SCAT in the Wilderness

Abstract

Bob Norris is correct, some surfing is an indoor sport1.Norris R. Surfing is an indoor sport.Wilderness Environ Med. 2005; 16: 61Abstract Full Text Full Text PDF Scopus (1) Google Scholar and a pretty low risk for trauma, except maybe for carpal tunnel overuse injuries! However, in that same recent issue of our journal2.Taylor D.M. Bennett D. Carter M. Garewal D. Finch C. Perceptions of surfboard riders regarding the need for protective headgear.Wilderness Environ Med. 2005; 16: 75-80Abstract Full Text Full Text PDF PubMed Scopus (31) Google Scholar we also open to page 75 to have illustrated for us a perfect example of two main issues in sport concussion. First, and no surprise to Wilderness Medical Society practitioners or participants, we learn that head injuries certainly do occur in the sport medicine “subspecialty” of wilderness medicine in, but not limited to, activities such as surfing,2.Taylor D.M. Bennett D. Carter M. Garewal D. Finch C. Perceptions of surfboard riders regarding the need for protective headgear.Wilderness Environ Med. 2005; 16: 75-80Abstract Full Text Full Text PDF PubMed Scopus (31) Google Scholar, 3.Nathanson A. Haynes P. Galanis D. Surfing injuries.Am J Emerg Med. 2002; 20: 155-160Abstract Full Text Full Text PDF PubMed Scopus (115) Google Scholar, 4.Sunshine S. Surfing injuries.Curr Sports Med Rep. 2003; 2: 136-141Crossref PubMed Scopus (22) Google Scholar, 5.Taylor D.M. Bennett D. Carter M. Garewal D. Finch C.F. Acute injury and chronic disability resulting from surfboard riding.J Sci Med Sport. 2004; 7: 429-437Abstract Full Text PDF PubMed Scopus (80) Google Scholar glacial sports,6.Johnson S.M. Johnson A.C. Barton R.G. Avalanche trauma and closed head injury: adding insult to injury.Wilderness Environ Med. 2001; 12: 244-247Abstract Full Text Full Text PDF PubMed Scopus (25) Google Scholar,7.Schindera S.T. Triller J. Steinbach L.S. Zimmermann H. Takala J. Anderson S.E. Spectrum of injuries from glacial sports.Wilderness Environ Med. 2005; 16: 33-37Abstract Full Text Full Text PDF PubMed Scopus (15) Google Scholar off-road biking,8.Chow T.K. Kronisch R.L. Mechanisms of injury in competitive off-road bicycling.Wilderness Environ Med. 2002; 13: 27-30Abstract Full Text Full Text PDF PubMed Scopus (44) Google Scholar,9.Kronisch R.L. Pfeiffer R.P. Mountain biking injuries: an update.Sports Med. 2002; 32: 523-537Crossref PubMed Scopus (66) Google Scholar high-altitude events,10.Thole R.T. Preparation and medical management of events in mountain and high-altitude environments.Curr Sports Med Rep. 2004; 3: 128-133Crossref PubMed Scopus (9) Google Scholar hiking, rafting, swimming, and back-country activities,11.Newman L.M. Diekema D.S. Shubkin C.D. Klein E.J. Quan L. Pediatric wilderness recreational deaths in western Washington State.Ann Emerg Med. 1998; 32: 687-692Abstract Full Text Full Text PDF PubMed Scopus (19) Google Scholar to name a few. Second, this article highlights thinking that mirrors the main driving force for the recent International Concussion meeting held in Prague in November 2004. That is, athletes and health care providers do not necessarily know when a concussion is sustained and an important component of protection and education is included in the most-effective management. Two goals that were achieved were unprecedented before the First International Concussion Symposium in Vienna in 2001, brought together by the Federation Internationale de Football, the International Olympic Committee Medical Commission, and the International Ice Hockey Federation. Consensus by experts on concussion topics was developed for the first time, culminating in the development of the Concussion in Sport Group, and the document from that meeting was simultaneously published in 3 separate journals (copyright to the authors!—the point being that dissemination of the material free of charge would improve the health care of the concussed athlete).12.Aubry M. Cantu R. Dvorak J. et al.Summary and agreement statement of the First International Conference on Concussion in Sport, Vienna 2001. Recommendations for the improvement of safety and health of athletes who may suffer concussive injuries.Br J Sports Med. 2002; 36: 6-10Crossref PubMed Scopus (514) Google Scholar, 13.Aubry M. Cantu R. Dvorak J. et al.Summary and agreement statement of the 1st International Symposium on Concussion in Sport, Vienna 2001.Phys Sportsmed. 2002; 30: 57-63Crossref PubMed Scopus (70) Google Scholar, 14.Aubry M. Cantu R. Dvorak J. et al.Summary and agreement statement of the 1st International Symposium on Concussion in Sport, Vienna 2001.Clin J Sport Med. 2002; 12: 6-11Crossref PubMed Scopus (239) Google Scholar The success of that endeavor was acclaimed to the extent that, 3 years later, the update meeting in Prague, in November, 2004, was a monumental success. The resulting papers were published recently, again in multiple journals,15.McCrory P. Johnston K. Meeuwisse W. et al.Summary and agreement statement of the 2nd International Conference on Concussion in Sport, Prague 2004.Br J Sports Med. 2005; 39: 196-204PubMed Google Scholar, 16.McCrory P. Johnston K. Meeuwisse W. et al.Summary and agreement statement of the 2nd International Conference on Concussion in Sport, Prague 2004.Physician & Sports Medicine. 2005; 33: 29-44PubMed Google Scholar, 17.McCrory P, Johnston K, Meeuwisse W, et al. Summary and agreement statement of the 2nd International Conference on Concussion in Sport, Prague 2004. Neurosurgery. In press.Google Scholar, 18.McCrory P. Johnston K. Meeuwisse W. et al.Summary and agreement statement of the 2nd International Conference on Concussion in Sport, Prague 2004.Clin J Sport Med. 2005; 15: 48-55Crossref PubMed Scopus (173) Google Scholar and are available for download from websites of the publishing journals and other nonprofit injury-prevention groups, such as www.thinkfirst.ca, all free of charge. The publication reviews and updates the current definition of concussion; the classification—introducing the simple vs complex concussion injury; outlines important clinical issues, including the preparticipation exam, signs and symptoms, cognitive testing, management strategies, rehabilitation and return to play approaches, and research issues. In addition, the new SCAT (Sport Concussion Assessment Tool, named as a token effort to remind us that we are still in the wilderness), is a standardized tool for assessment and patient education, and is also downloadable from www.wemjournal.org. Thus, although postinjury extrication may vary whether you are sacked as a quarterback or fall off your llama, the principles of management of the concussion are identical. I encourage interest in this user-friendly downloadable document and tool and persuade you that it was not only inspired by professional or Olympic sport but by the many recreational sporting activities that potentially could get any of us injured, in back or front country, at altitude or depth. The Summary and Agreement Statement of the 2nd International Conference on Concussion in Sport, Prague 200418.McCrory P. Johnston K. Meeuwisse W. et al.Summary and agreement statement of the 2nd International Conference on Concussion in Sport, Prague 2004.Clin J Sport Med. 2005; 15: 48-55Crossref PubMed Scopus (173) Google Scholar and the Sport Concussion Assessment Tool (SCAT) are reprinted at www.wemjournal.org with permission. Copyright © 2005 by the Concussion in Sport Group. Download .pdf (.42 MB) Help with pdf files Supplementary data