Concussions: The Traumatic Brain Injury
Concussions occur more frequently than reported, according to Dr. Clark Elliott (www.clarkelliott.com). Often times, people simply bump their heads, or have an unrecognized event in which there is only a short moment of confusion, or disruption of thought. As a concussion sufferer and author of “The Ghost in My Brain: How a Concussion Stole My Life and How the New Science of Brain Plasticity Helped Me Get It Back” Dr. Elliott knows first hand about living with Traumatic Brain Injury (TBI).
Dr. Elliott was in a small car accident on his way to work one day. He was rear-ended, resulting in his head whipping into his steering wheel, then bouncing back to his seat’s head rest. He was able to walk out of his car, assess the damage of his vehicle, speak to police, and go on to work where he would teach a college class. Later that day, his head felt “foggy”, and couldn’t recall where his car was. It took almost four days for him to receive his diagnosis: a concussion. Dr. Elliott has been able to live his life, with interruptions along the way. There were times he could not name all five of his children, or had difficulty walking across a room. Although Dr. Elliott, and many others, felt fine at the time of the head injury, the daunting effects came later.
Traumatic Brain Injury: What we need to know as we care for students
The Center for Disease Control (CDC) defines a concussion as a type of Traumatic Brain Injury, caused by a bump, blow, or jolt to the head or by a hit to the body that causes the head and brain to move rapidly back and forth. This sudden movement can cause the brain to bounce around or twist in the skull, stretching and damaging the brain cells and creating chemical changes in the brain. (http://www.cdc.gov/headsup/basics/concussion_whatis.html) Concussion news has become very popular recently. In soccer, a “headball” is when you use your forehead to direct the ball. This action has recently been banned for children under 10 years old. Rules in the National Football League have also been changed, and have caused much controversy over the last decade. The movie “Concussion” releases at the end of this year, based on a true story of Dr. Bennet Omalu, the neuropathologist who made the first discovery of Chronic Traumatic Encephalopathy (CTE), in a professional football player. This movie reveals many of the previously unknown long term effects of CTE, which Boston University defines as a progressive degenerative disease of the brain found in athletes (and others) with a history of repetitive brain trauma, including symptomatic concussions as well as asymptomatic subconcussive hits to the head. (http://www.bu.edu/cte/about/what-is-cte/)
The CDC has created the HEADS UP campaign to raise concussion awareness. This campaign aims to educate healthcare providers, school nurses, coaches and parents, on the importance of protecting, and preventing traumatic brain injury, especially for children. The website offers a range of information, from brain injury basics, helmet safety, to sports concussions policies and laws, in hopes for all to be able to spot a concussion right when it happens. Although mild brain injuries won’t cause death, the sudden impact to the brain alters its performance. Repeated trauma to the brain can have an accumulative effect, with long term repercussions.
ImPACT for Concussion Management
School nurses, occupational and geriatric health care providers can utilize the ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing) Computerized Testing Tool. ImPACT has a concussion management model that the interdisciplinary team can use before, during, and after a potential concussion. ImPACT’s neurocognitive tests measures a baseline of the students’ and patients’ brain function. There are many schools today that require the baseline test results to be submitted with the students’ back to school forms, usually before pre-season for the sport begins. This data is stored in the student’s medical record as baseline comparison for future potential events. It is important to have quantifiable information regarding the student before they participate in sports and other activities where they could suffer a head injury. Keeping baseline test results in a student medical record can benefit all students in case of a head injury, as school nurses, athletic trainers, and even coaches will have a first hand resource of the student’s brain activity during post-injury examination. In the event of a head injury, the ImPACT test can be performed to determine the level of trauma by comparing the student’s post-injury test results to the initial baseline test.
But where does Magnus Health fit in?
Magnus Health Software for Student Health Records (SHR) has a specific place where baseline test results can be collected, stored, and easily accessed without having to sort through multiple paper documents and folders. School nurses, athletic trainers, and coaches will have access the student’s medical record with the click of a button, and be able to provide vital information regarding the student within seconds. Additionally, if the school is using Magnus 911, the student’s medical record can be immediately sent electronically to the local hospital facility from the athletic trainer’s smartphone while at the sports venue, if necessary.
Recovering from a TBI can be challenging not only for the patient, but for the people involved in deciding if the pupil is ready to return to sports and activities. All 50 US states have a Return to Play law in place, to protect the safety of our youth. The CDC recommends the health care provider diagnose and track the progression of the student and determine when the student is able to safely return to sports activities. While using Magnus Health Software to document notes in the SHR, staff across the campus can plan to coordinate care, and track progress, to help make the decision when it is safe for the student to participate again. Magnus Health provides a user friendly view of all treatment provided to the student throughout their recovery period.
*Reminder: January is National Winter Sports Related TBI Awareness Month!
By Marlene Chotkowski, Sherlee Johnson and Christina Trimis
The Impact Test (2015). Retrieved from: https://www.impacttest.com/products/
Heads Up (2015). Retrieved from: http://www.cdc.gov/headsup/index.html
Brainline.org (2015). Preventing, treating and living with traumatic brain injury. Retrieved from: http://www.brainline.org/landing_pages/features/ate/ate.html (Brainline.org is a resource that teaches about TBI; by going to this website the parent or healthcare professional is able to “Ask The Expert” specific questions regarding concussions.)
Clark Elliott, PhD (2015). Retrieved from: www.clarkelliott.com
Boston University http://www.bu.edu/cte/about/what-is-cte/