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Recognizing a Concussion

Player concussion has become a widely discussed topic in contact sports in recent years. The increased incidence of serious head injuries, especially at amateur level, where appropriate medical expertise is not always present is a worrying concern. Thankfully both the IRFU and GAA are addressing the issue and there has been a surge of information and training available to players, parents, coaches and first aid responders.

Concussion
Concussion is a traumatic brain injury. It is a complex process in which forces are transmitted to the brain and result in temporary impairment of brain function. Concussion can have a significant impact on the short and long term health of player if not managed correctly.

Concussion can be caused by a direct blow to the head or body and from whiplash type movements of the head and neck that can occur when a player is tackled or collides with another player or the ground. Immediately following a suspected concussion, the brain is susceptible to further significant damage in the event of another impact. Recognizing that a concussion has occurred and immediately removing the player from play is the first and most important responsibility of those who have witnessed the incident.

The most obvious evidence that a concussion has occurred are the visual clues at the scene. These include:

  • Slow to get up
  • Unsteady on feet
  • Balance problems or falling over
  • Grabbing/clutching head
  • Dazed, blank or vacant look
  • Confused/not aware of play or events
  • Suspected or confirmed loss of consciousness
  • Loss of responsiveness

Apart from the visual clues, other signs and symptoms of concussion include:

  • Nausea or vomiting
  • Drowsiness
  • Player more emotional
  • Player is irritable
  • Dizziness
  • Memory loss
  • Feeling like “in a fog”
  • Player is nervous/anxious
  • Blurred vision
  • Don’t Feel Right
  • Headache
  • Sensitivity to light
  • Pressure in Head

The signs and symptoms of concussion usually start at the time of the injury but the onset of these may be delayed for up to 24–48 hours. Once a concussion has been suspected and the player removed from play there are further guidelines on how to manage the player’s care. I will discuss these in a later column.