Concussions are a very common type of traumatic brain injury that often occur in the realm of sports and recreation. Knowing what to do to administer first aid to someone suspected of having a brain injury can be life saving and can help prevent permanent brain damage. There are many misconceptions regarding concussions and the importance of properly treating even the mildest of brain trauma must not be overlooked.
Loss of consciousness is not required for a diagnosis of concussion, but it can be a sign of something more serious going on (such as bleeding in the brain). If loss of consciousness persists for more than a few seconds then 911 should be notified immediately.
If they seem woozy, sleepy or are unable to identify who they are, where they are or what day it is, then a brain injury should be suspected. Amnesia is common in concussed persons and they may have difficulty remembering simple questions or following simple commands.
Concussions and head trauma are usually the result of high impact forces which may lead to other injuries such as to the spine, chest or abdomen. If the injured person is unable to communicate properly, then they should be carefully evaluated for other injuries and they should be immobilized until a spinal injury can be excluded.
Once other serious injuries have been excluded, the patient should be removed from the field of play or scene of the trauma so as not to risk further injury. It is also important to continuously re-evaluate them to make sure that their condition does not worsen. Brain injuries can often present in one manner and then can change or deteriorate later on.
Concussions need to be evaluated by a healthcare professional in order to determine further treatment and when return to play and activities is safe. Different states may define the appropriate healthcare provider as a physician, athletic trainer or other allied health professional. It is important to have knowledge of your state’s or athletic body’s requirements and the expertise of the healthcare provider.
In addition to more severe types of head trauma, spinal injuries also need to be considered especially in the unconscious athlete or the athlete that is unable to communicate properly.
Loss of consciousness is only one possible symptom of concussion. Concussions are serious injuries regardless of whether loss of consciousness is involved. Symptoms such as headache, lethargy, confusion, amnesia, ringing in the ears, visual changes, balance problems, nausea and vomiting can all be signs of concussion or even more severe brain trauma and should not be ignored. Athletes commonly state they “Got their bell rung” or “saw stars” as ways of explaining concussion symptoms. Athletes especially will try and minimize their symptoms or hide concussions.
If concussion is suspected then all further risk of head trauma must be completely eliminated. This includes not allowing them to continue with their sport or activity. “When in doubt, sit them out!” If a second head injury is allowed to occur before the initial concussion has fully recovered, then the patient may be at risk for developing more long term brain damage or may even develop “Second Impact Syndrome” which can occur rapidly and has a high rate of mortality.
Although a concussion is a serious injury, it is not essential that they be evaluated in the emergency department or receive a CAT scan unless other injuries are suspected. Timely follow-up with the appropriate healthcare professional can occur on a non-emergent basis.
Physical and cognitive (mental) rest is required to allow the brain to fully heal after a concussion. Every concussion is different and some require longer healing times than others. Determining when the brain has fully recovered and when it is safe to return to sports and activities should be left to healthcare professionals who have expertise in managing concussions.
Concussions are common brain injuries that may occur due to sports or recreational activities. Symptoms of concussion can be varied including loss of consciousness, lethargy, headache, disorientation, amnesia, visual or hearing changes, nausea, vomiting, etc and thus concussion must be suspected and not overlooked in an injured person with any of these symptoms. Other injuries including more severe brain trauma as well as spinal injuries must always be considered in the concussed person and must often be assumed until proven otherwise.
In order to prevent further brain injury and to allow for proper healing, the concussed person must be removed from all sports and activities until they can be evaluated by a healthcare professional. All concussions are different in their symptomatology and duration and therefore experience in the management of concussion is essential in order for the healthcare professional to determine when it is safe to return to sports and activities.
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