Coordinate and produce local community lectures to increase concussion awareness

  Parents and Guardians

Our definition, and management, of concussion has changed significantly in recent years.

Definition of a concussion

A concussion is a head injury usually caused by a direct blow to the head, but occasionally can be caused by rapid deceleration of the head without a direct blow.

  • A person does not have to lose consciousness to have a concussion.
  • There may or may not be amnesia for the event.
  • There is no test to diagnose or exclude a concussion, including CAT scans or even MRI scans, which are usually normal with concussion.

Identification

Children with concussion typically may have

  • headaches
  • dizziness
  • cognitive changes (from confusion to mild memory loss)
  • increased sleepiness
  • change in personality

The first most important intervention in a sports concussion is to remove the child from play immediately. While coaches usually have education about signs and symptoms of concussion, as a parent you should intervene if the coach allows the child to keep playing. Ideally an athletic trainer on the sidelines should assess the child. If none is available, you should carefully observe the child for any alteration in consciousness, vomiting with headache, or any weakness or loss of balance.

If these signs are present, or you have a high level of concern, you should take the child to the nearest Emergency Room by car or ambulance. If the child is behaving normally and wide-awake, you may be able to take them home and watch them for any of the signs listed above. Tylenol may be used for headaches.

Management

The next important step is to allow the child to rest. You should have the child evaluated by a healthcare professional with experience in concussion within the first 48-72 hours. Until this evaluation, the child should stay home and rest with minimal stimulation

  • no video games, texting, computer or anything else that worsens symptoms

This is called cognitive rest and is key to recovery from concussion. At the healthcare visit, a careful history and neurologic exam will be done. Usually imaging studies (e.g. CAT scans) are not necessary. Your healthcare professional will set up a plan for gradual return to cognitive activity based on the child's symptoms.

Return to Activities

Once the child is able to return to full cognitive activity, including school, a "graded return to play" will be started. This involves starting with low levels of physical exertion and increasing daily as long as the child has no symptoms. Final return to any possible "contact" (e.g. games) will only occur after the child has been able to return to full non-contact exertion without symptoms. This final clearance for return to full activity can by law only be given by a healthcare professional with experience in concussion.

Facts for Parents and Guardians

  • More than 80% of children with concussion will recover in 3-4 weeks if they are managed correctly from the beginning.
  • Children with history of prior concussions or pre-existing conditions such as ADD or learning disability tend to take longer to recover.
  • We do not know if there are a certain number of concussions that lead to long-term damage, so each concussion should be reported and monitored carefully.
  • Your healthcare professional may recommend prolonged absence or even dropping a sport if there are multiple or frequent concussions.

Helpful National Resources

Center for Disease Control (CDC)http://www.cdc.gov/concussion/index.html
CDC fact sheet for parentshttp://www.cdc.gov/concussion/pdf/parents_Eng.pdf

What is the State of Connecticut doing for concussions?

In Connecticut, Public Act 10-62 "An Act Concerning Student Athletes and Concussions" was passed and became effective on July 1, 2010. This bill mandates that coaches of interscholastic and intramural athletes sit for a comprehensive training course on concussion and head & neck injury. Subsequent to this training, the legislation requires that the coach remove from play any player who is suspected as having sustained a concussion, thereafter not to return to play until cleared by a healthcare provider trained in the diagnosis and management of concussion injury.