CONCUSSION

INFORMATION

Concussion is a type of brain injury brought on by a force of the head or anywhere on the body that transmits a force to the head (i.e. ‘ hip and shoulder’/bump in AFL)

Recognising concussion can be difficult as the signs and symptoms can be variable, non-specific, subtle and delayed.

The evidence suggests only 10% of concussions involved a loss of consciousness.

SIGNS & SYMPTOMS

Those who best know the player may pick up on the subtle signs of concussion. Any player that shows any of the following signs or symptoms should be immediately removed from the ground and not allowed to return to play the same day:

• Loss of consciousness

• Balance or walking difficulties

• Blank/vacant stare or dazed look

• No protective seizure when falling to the ground

• Impact seizure

• A significant change in behaviour that’s not consistent with the player’s personality

Immediate referral to the Emergency Department is required for:

• Severe neck pain

• Increase irritability or worsening confusion

• Ongoing vomiting

• Decreasing conscious state

• Severe or increasing headache

• Numbness and/or weakness in the arms and/or legs

MONITORING

It’s important to monitor/re-assess players throughout the game, as delayed presentation of symptoms is not uncommon

SIDELINE TESTING

Maddock’s questions are highly specific for sideline assessment of concussion.

• What venue are we at today?

• What half is it now?

• Who scored last in this match?

• What team did you play last week/game?
• Did your team win it’s last game?

A useful tool to help you recognise concussion is the concussion recognition tool 6 (CRT 6) The Concussion Recognition Tool 6 (CRT6) (bmj.com)

When in doubt, sit them out

DESCRIPTION

Any athlete with a suspected or confirmed concussion should be accompanied home by a responsible adult. in the first 24 hours, they should not be allowed to drive, advised to avoid alcohol and avoid taking anti-inflammatories, aspirin, sleeping tablets and sedating pain medications. They need complete ‘brain’ rest, which means not using phones, watching TV, using electronics devices, etc. After 24 hours without symptoms, the player can return to gradual cognitive (work/study) and physical activity.

In regards to children, a more conservative approach is warranted. ideally, the child should have ‘brain’ rest for 48 hours before returning back to school. “Return to learn’ is the priority. The school environment can be modified to include extra regular breaks, reduced contact hours and workload and increased time to completed tasks. Players should not return to any contact training until they have been symptom free at rest for at least 14 days. They should not return to games until 21 days from their injury. These timelines may need to be extended if their recovery is slower than expected or if they have not completed a graded return to activity. This means that, in most cases, players will miss 3 games after a concussion.