You are receiving this information sheet about concussions because of California state law AB 25 (effective January 1,2012), now Education Code § 49475:
*Every 2 years all coaches are required to receive training about concussions (AB 1451), sudden cardiac arrest (AB 1639), and heat illness (AB 2500), and certification in First Aid training, CPR, and AEDs.
What is a concussion and how would I recognize one?
A concussion is a kind of brain injury. It can be caused by a bump or hit to the head, or by a blow to another part of the body with the force that shakes the head. Concussions can appear in any sport and can look differently in each person. Most concussions get better with rest and over 90% of athletes fully recover. However, all concussions should be considered serious. If not recognized and managed the right way, they may result in problems including brain damage and even death. Most concussions occur without being knocked out. Signs and symptoms of concussion (see back of this page) may show up right after the injury or can take hours to appear. If your child reports any symptoms of concussion or if you notice some symptoms and signs, seek medical evaluation from your team’s athletic trainer and a physician trained in the evaluation and management of concussion. If your child is vomiting, has a severe headache, or is having difficulty staying awake or answering simple questions, call 911 for immediate transport to the emergency department of your local hospital.
There is an increasing concern that head impact exposure and recurrent concussions may contribute to long-term neurological problems. One goal of concussion education is to prevent a too early return to play so that serious brain damage can be prevented.
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Symptoms may include one or more of the following: |
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• Headaches • “Pressure in head” • Nausea and/or Vomiting • Neck pain • Sadness • Has trouble standing or walking (dizziness) • Blurred, double, or fuzzy vision • Bothered by light or noise • Feeling sluggish or slowed down • Feeling foggy or groggy • Drowsiness |
• Concentration or memory problems • Repeating the same question/comment • Confused • Loss of memory • “Don’t feel right” • Tired or low energy • Nervousness or feeling on edge • Irritability • More emotional • Change in sleep patterns
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Signs observed by teammates, parents and coaches include: |
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• Loses consciousness (even briefly) • Looks dizzy, dazed, or stunned • Moves clumsily or awkwardly • Slurred speech, or speaks/answers questions slowly • Looks spaced out |
• Confused about plays, assignments, or position • Cannot recall events before or after the injury • Is unsure of game, score, or opponent • Any change in typical behavior or personality • Seizures or “has a fit” |
What can happen if my child keeps playing with concussion symptoms or returns too soon after getting a concussion?
Athletes with the signs and symptoms of concussion should be removed from play immediately. There is NO same day return to play for a youth with a suspected concussion. Youth athletes may take more time to recover from concussion and are more prone to long-term serious problems from a concussion.
Even though a traditional brain scan (e.g., MRI or CT) may be “normal”, the brain has still been injured. Animal and human research studies show that a second blow before the brain has recovered can result in serious damage to the brain. If your athlete suffers another concussion before completely recovering from the first one, this can lead to prolonged recovery (weeks to months), or even to severe brain swelling (Second Impact Syndrome) with devastating consequences.
On the CIF website is a Graded Concussion Symptom Checklist. If your child fills this out after having had a concussion, it helps the physician, athletic trainer or coach understand how they are feeling and hopefully will show improvement over time. You may have your child fill out the checklist at the start of the season even before a concussion has occurred so that we can understand if some symptoms such as headache might be a part of their everyday life. We call this a “baseline” so that we know what symptoms are normal and common for your child. Keep a copy for your records and turn in the original. If a concussion occurs, your child can fill out this checklist again. This Graded Symptom Checklist provides a list of symptoms to compare over time to follow your child’s recovery from the concussion.
What is Return to Learn?
Following a concussion, students may have difficulties with short- and long-term memory, concentration, and organization. They may require rest while recovering from injury (e.g., limit texting, video games, loud movies, or reading), and may also need to limit school attendance for a few days. As they return to school, the schedule might need to start with a few classes or a half-day. If recovery from a concussion is taking longer than expected, they may also benefit from a reduced class schedule and/or limited homework; a formal school assessment may also be necessary. Your school or physician can help suggest and make these changes. Students should complete the Return to Learn guidelines, successfully returning to a full school day and normal academic activities, before returning to play (unless your physician makes other recommendations). Go to the CIF website (cifstate.org) for more information on Return to Learn.
How is Return to Play (RTP) determined?
Concussion symptoms should be completely gone before returning to competition. A RTP progression is a gradual, stepwise increase in physical effort, sports-specific activities, and then finally unrestricted activities. If symptoms worsen with activity, the progression should be stopped. If there are no symptoms the next day, exercise can be restarted at the previous stage. RTP after concussion should occur only with medical clearance from a physician trained in the evaluation and management of concussions, and a stepwise progression program monitored by an athletic trainer, coach, or other identified school administrator. Please see cifstate.org for a graduated return to play plan. [AB 2127, a California state law effective 1/1/15, states that return to play (i.e., full competition) must be no sooner than 7 days after the concussion diagnosis has been made by a physician.]