Combat Concussion

 

Whilst working as a medic covering a Taekwondo tournament in December 2017 I dealt with an incident of concussion. The competitor returned this year and I caught up with her to find out what happened after the event. I was not expecting the story that followed.

Carla, a black belt in Taekwondo, was competing in a sparring contest. She was wearing the appropriate safety equipment including head guard and gloves.

I became concerned about the competitor after she received a blow to her head. She became unsteady on her feet and so the bout was stopped. I removed her from the ring, and she began to complain of nausea and photosensitivity. We moved to a quieter area as the noise levels were beginning to become a problem for her. Following a full assessment my immediate impression was that she was concussed and should not continue in the tournament. 

The assessment revealed that it was difficult for her to answer certain questions. She answered Maddocks questions with no problems, it was when I began filling in her details on my treatment record that she struggled. She was unable to recall her phone number and revealed that she hadn’t been able to remember things for a few days after hitting her head on a concrete archway in a friend’s house.

She began to drop her level of consciousness and I became increasingly concerned, especially as this was her second head injury in the space of a week. Although haemodynamically stable I felt her dropping level of consciousness, nausea and photosensitivity meant I needed to refer Carla to a Doctor as a matter of urgency. I was concerned that this could be a serious head injury, possibly an intracranial bleed. I called 999 and unusually a doctor, nurse and paramedic were on the ambulance that was sent. 

A concussion was diagnosed by the doctor, with the advice to see her own GP on her return to Devon. She left Cardiff that evening with somebody keeping a close eye on her during the long car journey home.

I contacted her in the days following and she said she was feeling tired but generally better. When I caught up with her she told me of her difficult year since.

It was a few weeks after the initial diagnosis of concussion that her symptoms began to worsen. Whilst attending another Taekwondo tournament, as an observer, her friends became concerned when she became vacant and began slurring her words. They quickly took her to hospital.

Numerous scans were performed and thankfully there was no evidence of a life threatening bleed. Following a detailed examination of Carla and her ongoing symptoms a diagnosis of post-concussion syndrome was made. She continued to experience impaired vision finding herself unable to focus for any length of time. 

The extreme tiredness that she encountered restricted her everyday life including her ability to return to work. Concentrating for any length of time lead to exhaustion, even the simplest tasks became difficult. The making of simple decisions such as what to eat for tea were now a challenge. Reading and listening to music became impossible. It took four months before she was back at work as a classroom assistant. This was facilitated by her occupational health department who developed an activity/sleep schedule to aid her rehabilitation. 

Her mental health suffered, experiencing emotional discomfort the year since her injury. Thankfully she has been supported through this with counselling sessions and is now taking medication to ease her depression.

Although some symptoms remain, especially travel sickness and tiredness, things are improving and for the first time in over a year she has returned to exercise. Her involvement with Taekwondo continues, and whilst she has been advised not to spar again, working as an instructor Carla continues to inspire young people to take up the sport. 

When teaching on our First Aid for Sports and Exercise (FASE) and Sports Trauma Management Courses, we stress the importance of recognition and correct management of concussion.

Keeping up to date on any change in guidelines and published research allows us to keep our information current. Hearing directly from someone who has experienced a serious concussion has helped us to understand it’s long-term effects and the impact it can have. 

Kind thanks to Carla Dunne for allowing us to share her story.  

Hi guys, we'd just like to provide you with some links regarding current guidelines 2017.

Firstly this is the new SCAT5 assessment tool 2017; 

http://bjsm.bmj.com/content/bjsports/early/2017/04/26/bjsports-2017-097506SCAT5.full.pdf

Here is the child SCAT5 assessment tool 2017;

http://bjsm.bmj.com/content/bjsports/early/2017/04/26/bjsports-2017-097492childscat5.full.pdf

Also here is the consensus statement on concussion in sport from the Berlin conference november 2016;

http://bjsm.bmj.com/content/early/2017/04/26/bjsports-2017-097699

We have updated our Sports trauma management course to comply with the latest guidelines. 

There has also been updates from the British Thoracic Society

Here are the all guidelines;

https://www.brit-thoracic.org.uk/standards-of-care/guidelines/

Here are the guidelines for emergency oxygen use in ambulances, community and pre‐hospital settings;

https://www.brit-thoracic.org.uk/document-library/clinical-information/oxygen/2017-emergency-oxygen-guideline/web-appendix-5-summary-for-ambulance-and-prehospital-settings/

We hope this has been useful for you and we're happy to answer any questions you may have regarding these guidelines.

All Lubas course's are up to date with all current guidelines at the time of the course. 

Hi guys, we'd just like to provide you with some links regarding current guidelines 2017.

Firstly this is the new SCAT5 assessment tool 2017; 

http://bjsm.bmj.com/content/bjsports/early/2017/04/26/bjsports-2017-097506SCAT5.full.pdf

Here is the child SCAT5 assessment tool 2017;

http://bjsm.bmj.com/content/bjsports/early/2017/04/26/bjsports-2017-097492childscat5.full.pdf

Also here is the consensus statement on concussion in sport from the Berlin conference november 2016

http://bjsm.bmj.com/content/early/2017/04/26/bjsports-2017-097699

We have updated our Sports trauma management course to comply with the latest guidelines. 

There has also been updates from the British Thoracic Society

Here are the all guidelines;

https://www.brit-thoracic.org.uk/standards-of-care/guidelines/

Here are the guidelines for emergency oxygen use in ambulances, community and pre‐hospital settings;

https://www.brit-thoracic.org.uk/document-library/clinical-information/oxygen/2017-emergency-oxygen-guideline/web-appendix-5-summary-for-ambulance-and-prehospital-settings/

We hope this has been useful for you and we're happy to answer any questions you may have regarding these guidelines.

All Lubas course's are up to date with all current guidelines at the time of the course. 

Chorley FC Supporters Trust fund lifesaving equipment

A big thank you to Danny Fishwick of Chorley FC for our most recent guest blog. Danny has attended a number of Lubas Medical courses and we felt Chorley's story of local supporters pulling together for the good of the club was too good to ignore! A great example of player safety being the number 1 priority throughout all levels of sport.

 

Danny explains the story in his own words. Enjoy!

 

I’m Danny Fishwick, the Sports Rehabilitator at Chorley Football Club. I have a degree in Sports Rehabilitation which I graduated from in 2010. Working in football I also have pitchside first aid and sports trauma management qualifications.

My role at Chorley Football Club is to lead the medical department for the first team through to the under 18s teams. I am the point of contact for all the players when it comes to injury diagnosis, treatment and rehabilitation and refer them on as and when required. Throughout my training I was involved in non-league football working voluntarily with Stalybridge Celtic, Ashton United and Northwich Victoria. I was given the opportunity to go to Huddersfield Town on placement at university and luckily I ended up staying there for the best part of three years. I worked with their first team and academy as well as working with Altrincham FC in the Conference North. Before joining Chorley I spent a year in Australia working with a semi-pro team called Armadale and also with Perth Glory who are the professional soccer team in Western Australia.


Chorley play in the National League North (formerly the Conference North) and were very close to reaching the National League last year in the play-off final – we were extremely unlucky on the day losing 3-2 to Guiseley, this would have been back-to-back promotions following us winning the Northern Premier League the season before. Our manager is Matt Jansen, who played in the Premier League with Blackburn Rovers. It is a sleeping giant of a club and everything is in place for us to keep building and progressing as far as humanly possible – with the main aim being the Football League.


We are lucky at Chorley as we have a good backroom team and good set of people behind the scenes. We have first aiders that would help me in a traumatic incident and stewards who are also stretcher bearers so everything is in place if traumatic injuries occur. The physios of each team are also very helpful in these situations. Traumatic injuries need to be managed efficiently and confidently – obviously with crowds of 1000-2000 every week we are being watched very closely to ensure we are following protocol fully and properly. As long as everything is done properly and the player is as comfortable as possible before the EMS arrives, we have done our job in a pre-hospital setting.


One of the courses which I really wanted to add to my toolbox was the use of Oxygen and Entonox. This is used in professional sport but not so much at semi-professional level. I wanted to get this introduced to the club, and have a few medical personnel from different clubs in our league attend so it becomes more regular at our level of football. This is life saving equipment and if one life is saved by using it over the space of 10 years then it is worth it. Due to a lot of the oxygen courses being held down south, I enquired about the possibility of hosting this at Chorley FC during the summer. This was arranged through Lubas Medical who came to our club and put on the course. We had medical staff attending from AFC Fylde, Curzon Ashton and Airbus UK just to name a few.


Being trained up is one thing, but purchasing the equipment is another at this level of football. I have been quite lucky with being supported fully when I want to introduce new ideas to the club. At this level of football however the funds aren’t there to be spent in large sums, especially in the summer / pre-season when there are no crowd incomes from games coming into the club. To purchase the oxygen I was lucky enough to have the full backing of the Chorley FC Supporters Trust, who sponsored and purchased it for the club.

Chorley Supporters Trust Board Member James Wilson, who arranged the LifeLine Pro Oxygen kit sponsorship, said:


"I help out as a steward at Chorley FC on matchdays. When the club suggested buying a Lifeline oxygen kit I immediately thought of the Trust. Safety in the football ground is of paramount importance, both on and off the pitch. The Trust are constantly working with Chorley FC to improve the matchday experience so this sponsorship deal was a natural fit for us."


I am tremendously grateful for this support and it proves that clubs at lower levels have a great camaradarie with everyone pulling together to reach the same goal. The staff, players, Trust and the fans all work together for the good of the club, we all want to be in the Football League and with this foundation the sky is the limit. This is what happens in non-league football as the money isn’t always there so everyone pulls together to run the club – which is what makes it so enjoyable to be involved in.

 

Fantastic work from Danny, Chorley FC and the trust.

For more information on the club:

www.chorleyfc.com

@chorleyfc

Follow Danny Fishwick:

@danny_boy23

 

Children's Hospital Challenge

We are very happy to have been asked to support and help provide volunteers for the Children's Hospital Challenge 2015. The challenge has been organised by a friend of Lubas Medical Adrian Harvie in order to raise awareness and help increase funding for a rare illness known as Alexander Disease. Adrian explains below but what we're looking for is a physio to help the team over the course of the 10 days. Meals and accomodation would be provided and you would be helping a very worthy cause. Please read on for further details.

The Children's Hospital Challenge 2015

 

 

I'd like to introduce you to a challenge that I'm organising this year.
 
Over the course of ten days from July the 31stof this year, myself and 7 friends will take on the task of cycling to every NHS children’s’ hospital in England and Wales. We will cover over 1,000 miles whist visiting 17 children’s’ hospitals in 13 cities including Cardiff, Birmingham, London, Newcastle and Manchester.
 
The inspiration behind this challenge is my three year old daughter, Emilia, who has a rare genetic disorder called Alexander Disease which affects the nervous system. It is a form of Leukodystrophy that affects just 500 people worldwide. Unfortunately, the prognosis is not great and children diagnosed with this disease rarely live past the age of 6 or 7.
 
Our aim in doing this challenge is to raise as much awareness as possible about the disease so that fundraising can be achieved, which in turn can be donated to research and children that are affected by this illness. We would also like to highlight the fantastic work done by children’s hospitals throughout the country by donating toys and books to their children’s’ wards when we arrive.
 
Awareness of this disease is just as important as raising money to fund research, and as a result we have created the following accounts in an attempt to achieve this. Please ‘like’ and ‘share’ our Facebook page, follow us on twitter and check out our website.
 
www.childrenshospitalchallenge.co.uk

Twitter - @CHC2015
Facebook – www.facebook.com/childrenshospitalchallenge
 
We have also set up a donation page via Givey.com and should you wish to donate please click here. All money raised will go to a charity called Climb who are the national information centre for metabolic diseases. Climb will donate all of the challenge’s proceeds to a restricted funds pot where researchers can apply for the funds in order to financially back their research project into Alexander Disease.

 
The challenge has generated great public backing from a number of sources with Cardiff City Football Club, BBC Wales, ITV, National and local press and GMTV all wanting to support and promote the challenge. We are however still on the lookout for a main sponsor of the event – predominantly to help with purchasing the bikes. The sponsor will have their logo prominent on all media work we do, on the support vehicles that will follow us, our riding clothes and equipment and at all fundraising events we will hold. Once we have completed the challenge we will sell the bikes and return the proceeds to the sponsor or donate to the cause. If you know of a person or company that would be interested in potentially supporting us please let me know.
 
As mentioned various media sources have

shown great interest in this story already and below are links to an article in the Wales Online Newspaper and a BBC Interview:
 
BBC Interview
 
Wales Online
 

Thank you for taking the time to read this mail and I hope you can support this very personal challenge for me whether it is in the form of awareness or donations.
 
Yours faithfully,
 
Adrian Harvie

If you or anyone you know would be interested in helping out Adrian and his team, please contact us info@lubasmedical.com.

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