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How to Manage a Sports Related Concussion

Janet Lee, MD

Janet Lee, MD
Pediatric Hospitalist

What is a concussion?
A concussion is a mild brain injury that causes a change in mental status that can occur with direct insult to the head. A concussion may also occur with movement of the body that cause acceleration/deceleration forces to the head.
 
What are the symptoms of a concussion?
  • Headache
  • Dizziness
  • Loss of consciousness
  • Amnesia
  • Difficulty concentrating
  • Confusion
  • Nausea and/or vomiting
  • Difficulty balancing
  • Sensitivity to light
  • Sensitivity to noise
  • Ringing in the ears
  • Drowsiness
  • Irritability
  • Sadness
When should I seek medical attention for a concussion?
  • A healthcare provider should evaluate every child or adolescent suspected of a concussion. 
  • If this occurs during a sporting event, the child should sit out the rest of the game
  • Your provider may conduct a standardized neuropsych assessment to help guide return to activities/sports
What is the best treatment for a concussion?
  • Rest, rest and more rest!
  • Absence from school may initially be necessary until one can concentrate on a task without exacerbating symptoms
  • Avoid excessive time texting, on the computer, watching television, playing video games or listening to loud music
  • Return to activity too soon can lead to worsening and prolonged symptoms.  A second injury to the brain while the brain is healing can lead to severe brain injury that is life-threatening
When can a child return to sports after a concussion?
A person with a concussion should not return to play until they no longer have symptoms at rest for at least 24 hours.  Return to play should then be a step-wise progression.  The child/adolescent should be symptom free for 24 hours before progressing to the next level of play:
  • Light aerobic exercise (e.g.: walking)
  • Sport-specific exercise
  • Non-contact training drills
  • Full contact practice
  • Return to play (Must first be cleared by a provider)
What resources are there for concussions?
Swedish’s Spine, Sports and Musculoskeletal Medicine team has developed a Sports Concussion Clinic with the following resources:
  • Baseline neurocognitive testing with a computerized exam called ImPACT can be done prior to playing a sport to assess changes and recovery if a concussion occurs.
  • Comprehensive concussion management, including clearance for return-to-play
Click here to learn more about the Sports Concussion clinic.  The team includes sports medicine physicians, psychiatrists, an athletic trainer, physical therapists and a neuropsychologist that can deliver individualized care for every athlete

How to prepare your child for a stay at the hospital

Audrey Fuhrer

Audrey Fuhrer
Certified Child Life Specialist

We all know that Swedish provides top-notch pediatric services for the emergent needs of children and their families.  You may be surprised to find out that many children come to Swedish for a planned inpatient stay as well.  There can be various reasons why a child and their family might be anticipating a hospital stay.  Some examples may include having a surgical procedure that requires them to be monitored for a set period of time afterward, neurological video monitoring, or medical preparations for a procedure the following day.

Regardless of what service your child will be receiving at the hospital, there are ways in which you can better prepare them and yourself for what to expect during your stay.

At Swedish, Child Life Specialists help children and families cope with the hospital process.  Child Life Specialists are available to help educate and prepare children and families prior to surgery and/or an inpatient stay.  Some tips on how to prepare your child for an inpatient stay include .....

Helping kids heal with music and technology

Nicole Roehrig, MSN, RN

Nicole Roehrig, MSN, RN
Pediatric Clinical Nurse Specialist

A young girl is cowering in the corner - it is the first day her care-taker has left her side. She has backed herself into a corner as far from anyone as possible. She appears to be filled with anxiety. Staff members and nurses try calming her, but nothing seems to work.

With her back turned, the little girl doesn’t notice a young man entering the room. He is holding a tool, one of which the full power and potential is still unknown to most. Even though he has witnessed its abilities before, what happens next still takes even him by surprise.

Not knowing what to say, he says nothing at all. He lifts his instrument and strikes the first chord. The girl stops. He continues to play. The girl turns and slides to the floor. The young man sinks to his knees, the same level as the girl. Strumming his ukulele the young man begins to sing. The little girl begins to scoot herself across the floor, 20 feet to where the young man kneels, closer and closer until her knees touch his.

There are gasps coming from the doorway, as a handful of hospital staff and nurses witness to an amazing transformation. In a flip of a switch, the little girl went from utter anxiety to calm and happy, soothed by the sound of music. As the young man finishes his song, the little girl smiles, reaches out her hand to touch his, then falls back, smiling and laughing.


This is the story of Melodic Caring Project Founder, Levi Ware, on his most recent visit to provide live music to pediatric patients at Swedish First Hill.

“I've been playing music for a long time and I've seen a lot of amazing things happen when music is introduced into certain situations. What happened on the Pediatric Unit at Swedish was one of the most wonderful, beautiful and undeniably powerful music experiences I've had.  ...

Think about injury prevention when returning to baseball season

Melissa Ballance AT/L, ATC

Melissa Ballance AT/L, ATC
Athletic Trainer, Swedish Pediatric Specialty Care, Sport and Dance Medicine

Baseball season is finally here! As we watch our Major League Baseball heroes take the field this April, kids of all ages will be returning to the field after winter break and time off from practicing. 

It is important that our kids return safely to help prevent overuse injuries from occurring during the season. Common overuse injuries in baseball are injuries to the elbow (ulnar collateral ligament, UCL) and shoulder in the throwing arm. A proper warm up, maintaining an age appropriate pitch count and good throwing mechanics are essential to preventing overuse injuries. 
 
Here are some specifics to keep in mind:

Tips for keeping young athletes safe and healthy

Sonal Avasare, MD

Sonal Avasare, MD
Pediatric Nephrologist

We all know exercise is an important factor in maintaining an active and healthy life. However, over-exercising can lead to a rare, but serious complication known as rhabdomyolysis – a medical team that literally means ‘dissolution or destruction of skeletal muscle’. There has been a recent increase in rhabdomyolysis amongst teen athletes so it is important to recognize the warning signs and learn how to prevent them.

The classic triad of rhabdomyolysis is dark urine, muscle weakness or fatigue, and muscle pain. Although exercise can be the primary factor, other key contributing elements such as dehydration, genetic conditions (e.g. sickle cell), metabolic disorders, nutritional supplements, drug use, and heat stress can exacerbate muscle damage. Without appropriate medical evaluation and care, rhabdomyolysis can cause permanent damage to the kidneys and may even be life-threatening in severe cases. Here are some tips to help your young athlete remain active and healthy:

  1. Maintain adequate hydration – preferably with plain water.  Sports and energy drinks may often contain caffeine and excessive amounts of sugar which can cause dehydration.  On average, children that are 6-10 years old should have about 1L of fluid a day, children 10-14 years old should have 1.5L/day and teens over 14 years should have at least 2L of fluid a day. It is important to increase fluids with increased activity due to the additional fluid losses that occur.
  2. Eliminate protein supplements. A recent study by the American Academy of Pediatrics found ...

4 tips to prevent injuries in sports

Terrence Cronin, MD

Terrence Cronin, MD
Pediatric Sports and Dance Medicine Physician

How do you prevent sports related injuries? Here are four tips:

Free Class on Nutrition for Young Athletes to be Held at Swedish/Issaquah Feb. 20

Swedish News

ISSAQUAH, WA, Jan. 23, 2013 - With spring sports starting, don't drop the ball on nutrition. Nutrition is just as important as physical conditioning for athletes. So, as spring sports begin, let Swedish help you and your children prepare to hit it out of the park. Join Registered Dietitian Ally Colson for an interactive training on game-winning meals and snacks and help your young athlete become a nutrition champion.

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