What are signs of a concussion, and what should be done?

I’m NOT a doctor!   Anything that I’ve written isn’t what should be taken as what must be done, I’m trying to help, but a doctor must be seen if there’s any questions about what you see.  Injuries to the head aren’t something that should be taken lightly, at all.

WHAT IS A CONCUSSION?
A concussion is a brain injury that cannot be seen on routine x-rays, CT scans, or MRIs. It affects the way a child may think and remember things, and can cause a variety of symptoms.

WHAT ARE THE SYMPTOMS AND SIGNS OF CONCUSSION?
A person doesn’t need to be knocked out (lose consciousness) to have had a concussion.

WHAT CAUSES A CONCUSSION? WHAT SHOULD YOU DO IF YOU, OR SOMEONE WITH YOU, GETS A CONCUSSION?
Any blow to the head, face or neck, or a blow to the body which causes a sudden jarring of the head may cause a concussion (ie. a ball to the head, being checked into the boards in hockey). Your child should stop playing the sport right away.  They should not be left alone and should be seen by a doctor as soon as possible that day. If your child is knocked out, call an ambulance to take him/her to the hospital immediately. Do not move your child or remove  any equipment such as helmet, in case of a cervical spine injury.  Wait for paramedics to arrive.

HOW LONG WILL IT TAKE TO GET BETTER?

STEP 1
No activity, complete rest. Once back to normal and cleared by a doctor, go to step 2.

STEP 2
Light exercise such as walking or stationary cycling, for 10- 15 minutes. The signs and symptoms of a concussion often last for 7-10 days but may last much longer. In some cases, children may take many weeks or months to heal. Having had previous concussions may increase the chance that a person may take longer to heal.

HOW IS A CONCUSSION TREATED? THE MOST IMPORTANT TREATMENT FOR A CONCUSSION IS REST.
The child should not exercise, go to school or do any activities that may make them worse, like riding a bike, play wrestling, reading, working on the computer or playing video games. If your child goes back to activities before they are completely better, they are more likely to get worse, and to have symptoms longer. Even though it is very hard for an active child to rest, this is the most important step.

Once your child is completely better at rest (all symptoms have resolved), they can start a step-wise increase in activities. It is important that your child is seen by a doctor before he/she begins the steps needed to return to activity, to make sure he/she is completely better. If possible, your child should be seen by a doctor with experience in treating concussions.

WHEN CAN MY CHILD RETURN TO SCHOOL?
Sometimes children who have a concussion may find it hard to concentrate in school and may get a worse headache or feel sick to their stomach if they are in school. Children should stay home from school if their symptoms get worse while they are in class. Once they feel better, they can try going back to school part time to start (eg. for half days initially) and if they are okay with that, then they can go back full time.

WHEN CAN MY CHILD RETURN TO SPORT?
It is very important that your child not go back to sports if he/she has any concussion symptoms or signs. Return to sport and activity must follow a  step- wise approach:

STEP 1) No activity, complete rest. Once back to normal and cleared by a doctor, go to step 2.

STEP 2) Light exercise such as walking or stationary cycling, for 10- 15 minutes.

STEP 3) Sport specific aerobic activity (ie. skating in hockey, running in soccer), for 20-30 minutes.  NO CONTACT.STEP 3) Sport specific aerobic activity (ie. skating in hockey, running in soccer), for 20-30 minutes.  NO CONTACT.

STEP 4) “On field” practice such as ball drills, shooting drills, and other activities with NO CONTACT (ie. no checking, no heading the ball, etc.).

STEP 5) “On field” practice with body contact, once cleared by a doctor

STEP 6) Game play.

Note: Each step must take a minimum of one day. If your child has any symptoms of a concussion (e.g. headache, feeling sick to his/her stomach) that come back at any step, STOP activity, wait 24-48 hours, and resume activity at previous step.

When should I take my child to the doctor? Every child who gets a head injury should be seen by a doctor as soon as possible. Your child should go back to the doctor IMMEDIATELY if, after being told he/she has a concussion, he/she has worsening of symptoms such as: WHEN CAN MY CHILD RETURN TO SCHOOL? Sometimes children who have a concussion may find it hard to concentrate in school and may get a worse headache or feel sick to their stomach if they are in school. Children should stay home from school if their symptoms get worse while they are in class. Once they feel better, they can try going back to school part time to start (eg. for half days initially) and if they are okay with that, then they can go back full time.

1. being more confused
2. headache that is getting worse
3. vomiting more than twice
4. strange behaviour
5. not waking up
6. having any trouble walking
7. having a seizure

Problems caused by a head injury can get worse later that day or night. The child should not be left alone and should be checked throughout the night. If you have any concerns about the child’s breathing or how they are sleeping, wake them up. Otherwise, let them sleep. If they seem to be getting worse, you should see your doctor immediately. NO CHILD SHOULD GO BACK TO SPORT UNTIL THEY HAVE BEEN CLEARED TO DO SO BY A DOCTOR.

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