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Concussion Q&A with Athletic Trainer Neila Buday

Concussions are a serious and real issue in athletics today, whether it is at the high school or professional level. Though they cannot always be prevented, Ranney’s Athletic Trainer Neila Buday is striving to improve the school’s post-injury management and educate parents and students about one of the most controversial topics in present-day sports.

What exactly is a concussion?
A concussion, or traumatic brain injury, is an injury to the brain that causes it not to function normally. They are not caused exclusively by contact to the head and can occur with or without loss of consciousness or findings on imaging.  A blow to the body or the head can cause the brain to move within the skull, and impact the skull with forces beyond what the cerebrospinal fluid can absorb. http://www.youtube.com/watch?v=b0z9S2rc59w
What is the ImPACT concussion test?
ImPACT (Immediate Post-Concussion Assessment and Cognitive Test) is a web-based neurocognitive assessment. The non-invasive test takes about 25 minutes and is similar to a video game—testing speed, memory and reaction time. The purpose of the test is to establish an individual baseline test for each athlete. In the event of a concussion, post injury tests are performed and compared to the baseline. It is included in a battery of tests used by athletic trainers and physicians to assist in concussion assessment and return-to-play decisions.

When do Ranney athletes take the test?
All varsity athletes take a baseline test prior to their first practice. Post-trauma tests are captured if an athlete sustains an injury. New baselines are established every two years to adjust and accommodate adolescent brain development. We are currently working on expanding our testing population to include those students in Middle School contact sports.

What other tests are taken into consideration?
There are many factors that are taken into account when making return-to-play decisions. An athlete must be symptom free for a designated period of time and they must be back to a full academic work load. Healthcare professionals then look at post-trauma neurocognitive tests and ensure that they are within an acceptable range. At Ranney, we also do balance assessments. Once an athlete has cleared all of these steps we begin a return-to-play progression. This provides a gradual increase in activity leading to sports specific activities and eventually full play. Athletes must remain asymptomatic to progress through these steps.

How is this beneficial to the athletes?
Using a variety of tools and assessments for concussion management help health care professionals keep athletes safe. Again, we cannot always prevent concussions but it is vital that we manage them correctly. Returning an athlete to the field too soon can have significant health ramifications, including second impact syndrome (a potentially catastrophic condition where an athlete sustains a concussion or TBI while the brain is not completely recovered from a previous injury) and prolonged symptoms.

What should an athlete do if they have symptoms of a concussion?
If an athlete is experiencing symptoms or others (friends, teammates, parents) notice signs of a concussion it is very important that the athlete be removed from play and evaluated by a healthcare professional trained in concussion management. Athletes should inform their coach, parents or athletic trainer.
Below is a list of signs and symptoms from the Center for Disease Control and Prevention website:

Signs Observed by Coaching Staff or Parents:

• Appears dazed or stunned
• Is confused about assignment or position
• Forgets an instruction
• Is unsure of game, score or opponent
• Moves clumsily
• Answers questions slowly
• Loses consciousness (even briefly)
• Shows mood, behavior or personality changes
• Can’t recall events prior to hit or fall
• Can’t recall events after hit or fall

Symptoms Reported by Athlete

• Headache or “pressure” in head
• Nausea or vomiting
• Balance problems or dizziness
• Double or blurry vision
• Sensitivity to light
• Sensitivity to noise
• Feeling sluggish, hazy, foggy or groggy
• Concentration or memory problems
• Confusion
• Does not “feel right” or is “feeling down”

What should I expect if I (or my child or teammate) have a concussion?
If you suspect a concussion let your athletic trainer know as soon as possible. If it is an away contest inform your coach immediately. No athlete showing signs or symptoms of a concussion will be allowed to return to play the same day. They must be cleared by a healthcare professional trained in concussion management, as well as by the Ranney athletic trainer.

What Should I do and not do to help the healing process?
Rest, both physical and cognitive, are important in assisting the recovery of a concussed athlete. That means refraining from reading, computers and school work while symptomatic, especially within the first few days. This also means no television, video games, texting, etc. Concussed athletes are permitted to sleep (in fact it is good for them), but parents may want to check on them throughout the night.
If you have questions or need information regarding the Ranney School concussion policy, please contact Athletic Trainer Neila Buday, ATC at nbuday@ranneyschool.org or 732.542.4777, ext.6155.
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Ranney School

235 Hope Road
Tinton Falls, NJ 07724
Tel. 732.542.4777
Our mission is to know and value every child, nurturing intellectual curiosity and confidence, and inspiring students to lead honorably, think creatively, and contribute meaningfully to society.