A man reassures a man strapped to a gurney on concussion sports first aid training course.

How to treat Concussion – An Overview

Concussion is a form of mild traumatic brain injury (TBI) caused by a bump, blow or jolt to the head. Doctors describe this type of injury as “mild” because it is usually not life-threatening but the effects can be serious. Most people recover fully after a concussion but repeated concussions are linked to serious long term brain conditions.

Concussions are particularly common if you play a contact sport, such as rugby or American football.

What happens when you get concussion?

The impact from a traumatic blow to the head or body cause the head and brain to move rapidly back and forth in a whiplash-like fashion. The sudden movement causes the brain to bounce and twist around inside the skull, stretching and damaging the delicate cells and structures inside your brain and bruising it as it pushes against the inside of the skull.

What are the signs and symptoms of concussion?

Signs and symptoms of concussion usually appear within a few minutes or hours of a head injury.
Sometimes they may not be obvious for a few days, so it’s important to look out for any problems in the days following a head injury.

Signs and Symptoms include:

• a headache that doesn’t go away or isn’t relieved with painkillers
• dizziness
• feeling sick or vomiting
• memory loss – you may not remember what happened before or after the injury
• clumsiness or trouble with balance
• unusual behaviour – you may become irritated easily or have sudden mood swings
• feeling stunned, dazed or confused
• changes in vision – such as blurred vision, double vision or “seeing stars”
• being knocked out or struggling to stay awake

Concussion can be harder to spot in babies and young children. As well as the symptoms mentioned above, you need to be aware of any change in their normal behaviour after a head injury, such as:

• crying a lot
• becoming easily upset or increased temper tantrums
• a change in their feeding or sleeping habits
• a loss of interest in people or objects
• loss of new skills, such as toilet training
• poor attention

Treatment for Concussion:

You should go to your nearest accident and emergency (A&E) department if you’ve injured your head and have any of the following:
• woken up after being knocked out
• problems with your memory
• a headache that doesn’t go away
• been vomiting since the injury
• changes in your behaviour, such as becoming more irritable
• had an operation on your brain in the past or are taking blood-thinning medicine such as warfarin
• been drinking alcohol or taking recreational drugs

You will be checked by a health professional trained in assessing head injuries. They will decide if you need a brain scan to rule out a serious brain injury.

When to call 999?

You need to call 999 (or 112) for an ambulance if someone has injured their head and has:
• been knocked out and hasn’t woken up
• difficulty staying awake
• problems with understanding, speaking, writing, walking or balance
• numbness or weakness in part of their body
• problems with their vision
• clear fluid coming from their ears or nose
• bleeding from their ears or bruising behind one or both ears
• a black eye with no obvious damage around the eyes
• a fit (seizure)
• hit their head in a serious accident, such as a car crash

You should also call for an ambulance if someone needs to go to hospital but you can’t get them there safely.

How long does it take to get over mild concussion?

In most cases of mild concussion, it takes about 7 to 10 days to recover. However, if you don’t get enough rest or follow your doctor’s recommendations, recovery may take longer.

Tips for helping you recover from concussion
• get plenty of rest and avoiding stressful situations
• ask someone to stay with you for the first 48 hours so they can look out for problems such as changes in your behaviour or difficulty concentrating or understanding
• take paracetamol or ibuprofen if you have a headache – don’t use aspirin because it could cause your injury to bleed
• avoid alcohol
• when you’re feeling better, gradually increase how much activity you do each day – do as much as you can without your symptoms coming back
• don’t return to things like work, college, school, driving or riding a bike until you feel you’ve recovered
• avoid sports or strenuous exercise for at least a week, and avoid contact sports for at least 3 weeks
• Speak to your GP if you still have symptoms after 2 weeks or you’re unsure about returning to activities such as work or sports.

Post-concussion syndrome

Some people experience concussion symptoms for several months.

Possible symptoms include:
• headaches
• dizziness
• problems with memory or concentration
• unsteadiness
• depression, anxiety and changes in behaviour
You should see your GP if you still have symptoms after 3 months.

The charity Headway has a very useful leaflet on minor head injury and concussion (pdf).

How do you test for concussion?

Your doctor may do a scan of your brain (such as a CT scan) or other tests, known as neuropsychological” or “neurocognitive” tests, assess your learning and memory skills, your ability to pay attention or concentrate, and how quickly you can think and solve problems. These tests can help your doctor identify the effects of a concussion.

Testing for Concussion on the rugby pitch

Knowing when to take a player off the pitch after a blow to the head or body can be a real dilemma for coaches and match officials and there is currently no fool proof pitch side test for concussion.

The RFU have developed a very comprehensive programme to increase understanding and awareness of concussion: https://www.englandrugby.com/participation/playing/headcase

New study into rugby head injury test to immediately diagnose concussion

The University of Birmingham, in association with the Rugby Football Union (RFU), Premiership Rugby and the Rugby Players’ Association are currently developing a new pitch-side test to quickly diagnose concussion and brain injuries. Players with suspected or confirmed concussion will be asked to provide samples of saliva immediately following the injury, as studies have shown it could be a rapid indicator of head injury, and will give follow-up samples as they go through the standard return-to-play protocol. The samples will then be compared to samples taken from other players who did not sustain injuries. If the study proves successful this could lead to pitch-side devices providing quick diagnosis and determining whether players are fit to continue.

First Aid Training for concussion and sports injuries

It is really important to make sure that if you are a P.E, sports teacher, coach or member of the fitness industry that you are up to date with the latest concussion treatment. The HSE strongly recommends that lifesaving skills are updated annually. Our sports first aid training course  helps keep these skills up to date. The course is a FAIB nationally recognised Emergency First Aid at Work for Sport certificate valid for three years.