Subcommittee on Sports-Related Concussions in Canada committee  I would like to thank you for having me here today to speak before the committee. I'm a sport and exercise medicine physician. We're uniquely qualified and experienced in concussion management. Sport and exercise medicine physicians have been founding members of the Canadian

Subcommittee on Sports-Related Concussions in Canada committee  I think it's very sport- and club-specific, to be honest with you. There are some pockets where people have adopted it. They've looked at what they can do to prevent concussion. But there are a lot—I hesitate to say "most"—that probably don't address it; it doesn't even cross the

Subcommittee on Sports-Related Concussions in Canada committee  I'll speak from the emergency medicine perspective because I am an emergency physician also. I'll let Pierre speak to family medicine. We're getting there. I think the challenge in emergency medicine is most of the doctors have the knowledge and the ability to initially manage a

Subcommittee on Sports-Related Concussions in Canada committee  I think they need to have a hard look at their own sport and look where the injuries are happening and what rules can be changed. I think where sport and exercise medicine physicians can add to that is looking to help with education: What do we do when we think we have a concussi

Subcommittee on Sports-Related Concussions in Canada committee  I would like to add to that. I agree with what you said, Pierre, completely. We have to look at the reality that many Canadians don't have coverage for some of these allied health professionals, who are invaluable, and that is a barrier, for sure.

Subcommittee on Sports-Related Concussions in Canada committee  As Pierre said, at the beginning, rest and then gradual return to activity is good for about 90% of patients, but there is about 10% who, after two weeks, still have symptoms. There are chiropractors, physiotherapists, occupational therapists, athletic therapists—am I missing any

Subcommittee on Sports-Related Concussions in Canada committee  I agree with everything Pierre said. I think we have the knowledge. I think we have the evidence. I think we have to keep that coming so that it keeps getting updated and renewed. Then the challenge is really getting that down to more recreational levels without missing anybod

Subcommittee on Sports-Related Concussions in Canada committee  I completely agree with Pierre. The only thing that I would emphasize is that I think we need help in some ways getting the attention of some of these sporting organizations. I don't think they think about it, and it's not because they don't think it's important; it's just that

Subcommittee on Sports-Related Concussions in Canada committee  I would echo that. The Canadian equestrian federation is actually being held up as an example in the international federation for its concussion protocol. That goes greatly against the culture of the sport where you get back up on your horse again. It has accepted that you come o

Subcommittee on Sports-Related Concussions in Canada committee  It has to be done by the sport, and each sport has to look at this. My background is in equestrian sports. I'm the national team physician and it took 10 years for us to change that rule. It's the culture; it's slow moving, but it really has to come from within the sport. Sport

Subcommittee on Sports-Related Concussions in Canada committee  Not being knocked out doesn't mean you don't have a concussion, okay?

Subcommittee on Sports-Related Concussions in Canada committee  It's a two-way street. It's a complex clinical assessment. You have to take into account the injury. Is it a mechanism that could potentially lead to a concussion? Are there signs and symptoms that are consistent with a concussion. It's really important to note there's no one t

Subcommittee on Sports-Related Concussions in Canada committee  For the first three days, it's definitely rest and relaxation. Then we try to increase the activity level gradually. In 90% of patients, in about seven to 10 days, they will be asymptomatic. They'll be able to start a gradual return to sport, learning or work, whatever that is. T

Subcommittee on Sports-Related Concussions in Canada committee  It depends.

Subcommittee on Sports-Related Concussions in Canada committee  The SCAT5 is the sport concussion assessment tool. It's not actually the fifth version, but they call it the SCAT5 for other reasons. The document comes out of the international consensus statement on concussion in sport. There's a narrative that you can read with evidence behin