WWhhaatt iiss aa CCoonnccuussssiioonn?? DDoonn’’tt IIggnnoorree TThheesseeSSyymmppttoommss ooff aa

CCOONNCCUUSSSSIIOONN!!SSIIGGNNSS

• Vacant stare• Delayed verbal and motor responses• Confusion and inability to focus attention• Disorientation• Slurred or incoherent speech• Gross observable lack of coordination• Emotions out of proportion to

circumstances• Memory deficits• Any period of loss of consciousness

SSYYMMPPTTOOMMSSEEAARRLLYY ((wwiitthhiinn mmiinnuutteess oorr hhoouurrss))

• Headache• Dizziness or vertigo• Lack of awareness of surroundings• Nausea or vomiting

LLAATTEE ((ddaayyss ttoo wweeeekkss llaatteerr))• Persistent low grade headache• Light headedness• Poor attention and concentration • Memory dysfunction• Easily fatigue• Irritability and low frustration tolerance• Intolerance of bright lights or difficulty

focusing vision• Intolerance of loud noises; sometimes

ringing in the ears• Anxiety and/or depressed mood• Sleep disturbance

Provided by:The El Dorado County Emergency MedicalServices Agency (EMS) 415 Placerville Dr., Suite J

Placerville, CA 95667 Phone: (530)621-6501 Fax: (530)621-2758email: David.Brazzel@edcgov.us

DDoonn’’tt IIggnnoorree TThheesseeSSyymmppttoommss ooff aa

CCOONNCCUUSSSSIIOONN!!

RReeffeerreenncceess

1. Traumatic Brain Injury (TBI):Incidence & Distribution, 2004.Center for Disease Control andPrevention (CDC), www.cdc.gov

2. Sports Concussions and SecondImpact Syndrome, 2004. Universityof Virginia Neurogram,www.healthsystem.virginia.edu

3. AAN Practice Guidelines, 1997.American Academy of Neurology,www.aan.com

Created and Designed by El Dorado Hills Fire Dept.

WWhhaatt iiss aa CCoonnccuussssiioonn??A Concussion is a violent jarring or shaking thatresults in a disturbance of brain function.

SSIISSSSIISSSSEECCOONNDD IIMMPPAACCTT SSYYNNDDRROOMMEE

Become educated...Become aware...

Become the coach, friend orfamily member who says ““NNOO!!””

He was aFire-fighterand Paramedicwho shouldhave knownbetter but hispassion forexcellence, his need to 'go big,' overruled hisjudgment one too many times. He was tenaciousin his pursuit of new athletic skills, and was theepitome of the 'extreme sport' enthusiast andathlete. But at the peak of his athletic career RyanShreve's life was unnecessarily cut short by acommon but little known condition calledSSeeccoonndd IImmppaacctt SSyynnddrroommee oorr SSIISS.

SSeeccoonndd IImmppaacctt SSyynnddrroommee ((SSIISS)) is a catastrophicevent that occurs when an athlete - or anyone -sustains a second head injury (a concussion)before the symptoms from the first injury haveresolved. These symptoms may occur immediatelyor several minutes after the traumatic event.

Concussions are a common consequence oftrauma to the head in contact sports, collisions,falls, and many other forms of athletic activity.The second concussion may occur anytime fromdays to weeks after the first injury. The secondimpact is the dangerous one and is more likelyto cause uncontrolled brain swelling or otherwidespread damage. IITT CCAANN BBEE FFAATTAALL!! At theonset of SIS, the athlete may be stunned butdoesn't lose consciousness and often continueswith the game or event. In the next 15 seconds -and up to several minutes later - the brain isseverely compromised. The residual swellingfrom the first impact impairs the brain's abilityto prevent further swelling from a second impact.The second impact may be as simple as a thump,a bump or a jarring motion to any part of thebody which causes a rotational force on thehead. Respiratory failure begins and the personcollapses. The time from second impact to brainstem failure is two to five minutes! Death oftenoccurs shortly thereafter.

Ryan, as a Paramedic, should have known better.He should have known that the symptoms hewas experiencing - headaches, intermittentconfusion, etc. - were indications of a concussion.In Ryan's case, they were indications of themultiple minor concussions he had receivedduring the summer while practicing his wake-boarding maneuvers. He should have beentaken out of the sport for two weeks or longer,but Ryan couldn't make that decision. His headinjuries had impaired his usually sound,professional judgment.

Each year in the United States an estimated 11..44MMIILLLLIIOONN people sustain a Traumatic BrainInjury or TBI. The Center for Disease Controland Prevention estimates that at least 300,000sports related concussions occur each year. Upto fifty percent of the reported SIS cases resultin death. More alarming is the fact that, afterathletes incur one concussion they are three timesmore likely to sustain a second concussion.

SSuuggggeessttiioonnss ffoorr pprreevveennttiinnggSSIISS ffrroomm ooccccuurrrriinngg

• Encourage the use of protective equipmentsuch as a helmet for all sports ranging fromsnow sports and bike riding to wakeboarding.Helmet damage likely indicates a head injury.

• Encourage rule changes in athletics toreflect the risk of SIS.

• Recognize that head injured athletes needimmediate medical attention.

• DO NOT allow the athlete to return to playafter any head trauma.

• Seek medical advice from a healthprofessional after any head injury.

• If an athlete complains of a headache, lightheadedness, vision problems or otherneurological symptoms, bar that personfrom any further athletic participation untilseen and cleared by a physician to returnto play.

Ryan Shreve was trained to save lives and yethe was unable to save his own. Because of hiseducation and training, he knew about traumatichead injuries. But due to his initial concussion,which impaired his judgment, he was unable tomake sound decisions about his own health. Ifthose around him had been aware of his headinjury, and knew about SIS, they may have beenable to help. Coaches, families and friends ofathletes, or anyone who sustains a head injury,should stress the need for immediate medicalattention. Become educated. Become aware.Become the coach, friend or family member whosays “NO!” Honor Ryan's memory and learnfrom his death. Tell the injured person to “Waitbefore it's too late.” Save a life.

For more information on SIS, Second ImpactSyndrome, please contact Dr. David Brazzel

SSuuggggeessttiioonnss ffoorr pprreevveennttiinnggSSIISS ffrroomm ooccccuurrrriinngg