Week 2, Day 4

Welcome to week 2 of your internship with Concussion Alliance! Last week was a great start to the program and we have lots to look forward to. This week, you will be assigned to your project and will get to sign up for the newsletter! We heard you on the curriculum load, let us know if we did a good job tailoring.

Zoom Link: https://us02web.zoom.us/j/8428523914?pwd=dXA0TkRocTE2RjJHUzJGNGx6UEJzdz09.

Our second expert guest speaker today is Dr. Shayza Karmali on Friday at 12:00 pm PT | 2:00 pm CT | 3:00 pm ET. Dr. Karmali is the Research Manager at the British Columbia Injury Research and Prevention Unit (BCIRPU), British Columbia Children’s Hospital. You can check out her short profile on our website here.

We also have Social Hour today at 10:00 am PT | 12:00 pm CT | 1:00 pm ET. Use the Zoom link below for the meeting!

https://brynmawr-edu.zoom.us/j/94797601705?pwd=U0xuWUNWWUErcUpWVlBhR2pqZjFXdz09Meeting

ID: 947 9760 1705
Passcode: 695636

Start-of-day Procedure

I’ll outline the procedure that we’d like for you to use for starting your days with us this summer. I’ll talk more about this at the welcome meeting and include this text for each “day” page this week.

  1. Check Slack for new messages

  2. Check the schedule in #weekly-schedules on Slack, on the week page in this portal, or on the shared Google Calendar (more on that below)

  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 (this will come into play starting later this week).

  5. Check in with your PM on Slack

  6. Check in with your project partner(s) on Slack (again, this will be relevant once you start your projects).

There are four Tasks to do today:

  • If you have not already, write in the thank you document to Dr. Valera

    • Please write a note to Dr. Valera thanking her for speaking Tuesday. As part of showing professionalism and respect to our speakers for taking time out of their schedules to talk to us, we try to send these thank you notes back within 2 business days of their talk. You can write your note here.

  • Sign up for Grammarly Premium! The link may have ended up in your spam, so check there if you cannot find the email.

  • Continue to look through your project info!

    • Look over the resource page(s) for your project

    • Check your emails - you should be CC’d on an email to project mentors from your program manager shortly.

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.

Unit 1B: Actual Assessments (~70 minutes)

  • 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.

A. Acute Assessment (0-10 days post-concussion)

  1. Symptom Assessment

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

      1. Read domain 2.1a of section A (~ 2 min) https://pedsconcussion.com/section/a/

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

      1. Read domain 2.1c of section A (~2 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

  2. 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. Read this section: https://pedsconcussion.com/pedsconcussion-physical-examination/

      2. 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.” 

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

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

  3. 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

  4. 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 (~2 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 

  5. 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  (~2 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 (~2 min) https://cde.nida.nih.gov/instrument/fc216f70-be8e-ac44-e040-bb89ad433387

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

      3. Look at actual questionnaire 2 (~1 min) https://cde.nida.nih.gov/instrument/fc216f70-be8e-ac44-e040-bb89ad433387/module/fc216f70-be8f-ac44-e040-bb89ad433387/question/fc216f70-bedd-ac44-e040-bb89ad433387

  6. 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 (~1 min)  https://www.5pconcussion.com/en/scorecalculator