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Concussion Management

What is a Concussion?

A concussion is a brain injury that cannot be seen on routine x-rays, CT scans, or MRIs. It can cause changes in how the brain functions, leading to symptoms that can be physical, cognitive, emotional and/or related to sleep. You do NOT need to lose consciousness to have a concussion.

What causes a concussion?

Any blow to the head, face or neck or a blow to the body that transmits a force to the head may cause a concussion, e.g., a ball to the head in soccer, being checked into the boards in hockey. A concussion can occur with or without a loss of consciousness

What is a Concussion Assessment?

A concussion assessment is the process of gathering information, from the student, parents, witnesses, medical professionals, staff and others to assess the physical, cognitive or emotional state of a student, to determine the likelihood of the student having a concussion.

What are the symptoms and signs of a concussion?

Any one or more of the following symptoms and signs may suggest a concussion:

​Symptoms Reported:

​Signs Observed:

​Physical

​Headache
Neck Pain
Stomach ache
Blurred vision
Pressure in head
Dizziness
Sensitivity to light/noise

​Loss of consciousness
Nausea/vomiting
Seizure/convulsion
Poor coordination/balance
Amnesia
Slowed reaction time
Slurred speech

​Cognitive

​Feeling in a fog
Difficulty concentrating
Difficulty remembering

​Difficulty concentrating
Difficulty remembering
Confusion
Slowed reaction time

​Behavioural

​Irritability
Sad/emotional
Nervous/anxious
Depressed

​Inappropriate emotions
Depression

​Sleep

​Drowsiness
Difficulty falling asleep

​Drowsiness

  
Note: It may be more difficult for students under the age of 10, those with special needs or students for whom English or French is not their first language, to communicate how they are feeling. The signs of a concussion for younger students may not be as obvious.

What to do if you suspect a student has a concussion

If the student is unconscious:

  • Initiate the Emergency Action Plan and call 911.
  • Assume a possible neck injury and, only if trained, immobilize the student before EMS arrives.
  • Do not move the student or remove athletic equipment; wait for EMS to arrive.
  • Do not leave the student alone.
  • Contact the student’s parent/guardian.

If the student is conscious:

  • Stop the activity immediately.
  • When the student can be safely moved, remove from activity.
  • Conduct an initial concussion assessment – review Symptoms and Signs, perform Memory Testing and Balance Testing (optional).

Memory Testing
Failure to answer any one of these questions correctly may suggest a concussion.

  • What activity/sport are we playing right now?
  • What field/facility are we at today?
  • What part of the day is it?
  • What is the name of your teacher/coach?
  • What school do you go to?

Note: Questions should be geared to student’s age and activity.

Balance Testing 

Instructions for tandem stance

  • Ask the student to stand heel-to-toe with non-dominant foot in back. Weight should be evenly distributed across both feet.
  • Student should try to maintain stability for 20 seconds with hands on hips and eyes closed.
  • Count the number of times the student moves out of this position. If student stumbles out of this position, have student open is/her eyes and return to the start position and continue balancing.
  • Start timing when student is set and has eyes closed. Observe the student for 20 seconds. If the student makes errors (e.g. lifts hands off hips; opens eyes; lifts forefoot or heel; steps, stumbles, or falls; or remains out of the start position for more than 5  seconds), this may suggest a concussion.

Following the initial assessment, if a concussion is suspected:

  • Do not allow the student to return to activity.
  • Contact the student’s parent/guardian to pick up student.
  • Stay with the student until parent/guardian arrives.
  • If any signs or symptoms worsen, call 911.
  • Inform the parent/guardian that the student needs to be examined by a medical doctor or nurse practitioner as soon as possible and provide them with a copy of this tool.

Following the initial assessment, if a concussion is not suspected:

  • The student may return to activity.
  • Contact the student’s parent/guardian to inform them of the incident.
  • Provide the parent/guardian with a copy of this tool and inform them that the student should be monitored for 24-48 hours since signs and symptoms may take hours or days to emerge.

Return to Learn
In support of student learning and well-being, it is important for students to be active and play sports. However, a student with a diagnosed concussion needs to follow a medically supervised, individualized Return to Learn/Return to Physical Activity Plan.

If you are aware of any concussions or suspected concussions that a student incurs outside the school environment, please notify school staff as soon as possible.   

What is Return to Learn?
Return to Learn means a student’s return to doing school work, including reading and writing, but does not include physical activities.

What is Return to Play?
Return to Physical Activity means the student’s return to participation in any physical activity that increases the student’s heart rate. It includes a student’s return to activities such as sports or physical education class.

The Return to Learn process is individualized and gradual to meet the particular needs of the student. There is no preset formula for developing strategies to assist a student with a concussion to return to his/her learning activities.



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