Can repeated concussions cause brain damage?

Yes.

You want to know more…?

There is now enough evidence that doctors have created or I suppose – defined – a new condition called CTE: Chronic Traumatic Encephalopathy. ‘Chronic’ means it comes on over time, not just from a one-off head injury, ‘Traumatic’ – well we know that’s related to trauma or damage, ‘Encephalopathy’ – brain damage due to swelling. So CTE is a condition caused by repeated blows to the head, leading to eventual brain damage.

How did they decide this? The docs looked at pieces of brain, not knowing whose they were. (I’ll quickly point out this is after the people have died!) They found specific, obvious changes in the brains of some people. Once they had seen these changes they  were told which people the brains had belonged to. It was obvious that they were people who had chronic trauma. These changes could not be explained by any other disease or process. (They weren’t just normal changes from getting old.) They were only found in people who had head traumas.

So yes, they can be quite certain that repeated head injury (whether there are symptoms at the time or not) can lead to permanent brain damage.

How bad does the concussion need to be?

They don’t know yet. They did say CTE “has only been found in individuals who were exposed to brain trauma, typically multiple episodes” and that they don’t have to have had symptoms of concussion at the time. The CTE can start “months, years or even decades” after the last blow to the head.

What are the signs and symptoms of CTE?

  • memory loss, 
  • confusion, 
  • impaired judgment, 
  • impulse control problems, 
  • aggression, 
  • depression, 
  • eventually, progressive dementia

The head injuries seem to cause damage both to the outer layers of the brain as well as the deeper areas.

Treatment?

No, not yet. Although it’s a question often asked in class, they’ve only just figured out for sure that this happens. The best thing we can do is prevent head injuries from happening as far as possible; and know what to do if someone does get a head injury by taking training.

References:

The easier read (but not as easy as the notes above): http://www.neuroscientistnews.com/clinical-updates/cte-confirmed-unique-disease-can-be-definitively-diagnosed

The technical read: http://link.springer.com/article/10.1007%2Fs00401-015-1515-z

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Canadian First Aid Changes 2015-16

Seems like first aid changes every few years: we have to do something to make your re-cert less dull, right? Canadian Red Cross first aid will change during 2016 and even we haven’t had any official updates yet, so here’s some advice and speculation.

When First Aid Changes, what Happens to my Training?

A common enough question, especially for people I’m teaching at the moment, knowing that change is coming long before their certificates expire. The answer is, nothing changes. What you’re taught today is still good for 3 years, even if everything changes! You may have to negotiate with other first adders if they have different training, but things don’t change that dramatically.

911

Which number do People Savers call in emergencies?

So what first aid changes might we expect?

  1. A strong emphasis on your smart phone. Dial 9-1-1, put it on speaker phone and get on with the first aid. Even if you don’t know any, they can talk you through what to do – and yes, that includes CPR.
  2. Stop trying to be perfect. You’ve heard me tell you this in class many times! Anything is better than nothing and when it comes to CPR, basically they’re dead without your help, so do something…. the CPR can be good, better or best!
    1. Good: just follow point 1 – call 911 and do what they say
    2. Better: get training before you need it. Hand’s only CPR is an option.
    3. Best: get excellent training (you know where!) and do CPR including rescue breathing, and using an AED.

From what I see, hand’s only CPR continues to be an option, but is still not ‘the best’. Then again, anything is better than nothing. Getting training remains your best option….. you know what to do!

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Does CPR actually help you survive?

That would be a hard question to answer… except; Sweden! Fully 1/3 of the adult population is trained in CPR and they have a national database of cardiac events. What better place could there be to do some research? So let’s ask some questions about CPR.James tries CPR at age 4

  • Does having that many people trained mean they actually do the CPR?
  • If so, does it work?
  • And if it works, does it make much difference?

Do people do CPR?

Just over 30 thousand cardiac arrests were studied (see below). 51% of people received CPR before the E.M.S. providers arrived on scene. So in country where 1 in 3 adults can do CPR, 1 in 2 receive CPR.

Does CPR work?

Yes.

Oh, ok – the study showed that people receiving CPR had a better chance of survival than those who had to wait for EMS. Even when things like age were included in the statistics. They also saw that the sooner CPR was started, the better chance of survival.

But does CPR make a difference?

In this study, ‘surviving’ meant being alive 30 days after the cardiac arrest. Average survival for people not getting CPR was 4%. Those who got CPR were two and a half times more likely to survive, averaging 10.5%

So in short, if people have CPR training, they will use the skills and increase your survival rate by two & a half times. There’s a good reason to make sure your neighbours are trained.

Original Paper

Early Cardiopulmonary Resuscitation in Out-of-Hospital Cardiac Arrest (New England Journal of Medicine)

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It’s tick time!

Tick Time?

What with the winter being very mild and the spring already having topped 26 C in our area, the ticks are back. We know because one was found on a child at our school last week. So, time to talk about them again….

Ticks are small creatures which will attach themselves to your skin, bite and drink your blood. Many of them are happy to attach to humans, dogs or other animals. There are about 20 species in BC, but only 3 will bite humans. Oh, and they can’t fly or jump!Ticks Sizes from HealthLink BC

Preventing Ticks

  • Cover up before you go out. This may include long sleeves & full length trousers. Consider some kind of cap or hat. Tuck pant legs into socks or boots.
  • Consider insect repellant on bare skin.
  • When you return, check yourself and your companions for ticks – including your scalp.
  • Walk on well cleared trails where possible.
  • Avoid narrow trails which are obvious game routes.
  • Keep lawns short & yard free from leaves & weeds.
  • Keep play equipment away from words & forested areas.

Treatment for Ticks

  • If you do find a tick, brush it off. If it hasn’t started biting, that’s all you need to do.
  • If you find one, check carefully for others
  • If the tick is already biting, use pointed tweezers. Grasp as close to the skin as you can and pull it straight out.
  • Try not to crush or damage the tick. If you want it testing for Lyme Disease it needs to be alive.
  • Clean the bite (soap & water is fine) – it’s still a bite after all!

There are a whole bunch of other methods for removing them. If you have one that works, comment below so we can all learn. Avoid removal methods which risk harming yourself or child e.g.: burning them off with gasoline.

Lyme Disease

  • As far as BC goes, ticks carrying Lyme Disease are more common in coastal BC than the interior. But, well… people travel and ticks can hitch a ride on your dog.
  • About 3/4 of people infected with Lyme Disease will develop the bulls-eye (or Target) rash. But that means 1/4 won’t – don’t use this as your only symptom.
  • Other symptoms include fever, headache, joint aches & pains.
  • If you have the rash or other symptoms, time to see your doctor. In the early stages Lyme Disease is completely treatable.
  • Locally (coastal BC) some docs will treat everyone who was bitten, others will try to have the tick tested first.
  • Untreated Lyme Disease can cause arthritis, heart problems, nervous system disorders and all kinds of nastiness. Deal with it early!

Finally….

Get outside and have fun! Just be aware of what can happen.

BC Ministry of Agriculture Tick page

Healthlink BC includes tick information in various languages besides English

BC CDC on Lyme Disease

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