Concussion Management

HOW DO I DETERMINE IF A CONCUSSION MAY HAVE OCCURRED?

A concussion can only be diagnosed by a physician.

Coaches, parents, and athletes can play an important role in helping to recognize when a concussion may have occurred, and can initiate actions to protect an individual who may have sustained a concussion.

A concussion should be suspected when:

  • 1 mechanism of injury occurs (falls, whiplash, direct blow to head, face, neck, body)

          AND

  • 1 or more signs/symptoms of a concussion are present

WHAT ACTIONS SHOULD BE TAKEN?

If properly trained, ensure that any life threatening scenarios are properly addressed, including ruling out a potential spinal injury.  If in doubt, call Emergency Medical Services (EMS).

Immediately remove athlete from play.

If a trained medical professional is available on-site, he/she can begin sideline assessment of potential concussion.

In the absence of a trained medical professional, record all reported and observed signs and symptoms for the athlete, and monitor for deteriorating conditions.

Ensure that the athlete is accompanied by a responsible adult that can escort the athlete to a Physician for assessment and diagnosis as soon as possible.

Ensure that the athlete begins complete cognitive and physical rest.  This includes avoiding all mental stimulus (reading, TV, computers, video games, music, texting), as well as all physical stimulus (running, hiking, swimming, training). 

Rest is imperative as the best initial treatment for an individual who has sustained a concussion.  A health care professional can help to guide the management and recovery process for a concussion.

WHEN SHOULD I SEEK URGENT CARE? (RED FLAGS)

  • Headaches worsen
  • Neck Pain
  • Seizures
  • Unusual behavior change
  • Repeated vomiting
  • Slurred speech
  • Increasing confusion/irritability
  • Weakness/Numbness in arms or legs
  • Can’t recognize people or places
  • Decreasing state of consciousness

HOW LONG WILL IT TAKE TO RECOVER?

Concussions are complex injuries with varying impacts.  A standardized time frame for recovery does not exist.  Each respective concussion case must be managed and guided individually by a health care professional.  Research continues to explore best practices for concussion management. 

Health care professionals can help to guide recovery, return to learn/work and return to play.

For an adult population, most concussions (80%-90%) resolve in a short period of time (~7-10 days), if managed properly.

For children and teens, recovery may take longer.  A more cautious approach should be exercised regarding return to learn and return to play due to continued brain development.

WHEN CAN AN ATHLETE RETURN TO PLAY?

Once an athlete is asymptomatic and has been medically cleared by a physician, the athlete should initiate a graduated return to play protocol with guidance from a health care professional.

This graduated return to play protocol is adopted from the Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012.

The protocol follows a stepwise progression that will help to safely integrate an athlete back into his/her respective sport following a concussion injury.

After each stage, the athlete should rest and be monitored for any signs/symptoms.

There must be 24 hours between each stage of the protocol.

If any signs/symptoms appear, regardless of severity, the athlete should take a minimum of 24 hours rest before returning to the previous asymptomatic level of the protocol.

GRADUATED RETURN TO PLAY PROTOCOL (click on the image to view)