A concussion is a brain injury and all brain injuries are serious. They can range from mild to severe and can disrupt the way the brain normally works. Even though most concussions are mild, all concussions are potentially serious and may result in complications including prolonged brain damage and death if not recognized and managed properly. In other words, even a “ding” or a bump on the head can be serious.

When do Concussions Occur?

Concussions are caused by a bump, blow, or jolt to the head; or by a blow to another part of the body with the force transmitted to the head causing the brain to move rapidly back and forth. You can’t see a concussion and less than 10% of concussions occur with loss of consciousness. Signs and symptoms of concussion are different for each person and may show up right after the injury or can take hours or days to fully appear. If your participant reports any symptoms of concussion or if you notice the symptoms or signs of concussion yourself, as described below, seek immediate medical attention.

Signs & Symptoms of a Concussion

*Be ready to recognize and respond to a suspected concussion by knowing the signs and symptoms, and having tools readily available to you.

Danger Signs

Call 911 immediately if any of the following symptoms are observed: • Seizures • Repeated vomiting • Loss of consciousness • Breathing difficulties • Decreasing levels of consciousness • Change in mental status • Pupils unequal • Slurred speech • Unsteady on feet • Headache that worsens • Any other immediate cause for concern

*Do not provide any medications (Tylenol, Advil, etc.), for symptoms.

Post-Concussion Procedure

1. Remove the Participant from Activity • As the instructor, use tools, (such as the CDC HEADS UP App – see back panel) to help assess the situation and decide if a concussion is suspected. The following information can help with the healthcare professional’s assessment:

i. Cause of injury ii. Any loss of consciousness and for how long iii. Any memory loss iv. Any seizures v. Number of previous concussions

• If you suspect a concussion, or your student shows any concussion-like symptoms remove them from activity immediately.

• Do not try to judge the severity of the injury yourself, instead leave this to a healthcare professional.

2. Ensure Participant is Evaluated by Appropriate Healthcare Professional

3. Inform the Participant’s Emergency Contact • Oral and written instructions for home care should be provided to both the participant and caregiver.

4. Keep the Participant from Activity • No participant may return to activity after a suspected concussion, regardless of how ‘mild’ it may seem or how quickly the symptoms appear to clear, without medical evaluation and clearance.’

• During this time, participant may need to avoid activities that require heavy concentration or high activity level as these could increase symptoms.

Throughout this process the participant should be monitored. Do not leave a participant alone that you suspect has a concussion.

Recovery time varies for each person and injury. There is no standard timetable, and the recovery process should not be rushed.

Participants with a history of concussion, traumatic brain injury, migraines, learning disabilities and psychiatric conditions are at an increased risk for slowed recovery and subsequent injury if returning to sports activity too quickly.

Don’t let your participant convince you that he or she is “just fine” and discourage others from pressuring those injured to continue participating.

SIGNS OBSERVED • Appears dazed or stunned • Is confused about events • Answers questions slowly • Repeats questions • Can’t recall events prior to, or after the hit, bump, or fall • Loses consciousness (even briefly) • Shows behavior or personality changes • Forgets schedule or previous instructions

SYMPTOMS REPORTED BY PARTICIPANT Think/Remembering: • Difficulty thinking clearly • Difficulty concentrating or remembering • Feeling slowed down • Feeling sluggish, hazy, foggy, or groggy

Physical: • Headache or “pressure” in head • Nausea or vomiting • Balance problems or dizziness • Fatigue or feeling tired • Blurry or double vision • Sensitivity to light or noise • Numbness or tingling • Does not “feel right”

Emotional: • Irritable • Sad • More emotional than usual • Nervous

Sleep*: • Drowsy • Sleeps less than usual • Sleeps more than usual • Has trouble falling asleep * Only ask about sleep symptoms if the injury occurred on a prior day.

Concussion

Preventative Measures:

• Wear a Helmet ∙ Helmets should meet standards set by the National Operating Committee on Standards for Athletic Equipment • No helmet can prevent a concussion, however equipment that meets standards is effective in reducing skull fractures and more serious head injuries • Ensure all sports equipment used is properly maintained and fitted to participant • Teach proper technique • Teach proper body control • Consistently evaluate speed

Proper Helmet Fitting:

Although helmets do not prevent concussions, they are crucial for preventing other injuries, such as skull fractures. For a helmet to be effective, it must fit properly. To ensure proper fitting, follow these steps.

• Measure – Take a soft measuring tape and wrap it around the head, about 1 inch above the eyebrow. The measurement should match the helmet size (i.e. if the measurement is 56cm, the participant will wear a 56cm helmet). • Try it On – When putting on the helmet, it should feel snug all the way around the head. No excess space should occur between the helmet and the head. If the participant feels pressure spots, the helmet is most likely too small. • Shake Test – With the helmet on, the participant should shake their head around. If the helmet moves on its own, it is too big. Move the helmet to the left and right, up and down. The skin of the head should move with the helmet without the helmet shifting on its own. • Adjust the straps – The Y of the side straps should meet just below the ear, and the chin strap should be snug against the chin so that opening the mouth very wide pulls the helmet down a little.

• Helmet Storage – When not in use, helmets should be stored in a temperature-controlled environment, as extreme heat and cold could affect the integrity of the helmet.

• Replacing Helmets – Helmets should be inspected and replaced regularly, even if they appear undamaged. Check helmet manufacturer for recommended replacement schedule, however most fall within 3-5 years. Program or rental helmets may need to be replaced more frequently than a personal helmet.

FRONT COVER ATTACHES HERE

BACK COVER ATTACHES HERE

CONCUSSION AWARENESS

More information and resources: cdc.gov/headsupHEADS UP App:

cdc.gov/headsup/resources/app.html

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