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EM:RAP Special Report: Concussion

Mel Herbert, MD MBBS FAAEM and Jessica Mason, MD
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On this episode we discuss concussions, the sequelae that happen as a result of concussions, and the long term effects of repeated head trauma. We seek answers from “Captain Cortex”, Prof. Stuart Swadron. Medical team physician for the Cleveland Indians, Dr Tom Waters, explains the process of assessing when an injured player in the NFL can go back in the game. Dave’s personal trainer, Steven Yates, talks about his experience with concussions, as a former college football player, and Jess speaks to a young patient and his mother, who recently came into the ER after a head injury, about their story.   

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Jacob B., M.D. -

Great special report. Two things that need clarification:
1) You do not have to be hit on the head to sustain a concussion

2) MOST concussions are not associated with a LOC


mark g. -

Have some problems with this one.
First and foremost is emergency physicians need to think of concussions not just as a sports injury but a community acquired disease. Second we need to understand that brain injury is a very dynamic process, especially as it pertains to mild TBI. While there is some predictive information to be gleaned from the initial presentation it is really the evolution over the first 72 hours in particular which best defines a concussive injury. It is also during this phase where we have the best window for intervention, cognitive rest is critical. And for heavens sake don't think they have to hit their head. If you flip your car over 4 times you may not hit your head but you sure as poop can have a concussion.
Most kids have a cocoon of parents, teachers, coaches etc... watching over them. The chance of missed concussion is there, but it's on everyones radar. The adult? That's a different story. It's likely to be from a car collision, assault or a work related injury. Maybe they were intoxicated, often don't have a primary MD. We see them, figure out if we want to CT their brain and often they just disappear into the abyss. Please inform these patients they have sustained a brain injury and make sure they know about cognitive rest, give them a work or school note and resources to follow up with.


Mel H. -

Mark you are of course our attempt to simplify for a general audience we made a few edits that we should redo...of COURSE you can get a concussion without getting hit on the head...we will rework the piece and repost because a non-clinician audience might come away with the wrong idea.

mark g. -

Mel- you continue to be the man.

Harshad W., M.D. -

There is no MP3 version on this short?

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EM:RAP Special Report: Concussion Full episode audio for MD edition 36:19 min - 17 MB - M4AEMRAP Special Report - Concussion MP3 50 MB - MP3