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NEXL CD3 is bringing attention to the danger of concussions in memory of Carl DeVellis 

Concussion Awareness & Protocols:

What You Need to Know About Concussions as a Parent

Correctly identifying a concussion and responding appropriately is uniquely challenging because there are few visible signs. Because concussions are complex and can be difficult to diagnose, schools and athletic programs may be ill-equipped to recognize and treat them. Parents have the ability to close that gap, and advocate for their child’s health and safety, by educating themselves about the most common form of traumatic brain injury. Whether your child is enrolled in sports programs, or not, here is what every parent should know about concussions.

What is a concussion?

A concussion is a type of traumatic brain injury where an abrupt bump or jolt that causes the brain to move inside the skull. When sudden force causes the brain to bounce, twist, or hit the inside of the skull, it can cause damage to brain cells and trigger chemical changes to the brain. The side effects of these injuries can take hours or days to appear, making concussions difficult to diagnose in the immediate aftermath of a head injury.

Key Indicators of Concussion

In the immediate aftermath of witnessing a head injury, you should be on alert for any observed signs of a concussion. Observed signs are behaviors a bystander can identify, according to the Centers for Disease Control and Prevention. Recognizing observed signs of concussions is particularly important in children, as they often can’t communicate their symptoms as well as adults.

Observed signs might include:

  • Being unable to remember what happened before the head injury

  • Appearing dazed, confused, forgetful or clumsy

  • Being slow to answer questions

  • Exhibiting behavior or personality changes.

Reported symptoms are signs that only the person who underwent the head injury would recognize.

According to the CDC, reported symptoms can include:

  • Headache

  • Nausea

  • Blurry vision

  • Sensitivity to light or noise

  • Memory problems and confusion

  • Feeling hazy or foggy, or feeling “down.”

Keep in mind that many people with concussions never lose consciousness. However, if the person was knocked unconscious, a concussion was absolutely sustained, regardless of observed signs or reported symptoms.

Additionally, there may be delayed effects of concussion, which include:

  • Personality changes

  • More significant memory loss

  • Trouble sleeping

  • Differences in taste or smell

  • Irritability

  • Psychological problems, such as depression

Risks of Concussion

Children’s still-developing brains are more susceptible to concussion than adults, according to the Concussion and Brain Injury Clinic at Weill Cornell Medicine, and kids who are active, especially kids who play sports, face an increased risk.

Returning to play too early risks additional head injuries that can compound the effect of a concussion, further amplifying the potential for lasting damage. It can take up to a week for head pain stemming from a concussion to appear. The longer a concussion is untreated, the greater the risk of long-lasting side effects such as post-traumatic headache or second impact syndrome—when someone gets a second concussion before the first one had time to heal.

When to See a Doctor

Even if your child shows no symptoms of concussion, it’s important to know what to watch for in the days following a head injury. The American Academy of Pediatrics recommends a doctor visit within 1-2 days for anything more than a light bump on the head.

If your child develops a new or worsening headache, seems more tired, sluggish or uncoordinated, or behaves in any way that seems out of character, seek medical care immediately. 

Certain symptoms may be signs of a brain bleed and require immediate emergency medical care. These are known as danger signs.

Concussion Danger Signs

  • Loss of consciousness

  • Vomiting

  • Different pupil sizes

  • Difficulty waking up in the days after an injury

Concussions are serious injuries, but unlike an illness or broken bone, they can be difficult for parents to detect. Young children may have difficulty explaining symptoms like sluggishness or disorientation, and older kids and teens, especially athletes, may be tempted to brush off their symptoms. Talking to your child before the issue comes up about the seriousness of head injuries, and being mindful of these signs, can help you identify a concussion and get the treatment he or she needs. For more tools for parents, visit our resource center.

Action Plan: What to Do After Sustaining a Concussion

Follow this protocol after a sports-related head injury

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Concussions are a form of traumatic head injury caused by a bump or blow to the head, or even a subtle, sharp jolt. While their symptoms can seem minor or take some time to appear, concussions carry serious risks and can have long-lasting side effects.

If you, your child or your athlete experiences a head injury during practice or a game, consult the return-to-play protocol that is set in place by the league or the school. All 50 states have return-to-play laws, but schools, sports leagues and organizations adopt them differently, according to the CDC. If a specific plan isn’t in place—or it doesn’t seem thorough enough—consult the CDC’s guidelines, which are a good benchmark for responding to a concussion. Ensure a safe return to play by following this protocol after a head injury:

What to do after a concussion

1. Respond Immediately

Don’t be dismissive about any form of head trauma: Concussions can occur from even a minor bump, and you don’t need to be knocked out to experience a concussion. If you’ve sustained a head injury during an activity, like playing sports, immediately remove yourself from play and take inventory of how you’re feeling.

Be on the lookout for early and common symptoms of a concussion, such as a headache, dizziness, difficulty concentrating, confusion, sensitivity to light, blurry vision, irritability and nausea, according to The Cleveland Clinic. Some symptoms of concussion might not develop until hours—or even days—after a blow to the head, according to the CDC.

2. Sit Out

Once the individual has been removed from play, consult a medical professional if one is available, or call a primary care doctor to discuss the injury. It’s best to take it easy and err on the side of caution. Resuming physical activity too soon after a head injury can make symptoms worse, make recovery take longer or even cause lasting side effects like post-traumatic headache.

Recovery from a concussion takes up to two weeks for many people, or even longer for about 20 percent of the population, according to the Mayo Clinic. Don’t try to rush back into action until you’ve been cleared by a doctor.

3. See a Doctor

It’s best to seek medical attention as soon as you recognize concussion symptoms for an exam and diagnosis. Even if you felt well initially after your head injury, visit your doctor if you start to feel any concussion symptoms later. It’s not unusual for the effects of a concussion to be delayed by days or weeks. Post-concussive syndrome can appear even months after your initial injury. Untreated concussions can have serious, long-term effects, including post-traumatic headache and neurodegenerative issues, according to the Mayo Clinic.

Remember to give a detailed report of the injury. The health care provider will want to know things such as what caused the injury, how forceful the blow was and if the player sustained any loss of consciousness, memory loss or seizures. Be as detailed as possible in describing when your symptoms appeared and how severe they were; this can help a doctor determine the severity of your injury. You should also mention if the player has had previous concussions.

4. Watch for Additional Symptoms

Concussion symptoms aren’t limited to head pain. Sluggishness, clumsiness and just feeling “off” are key indicators that your head injury could be more serious. If a player demonstrates any of the dangerous symptoms associated with a concussion—such as loss of consciousness, a seizure, one pupil larger than the other or trouble recognizing people or places, according to Rush University Medical Center—call an ambulance right away.

Even if you don’t feel different immediately after bumping your head, you might still have a concussion and should watch out for the typical warning signs. Nausea, loss of consciousness and head pain are more noticeable symptoms of concussion, while others—like changes in your behavior or personality, or mood swings—can be harder for you to recognize. Concussion symptoms can vary from person to person, and they can emerge or worsen when you engage in physical activities or activities that require concentration.

If the child’s parents or guardians are not at the game or practice, contact them immediately to let them know about the injury and suspected concussion. Provide them with any informational materials you have about concussions, and refer them to additional online resources such as CDC’s HEADS UP Resource Centeror the Sports Concussion Resources from the American Academy of Neurology.

5. Recovery

Once you’ve been diagnosed with a concussion, follow your doctor’s prescribed treatment plan. There’s no one “cure” for a concussion, but following your treatment plan will give your brain the time and care it needs. It can take several weeks to recover from a concussion, and during this time you’re especially vulnerable to brain injuries like second impact syndrome—a second concussion before the first one had time to heal. So take it nice and slow. The CDC recommends asking your doctor for guidelines on when you’ll be well enough to drive or ride a bike and return to work. Get plenty of rest and avoid alcohol, drugs and physically demanding activities, and reintroduce things into your routine gradually.

Returning to Play

People with concussion can return to playing sports and being active once their concussion has healed and they’ve been cleared by a medical professional. Returning to play should be done with the utmost care. Ease in with light aerobic activities, gradually working your way back, and monitor your concussion symptoms closely during this time.

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