TBI

=TBI=

REAP program

 * Reduce
 * Educate
 * Accommodate
 * Pace

Rocky Mountain Hospital for Children

It is not appropriate for student to return to play RTP on the same day as the injury regardless of the athletic performance

Sx are critical to monitor, worsen of H/A confusion, disorientation, vomiting, difficulty awakening within first 48--72 hours is a sign of more serious medical condition, seek med attention,

**Community Based Concussion** (MTBI) Management Program made up of:

 * Family
 * School physical team - graduate return to play resource graduated pacing - see grid
 * School cognitive team 0 see suggestions for accommodations 0 neuro-cognitive test at http:// COkidswithbraininjury.com
 * Medical team

All team should rate symptioms on scale fo 0-6 gives more objective measuer for team Injury day one, 3 week management - window of opportunity

LOC not critical for concussion dx

1.6-3.8 mill sports /rec concussion in us /uear

SX mild to severe - confusion, disorientation, memory loss, slow reactions, extreme emotional reactions

**Second impact Syndrome - (SIS)** - second blow before first injury is healed. can cause perm damage or death
Reduce potential for further injury - remove from activity that could cause further injury

Must reduce both physical and cognitive demands on brain until healed. if fail to do this can compromise recovery.

give teacher strategies to reduce cognitive load, **accommodate**

look for symptoms,

 * physical** - Headache/ pressure, blurred vision, dizziness, poor balance, ringing in ears, seeing stars, vacant stare/glassy eyed, nausea, vomiting, numbness/tingling, sensitivity to light, sensitivity to noise, disorientation, neck pain
 * cognitive** - Feeling in a fog, feel slowed down, difficulty remembering, difficulty concentrating/easily distracted, slowed sleep, easily confused,
 * emotional** - inappropriate emotions, personality change, nervousness/anxiety, feeling more emotional, irritability, sadness, lack of motivation
 * maintenance** - fatigue, excess sleep, trouble falling asleep, drowsiness, sleeping less than usual

resources:
cokidswithbraininjury.com biacolorado.org cde.state.co.us nata.org/ athletic training