1. CONCUSSION

2. The syndrome of concussion is very common in sport. • It is a transient condition with full recovery anticipated.

3. CAUSES • Blow to the head or face - The head coming to a sudden stop or being propelled forward suddenly resulting in sudden acceleration/deceleration eg-Landing on the back after a fall from a height.

4. SYMPTOMS - Mechanism of injury- Loss of consciousness (Can last from seconds to minutes)- Confusion or agitation- Memory loss & impaired information processing.- Blurred vision- Headache- Loss of balance, “dizziness”- Nausea

5. MANAGEMENT • Suspect the athlete has concussion if there is: • - Obvious loss of consciousness- Altered mental state- Unable to answer simple questions eg. Who are we playing? • If there are no symptoms or signs of concussion he/she MAYbe considered for return to play.

6. If these symptoms are present: - If athlete is unconscious, apply DRABC- Assume cervical spine injury till proven otherwise by appropriate protocol- Appropriately immobilise the athlete- Once DRABC is stable, remove the athlete from play- Transport to hospital for urgent medical referral

7. If there is any memory loss, then the athlete has lost consciousness and requires management. The severity of the brain injury is related to the duration of the period of memory loss and the length of the period of loss of consciousness. See your notes for Concussion Classifications

8. See Handout - Management of an athlete who has lost consciousness

9. COMPRESSION • A blow to the head can bruise the brain tissue, resulting in: - Swelling- Tissue damage- Bleeding • The amount of swelling and bleeding depends upon the severity of the blow. This swelling may not occur immediately, but may develop over the following few hours. Therefore all head injuries must be referred to a doctor for further assessment.

10. Signs of bleeding into the brain • If the following symptoms are noticed 4-6 hours following a blow to the head the athlete must be referred to a doctor immediately: - Tiredness & Drowsiness- Listlessness- Headache- Nausea and possible vomiting- Lack of Co-ordination- Loss of balance- Dizziness- Possible blurred vision or visual disturbance.

11. Future management • Athletes who have lost consciousness should: • Receive a medical clearance before resuming training and competition. • - Once medical clearance has been received, the athlete should follow a plan of graduated return to general exercise, then non-contact drills and then contact drill. Should symptoms of headache, recur at any stage, the athlete should be referred back to a doctor for reassessment. • - Pass a skills test before returning to full training and competition- Should the athlete develop headache, lethargy or nausea with any of these activities, the activity should cease and the athlete should be referred back for further medical opinion. • The athlete’s skill and coordination will be the last function to regain normal levels of skill following an episode of concession.