MANAGE
IMMEDIATE
MANAGEMENT
MANAGEMENT
ONGOING
MANAGEMENT
MANAGEMENT
PERSISTENT
SYMPTOMS
SYMPTOMS
MULTIPLE
CONCUSSIONS
CONCUSSIONS
IMMEDIATE MANAGEMENT
If you suspect a concussion in yourself or an athlete/player inform the appropriate people (coach, teacher, physio, parents, etc.). The individual should be removed from play/physical activity immediately – DON’T PLAY ON and seek medical advice for confirmation.
Sometimes a concussion is difficult to identify and symptoms may develop over a period of time. A tool such as a Concussion Recognition Tool 5 can sometimes be beneficial in helping to identify concussion. If there is any suspicion of a concussion – please DON’T PLAY ON and seek medical advice for confirmation.
Anyone with concussion or suspected concussion:
Should not be left alone in the first 24 hours. They should be accompanied by a responsible adult.
Should not consume alcohol in the first 24 hours, and beyond that period continue to avoid alcohol until medical clearance has been provided or they are symptom free.
Should not drive a motor vehicle until medical clearance has been provided or they are symptom free.
The Concussion Recognition Tool 5 is useful to carry at sports events. It can help you to identify concussion and give advice on immediate management.
ONGOING MANAGEMENT
Principles of treating concussion – ‘Rest the Body/Rest the Brain’
Rest is the key component of concussion treatment. This includes ‘physical rest’ from activities such as running, cycling and swimming, as well as ‘cognitive rest’ from activities such as school work, homework and watching screens (television, tablets or phones). Giving the brain a break from strenuous mental and physical activity will allow symptoms to recover more rapidly and a quicker return to sport.
After a brief period of rest (24-48 hours) activity should be increased gradually and progressively, staying below levels that increase symptoms.
How To Return To Study/Work
During the first few days after a concussion, activities that involve concentration and focus can make symptoms such as headache and blurred vision worse. In this acute period, modifications to school/work may be necessary to allow the brain to recover.
How To Return To Sport
Any physical activity that raises heart rate may also increase symptoms in the early days of a concussion. Following a short period of complete rest (24-48 hours) a low-level of physical activity can be commenced, selecting a level where symptoms do not increase. Strenuous activity should be avoided in this period. There should be a full, symptom-free return to tasks at work or school before a return to physical activity is considered.
Once symptoms have settled, a gradual return to sport can be commenced over 6 stages, with a minimum of 24 hours between each stage.
The progression between each stage is guided by the appearance or increase of concussion symptoms.
Progression through the return-to-play process takes a minimum of 7 days. The length of this process will vary between individuals and the specific sport.
If concussion symptoms persist beyond 14 days please seek medical attention.
PERSISTENT SYMPTOMS
Most athletes recover from a concussion within 7 to 10 days. Recovery can take longer in children and adolescents. While 90% of athletes/players will recover within this period, 10% will continue to experience persistent symptoms.
Factors that may predispose someone to a prolonged recovery from concussion include:
Hover over for more info
Common persistent symptoms include:
If an athlete’s symptoms persist for more than 2 weeks after the concussion they should go back to see their GP.
This may include onward referral to Neurology, Neurosurgery or Sports Medicine doctors or further management from your GP or other healthcare providers.
This diagram illustrates when it is important to seek medical attention following a concussion and what the potential outcomes of this may be.
Individual sports’ governing bodies may have their own sport-specific guidelines for managing concussion and these should be referred to where available.
Other healthcare disciplines, such as a Physiotherapist or Psychologist may manage some prolonged post-concussion symptoms. Medical advice should be sought initially to direct to the most appropriate treatment.
Seek medical advice intially to direct to the most appropriate treatment if concussion symptoms persist.
MULTIPLE CONCUSSIONS
Symptoms of concussion are not always immediate, but typically present within the first 24-48 hours following a head injury.
Most concussions resolve within several days of rest, but in some cases, symptoms can persist beyond 14 days. If symptoms do persist, please consider the following:
Any athlete who has sustained two or more concussions within the last 12 months should consider attending a Medical Practitioner experienced in the management of concussion.
An athlete who sustains more than one concussion in their playing career may require a longer recovery period than advised in these guidelines.
An athlete who has had a previous concussion and who sustains a new concussion(s) may need specialist assessment.
Worrying features include getting concussed with progressively lower impact forces or taking progressively longer to recover from each episode.
These individuals require careful management ideally with medical supervision. If this trend continues, it may be a cause for retirement from a high-risk sport.
Rules regarding return to sport after multiple concussions can vary depending on the sport.
Headache is the most common persistent symptom post-concussion but may be due to other causes – seek medical advice.
