Week 2, Day 5 (friday)

Welcome to Day 5 of the second week with us, we hope you enjoyed your break for the 4th of July!

Thanks for being flexible with Dr. Broglio, who had to reschedule for this upcoming Monday! If you haven’t already done so, check out Dr. Chris Giza’s talk from last year.

For our daily agenda, we have a Social Hour today at at 10:00 am PT | 12:00 pm CT | 1:00 pm ET. 

Start-of-day Procedure

  1. Check Slack for new messages

  2. Check the schedule in #weekly-schedules on Slack, on the week page in this portal

  3. Check the ‘day page’ (like this one) for tasks & content

  4. Check your project resource Google doc in your project folder for new resources

  5. Check in with your PM on Slack

  6. Check in with your project partner(s) on Slack

There are 2 tasks to do today:

  • Check in with your project partners about progress made so far

  • Pick a topic for the newsletter synopses and check out the research

Curriculum for Today

We’ve provided a group of educational resources below. We’ve listed them in an order that we hope will build on your understanding of concussions as you go through them. Please make sure you’ve put your name down on the sign-up sheet and completed your practice synopsis before going on to the new curriculum today.

Unit 1B: Actual assessments? See what specific assessment tools look like (~2 hrs)

  • Watch video demonstrating an assessment in the clinic following a concussion from the Children’s Hospital of Philadelphia: https://www.youtube.com/watch?v=Uy8V5MGX8Ag (~10 minutes) Note: this video is 8 years old and their may be some changes to how Dr. Master does assessments in 2023, but it is still a good overview.

  • Acute assessment 0-10 days

  1. Symptom Assessment

    1. Take a history (excerpt from PedsConcussion.com)

      1. Read domain 2.1a of section A (~ 5 min) https://pedsconcussion.com/section/a/

    2. Comprehensive physical exam (excerpt from PedsConcussion.com)

      1. Read domain 2.1c of section A (~5 min) https://pedsconcussion.com/section/a/

    3. SCAT 5 - Instructions: skim through both of these-for the SCAT5, pretend you are patient and fill out the form (~10 min)

      1. Link: SCAT5 for Athletes aged 13+ English / French

      2. Link: Post-Concussion Symptom Inventory (PCSI) 

    4. GOAT - read test (~2 min)

      1. http://scale-library.com/pdf/Galveston_Orientation_Amnesia_Test.pdf

  1. Brief neurocognitive tests - ImPACT 

    1. Watch video demonstrating the ImPact test (~1 minute) https://impactconcussion.com/post-injury-testing/

      1. Additional information: “The ImPACT post-injury test should be administered within 72 hours of a concussion to all athletes ages 12 and up. The test can be readministered every seven to 10 days to document improvement of neurocognitive function and should be repeated until the athlete is cleared by his or her doctor” 

    2. Neurologic Exam

      1. Additional Information:“A comprehensive neurologic exam including mental status/orientation, fundoscopic exam, cranial nerve testing, strength, sensory testing, reflexes, coordination testing, and gait is usually normal in the individual with mTBI; however, a thorough exam helps to identify other injuries or more significant injury. For example, the presence of brisk reflexes or ankle clonus may be indicative of a more severe TBI, or sensory deficits may suggest a plexopathy, stinger, or spinal cord damage.” 

      2. MoCA- Montreal Cognitive Assessment (~ 5 min)

        1. Look at the MoCA assessment: MOCA-Test-English.pdf

  2. Balance

    1. Watch video on the BESS (Balance Error Scoring System) (~8 min): https://www.youtube.com/watch?v=gz_iInhR3d0

    2. Watch video on Complex Tandem Gait assessment (~3 min) https://www.youtube.com/watch?v=jjhAMiTMPsw 

  3. Ocular motor

    1. VOMS

      1. Watch this video about VOMS (~2 min) https://www.youtube.com/watch?v=XlA_wJAMBmg

      2. Additional Information: “The VOMS is a screening test that can be done by any provider but is not a complete diagnostic test for vestibular-oculomotor dysfunction. A vestibular physical therapist can perform a complete diagnostic test.” 

      3. Read (~5 min) https://www.upmc.com/services/sports-medicine/services/concussion/symptoms-diagnosis/voms 

    2. VVE

      1. Watch this video on VVE (~4 min) https://www.youtube.com/watch?v=lGUDZnZOieM 

  4. Mental Health Screening

Note: The tools below are for primary care providers to screen patients. If screenings show positive results or receive a sufficient score, further evaluation should be done  

  1. PC-PTSD

    1. Read webpage and look at the assessment  (~5 min) https://www.ptsd.va.gov/professional/assessment/screens/pc-ptsd.asp

  2. Depression: PHQ2

    1. Read description of the questionnaire and the scoring system (~5 min) https://cde.nida.nih.gov/instrument/fc216f70-be8e-ac44-e040-bb89ad433387

    2. Look at actual questionnaire 1 (~ 3 min) https://cde.nida.nih.gov/sites/nida_cde/files/PatientHealthQuestionnaire-2_v1.0_2014Jul2.pdf

    3. Look at actual questionnaire 2 (~3 min) https://cde.nida.nih.gov/instrument/fc216f70-be8e-ac44-e040-bb89ad433387/module/fc216f70-be8f-ac44-e040-bb89ad433387/question/fc216f70-bedd-ac44-e040-bb89ad433387

  1. CT scan or not

    1. Listen to podcast: Does My Child Need a CT Scan After Their Concussion? (~20 minutes) https://podcasts.apple.com/us/podcast/does-my-child-need-a-ct-scan-after-their-concussion/id1501459416?i=1000613286659

    2. Read Pedsconcussion.com Section A,  2.1D (~2 min)  https://pedsconcussion.com/section/a/

B. Predicting persistent symptoms (this is also done during acute assessment)

  1.  Read the info about this screening on the home page (~5 min) https://5pconcussion.com/ 

  2. Look at Score Calculator: 5P (~3 min)  https://www.5pconcussion.com/en/scorecalculator

Unit 5: Science Writing

Do this at your own pace throughout the week, each lesson is separate (~2 hours total)