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A concussion is a temporary loss of usual function caused by a brain injury. Whether the injury came from work, a sport, a car accident, or at home, a concussion protocol is necessary.
What is a concussion protocol?
A concussion protocol is a set of policies that aim to educate and guide all stakeholders with regards to concussion definition and symptoms, immediate recognition, treatment, management, and recovery.
Specific information may vary per organization but the usual details include:
- Diagnostic criteria and clinical symptoms
- Practices monitored throughout the rehabilitation process
- Reintroduction of physical exercise on a timetable
- Instruments for evaluating symptoms and signs
- Medical clearance policies for returning to activity / play
A concussion can be difficult to detect. The symptoms could go unnoticed or they could be mistaken for other injuries or illnesses. Following a fall or head impact, the diagnosis is usually made in an emergency ward or on the sporting field.
Concussion protocol steps
The Centers for Disease Control and Prevention presented a step-by-step plan for getting back to routine activities at home, school, work, and sports. Usually, the doctor-in-charge will let the patient do minimal exercises to slowly get back on track. These activities are for strict monitoring.
The six stages of concussion recovery are:
Rest and return to limited activities
The first step is getting enough rest and avoiding physical effort. The patient should limit screen usage until the doctor clears them for school or work. The goal is to get back to low-risk physical activities such as short 10-minute walks.
Take light aerobic exercises
The goal is to conduct exercises to get heart rate up once they reintroduce moderate activities and symptoms are subsiding further. The patient can take a walk, go swim, or ride a stationary bicycle for 20 minutes at 70% maximum heart rate.
Take sport–specific exercises
Exercises related to a specific sport are gradually reintroduced. These may include contactless workouts, such as sprinting or skating drills.
Contactless drills
The patient performs increasingly demanding drills. They begin strength and resistance training as soon as it’s safe to do so.
Full-contact practice
With the doctor’s approval, the patient participates in full-contact training and practices before returning to competitions, work, school, or daily tasks. They should be closely evaluated after each session.
Return to play
The doctor can clear the patient for competitions if there are no symptoms or concerns found after practice and a thorough examination.
What causes a concussion?
Direct head trauma, such as falling, getting hit, or getting involved in an accident, can cause concussions. They can also happen as a result of abrupt head acceleration and deceleration, such as whiplash or explosion injuries in a combat zone.
Many individuals believe that concussions cause them to pass out or lose consciousness. However, that’s not the case. Many people who have had a concussion didn’t lose consciousness. External markers of head trauma, such as bleeding, may also be missing in certain circumstances.
Signs and symptoms
A concussion can affect memory, judgment, reflexes, speech, balance, and muscular coordination. Most patients often experience short-term memory loss or forgetfulness and may be unable to recall events that occurred shortly before or after the injury.
Emergency responders and sports trainers may ask the injured person if they know their name, the current month and year, and where they are. They use these questions to evaluate if the injury has an immediate effect on memory and speech.
A concussion is a serious matter. Although some concussions seem less dangerous than others, neurosurgeons and other brain injury specialists stress that there’s no such thing as a mild concussion.
A single concussion shouldn’t, in most situations, have long-lasting effects. A second concussion that occurs soon after the first one doesn’t have to be severe to trigger long-term negative effects. Here are some of the common signs and symptoms of a concussion:
- Confusion
- Headache
- Double or blurry vision
- Unbalance or dizziness
- Vomiting or nausea
- Loss of memory
- Ears ringing
- Concentration problems
- Light sensitivity
- Loss of smell or taste
- Having difficulty falling asleep
Diagnosis
A coach, sports trainer, or team doctor should conduct a sideline evaluation if they suspect a concussion. This includes testing the patient’s eye movements, language, and attention.
When a person with a head injury arrives at the emergency department, doctors will examine them, check for symptoms, and ask them what happened. If necessary, they will perform a CT scan of the head.
After a few hours of monitoring in the emergency room, patients with minor head trauma are often sent home. In the following 24 to 48 hours, a family member or caregiver must closely observe the patient and watch for changes in behavior. On the other hand, the hospital will admit patients who have suffered a moderate to severe traumatic brain injury for treatment.
Go to the ER if any of these symptoms worsen or appear:
- Persistent drowsiness which makes it difficult to stay awake or to wake up from a nap
- Migraine that worsens and doesn’t respond to common treatments
- Nausea and frequent vomiting
- Agitation, restlessness, or bewilderment
- Changes in eyesight, speech, or movement
- Convulsion or seizure
Treatment
If symptoms of a concussion are present, the patient must not return to sports or physical activities yet. Treatment for a minor brain injury includes rest and medicines. Time is the best medicine for allowing the brain to repair itself.
It’s highly recommended for patients to get enough rest. Avoid activities that involve physical movement. Avoid activities that require mental attention, such as playing video games, watching TV, texting, or using the computer should also be put on hold. Tasks and activities in work and school should be temporarily reduced as well.
Acetaminophen can help with headaches. Avoid other pain killers, such as ibuprofen and aspirin, since they may increase the risk of bleeding.
Recovery
In one to four weeks, the symptoms of a head injury should progressively improve as long as the patient avoids physically and mentally exhausting activities. However, during recovery, you may experience the following:
- Migraine sufferers may experience more intense pain
- Fatigue and sleep issues
- Memory issues, such as organizing activities, remembering names, or remembering the grocery list
- Trouble concentrating and learning new things
- Irritability and mood fluctuations
- Blurry vision or loss of smell
- Seizures are uncommon following a brain injury, but they might happen in the first week
It’s never too late to prevent a concussion
A concussion increases the risk of a second concussion by 5 times. A second concussion shortly after the first increases the risk of catastrophic brain swelling, thus, preventing a second injury during recovery is critical. Cognitive-behavioral treatment may be beneficial in more severe forms of post-concussion syndrome.
Some things you can do to help prevent or lower the risk of concussions are to wear protective gear or equipment that fits well and to follow sports safety guidelines or rules. If you drive, always wear a seatbelt and drive safely. If you’re going up or down a flight of stairs, always hold on to the handrails to keep yourself steady.
