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Q&A Transcript: Concussion Management Webinar

The following is a transcript from the Q&A function of the USCAH+AHAA webinar on concussion management. For clarification on any of these topics or questions about USCAH programming, please contact us.

Comment:  Not all college athletes are NCAA athletes.  I think we need to remember all the club sports, individual pursuit sports and then intramural sports.
Certainly resources are important - and I agree with the panelists that education, recognition are more important than sophisticated tools etc.  Creating a culture of accountability and recognition in club sports and recreation sports is significant and cannot be undervalued.

I never use the computerized test. I only do it at the beginning of the year. If someone has a possible concussion, I am not going to put them through a computerized test to compare based off the baseline computer test. So why is that something required? I use other tools to determine a concussion.
This is a really good point. I think we have to be proactive in thinking about how these tools are best used in the evaluation and management of a concussed athlete.

I agree with everything that you are saying about baselines.  However, I continue to do them more out of potential legal concerns
They are called out in the Arrington NCAA settlement - baseline testing is required annually and prior to any practice or competition - not necessarily best practice but there is a legal precedent here.

The symptom checklist... fatigue is on there to me that is a useless symptom. Of course an athlete is going to be fatigued. So I agree with all of this with the symptoms.
Definitely agree. Most adolescents have numerous symptoms regularly. Using our existing symptom scales as an initial screen is only the first step. Then dig deeper with follow-up questions for those endorsed.

Yes, annual baseline testing of some format is an NCAA DIV I requirement for those of us trying to be in compliance.  Entirely different discussion than best practices but our hands are tied.
Agree - legal precedence can force policy in spite of best practice

What is a good guideline for college athletes and driving?
With respect to driving, I think any symptoms, visual or vestibular, or reaction time impairments should result in caution with driving and recommendations to not drive while symptomatic. Concern with driving is they can hurt others and not just themselves.

I understand the cardiovascular titration with exercise...what about resistance exercise (valsalva, overhead with weights, etc.) I'm assuming the same principle applies with all RT that it would start conservative and titrate up and monitor for sxs?
Yes - that principle applies - CDC agrees with you!
https://www.cdc.gov/headsup/basics/return_to_sports.html

Would you guys share your thoughts more on return to the classroom, and when to return to the classroom? You talked about accommodations, and 48 hours post injury to become active.
24-48 hours of initial rest, followed by a gradual return with adjustments as needed. Get them into school first with adjustments then wean those as needed.

 

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