (US); 2014 Feb 4. Harmon KG et al. American Medical Society for Sports Medicine position statement: concussion in sport. Br J Sports Med. 2013; 47:15-26. McCrory P et al. Consensus statement on concussion in sport—the 5th international conference on concussion in sport held in Berlin, October 2016. Br J Sports Med. 2016 Purcell LK et al. What factors must be considered in “return to school” following concussion and what strategies or accommodations should be followed? Br J Sports Med. 2018; 0:1-15. Wang KK et al. An update on diagnostic and prognostic biomarkers for traumatic brain injury. Exp Rev Molec Gen. 2018; 18(2):165-180. Wang Y et al. Cerebral Blood Flow Alterations in Acute Sport-Related Concussion. J Neurotrauma. 2016 Jul 1; 33(13): 1227–1236.

In this episode of Ask Concussion Doc with Dr. Cameron Marshall, DC, we discuss the role of acupuncture in concussion management and manual therapy, the SCAT5, and a recent study on exercise therapy highlighting the potential benefits of early intervention of guided physical activity. Follow Complete Concussion Management for more information: https://completeconcussions.com https://instagram.com/completeconcussions https://facebook.com/completeconcussions https://twitter.com/ccmconcussions

Dr. Michael Makdissi is a Sports & Exercise Medicine (SEM) Physician based in Melbourne. He has pursued a career that blends both clinical and research roles. His research is mainly based around concussion and it is this area where he has become a globally respected voice. Liam West poses the questions in this podcast that sees Dr. Makdissi discuss the new Sports Concussion Assessment Tool (SCAT) 5, common mistakes made when managing athletes with concussion, updates within the SCAT5 and tips on how to use it. To read the full paper related to the new SCAT5 please follow the link, The Consensus Statement - http://bjsm.bmj.com/content/51/11/838. Or head to the BJSM website to find further related papers: The Sport Concussion Assessment Tool 5th Edition (SCAT5): Background and rationale - http://bjsm.bmj.com/content/51/11/848; Sport concussion assessment tool - 5th edition - http://bjsm.bmj.com/content/51/11/851.