Re: Concussion Management (was Head Blows and Stability)

[Guest guest]

----- Original Message -----

From: <Mcsiff@...>

> .Ball1@... wrote:

>

> <I was just watching some boxing and was wondering what it is that causes

a

> person to be knocked unconscious.

Mel Siff wrote:

> That is why the boxing boards of control are extremely strict. I cannot

> recall the exact rules for the moment, but they run something like this:

> one concussion producing any unconsciousness during a match and you

cannot

> continue. Two concussions in a season and you are not allowed to box for

> three months; three concussions and you are out of boxing for a year.

> Judging from what I have seen in other pro sports such as NFL, it appears

as

> if these sports could learn a thing or two from boxing in being

considerably

> more strict about allowing a player to return to the game after

concussions.

The Cantu guidelines, adopted by several sporting bodies worldwide, address

this issue, although I am not sure whether the NFL uses them (I believe they

were developed for gridiron, but no proof).

The matrix below shows the management for various concussion grades.

However, the Cantu guidelines are no substitute for medical advice- any loss

of consciousness (LOC), however brief, must be investigated by a doctor.

Every suspected concussion or spinal injury must be managed with correct

procedure for spinal immobilisation (call an ambulance!) and the patient

transported to hospital for evaluation. I use the guidelines when students

return to school in a stable condition with a Doctor's note. Some doctors

seem unfamiliar with the guidelines and advocate insufficient recovery time.

Criteria for evaluation are LOC orpost Traumatic Amnesia (PTA)- use the more

severe indication to decide the severity of the concussion.

Severity 1st concussion 2nd concussion

3rd concussion

grade 1: May return to play if May return in 2 weeks

Terminate season.

no LOC asymptomatic * if asymptomatic for

May return next year

PTA , 30 minutes 1 week *

if asymptomatic.

Grade 2: Return after 1 week Wait at least 1 month.

Terminate season.

LOC < 5 minutes if asymptomatic * Then if asymptomatic May return

next year

30 minutes <PTA for a further week,

if asymptomatic.

< 24 hours may return, else

terminate

season.

Grade 3: Wait at least 1 mth. Terminate season. May

return next year if

LOC > 5 minutes Then if asymptomatic asymptomatic.

PTA > 24 hours for a further week,

may return, else

terminate season.

Source: Dr Cantu (1986), quoted in " Concussion in Sport " (course

notes for sports first aid course) Dr Austin Jeans c. 1998

* In Zimbabwe, the schoolboy rugby governing body has a mandatory 3 week

minimum recovery period for ANY concussion. It is far better to err on the

side of caution!

Simon Walsh

Harare, ZIMBABWE

[Guest guest]

Oops, sorry everyone- I see the table with the Cantu guidelines for

concussion has strange line breaks- if you'd like it in a Word document just

email me (off the list)

Simon Walsh

Harare, ZIMBABWE