Concussion
New government guidance was issued on April 24th 2023 regarding Non-Elite (Grassroots) Sport on concussion and its aftermath.
All those suspected of sustaining a concussion should be assessed by an appropriate onsite Healthcare Professional or by accessing the NHS by calling 111 within 24 hours of the injury. If there are concerns about other significant injury or the presence of ‘red flags’ then the player should receive urgent medical assessment onsite or in a hospital Accident and Emergency (A&E) Department using ambulance transfer by calling 999 if necessary.
"If in Doubt, Sit Them Out"
It can be challenging to detect head impacts and signs of concussion in fast-paced sports. Therefore, it is the responsibility of all parties involved, including players, coaches, teachers, referees, spectators, and families, to be vigilant and identify individuals who may have suffered a concussion, promptly removing them from the game. Continuing to participate in such activities post-concussion can be hazardous and delay the recovery period. The primary objective is to safeguard the individual from further harm by immediately taking them out of play. Before returning to the sport or any activity (education/work), an appropriate Healthcare Professional should evaluate them and successfully complete a gradual return to activity program.
Signs and Symptoms
If any of the following visible symptoms or indications emerge following a head injury, the player should be suspected of having a concussion and immediately removed from the game or practice to be evaluated by a qualified healthcare provider.
- Loss of consciousness or responsiveness;
- Lying motionless on ground/slow to get up;
- Unsteady on feet/balance problems or falling over/incoordination;
- Dazed, blank or vacant look;
- Slow to respond to questions;
- Grabbing/clutching of head;s or events;;
- Grabbing/clutching of head
- An impact seizure/convulsion;
- Tonic posturing – lying rigid/ motionless due to muscle spasm (may appear to be unconscious);
- More emotional/irritable than normal for that person; and
- Vomiting,
Symptoms of concussion at or shortly after injury
The presence of any one or more of the following signs & symptoms may suggest a concussion:
- Disoriented (not aware of their surroundings e.g. opponent, period, score);
- Headache;
- Dizziness/feeling off-balance;
- Mental clouding, confusion or feeling slowed down;
- Drowsiness/feeling like ‘in a fog’/ difficulty concentrating;
- Visual problems;
- Nausea;
- Fatigue;
- ‘Pressure in head’;
- Sensitivity to light or sound;
- More emotional;
- Don’t feel right; and
- Concerns expressed by parent, official, spectators about a player.
afPE
The Association for Physical Education (afPE) guidance includes a written procedure for managing concussion and managing students who have suffered concussion or are suspected of it back into physical activity. This can be used in addition to the Handsam incident log to record instances of concussion.
What should supervisors do?
Following a suspected concussion, what’s your role?
- Safely remove the individual from the field of play and ensure that they do not return to play in that game even if they say that their symptoms have resolved;
- Observe the player or assign a responsible adult to monitor the individual once the player is removed;
- If player is under 18 years old, contact parent/guardian to inform them of the possible concussion;
- Arrange for the player to get home safely;
- Arrange for a responsible adult to supervise the player over the next 24-48 hours;
- Ensure any relevant injury report form is completed and stored by the club/school/organisation; and
- Follow a graduated return to activity (education/work) and sports programme with an emphasis on initial relative rest and returning to education/work before returning to training for sport.
Resources
UK Concussion Guidelines for Non-Elite (Grassroots) Sport
St John Ambulance: Head Injuries
Health and Safety (First-Aid) Regulations 1981: Guidance on Regulation