First, for those of you who don't know what it is, think of a seminar performed over the web. That is how it gets its name. The topic of a webinar can be anything you can think of. The nice part is that you can attend a webinar in your pajamas from home. You are not expected to arrive at some venue and sit in a lecture hall for a seminar. It is an outstanding way to bring content over long distances too, since you don't have to travel.
This webinar was presented my Dr. Mickey Collins, a leader in the United States on sports related TBIs. He is one of the founders of ImPACT software that many schools, colleges, and professional teams use to baseline and test their athletes to judge the severity of a TBI and when it is safe to RTP. It was very encouraging to hear Dr. Collins assert that often times, EDs will give advice as to when it is safe to RTP when they really should not be doing it. There are far too many variables that go into treating a TBI that can create a large difference in the rate of recovery between athletes. He states that there is no way any ED physician could know when it is truly safe to RTP unless they are able to follow up with the athlete consistently. This, of course, is not within the scope of ED physicians. Dr. Collins even went so far as to say ATCs should disregard those recommendations completely. Since I recently had an ED physician try and offer RTP guidelines recently that I ignored, I was very pleased to hear this. However, I foresee a parent who will not be as agreeable when I hold a child out longer than the ED physician stated was necessary in the future and it can create a serious amount of tension. I would hope that some education to the ED physicians about referring mild TBI cases to those trained in follow up care would be shortly forthcoming.
The other fascinating part of the webinar was the description of what is going on physiologically in the brain to create the energy deficit that the brain experiences after sustaining a TBI. Now I admit, I was never one to find the physiology of anything else all that exciting and trying to explain the Kreb's cycle now would be fruitless without some serious review. The concept of how long the brain remains in an energy deficit state is the part that is really scary. With athletes that report lingering symptoms, the deficit can last up to a week in 90% of cases and even longer in the other 10%. A few cases never really recover and need to be removed from participation in contact sports. Certainly after watching the number of videos that can be found on secondary impact syndrome, it is enough to scare anyone into doing the right thing.
Finally, the last point that I found interesting was that the research stated that children who sustain TBIs heal much slower than adults do. Children, whose brains are still developing up until the age of 22, simply take longer to heal from TBIs. That is not the point that was new to me, as I have heard that many times before. However, Dr. Collins points out that just because an NFL player (who are all adults and most are older than 22) can return from a TBI in a week, doesn't mean that a high school player or their parents should think that it is safe for the high school athlete to do the same. Again, this point can become a strong point of contention with a parent who thinks that their son or daughter really needs to be out on the field playing in order to earn the scholarship.
One thing is for sure, I will be sharing this webinar with colleagues so that they can all benefit from the same information.
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