Concussion

Concussion is the most common head injury in sport. It is caused by a temporary disturbance in brain function due to trauma. Most damage is caused by rotation and acceleration, for example spinning of the head caused by a blow to the side of the head. Concussion may occur with or without loss of consciousness.

Signs and symptoms

Signs	Symptoms
A vacant stare Slow responses Slurred or incoherent speech Forgets events prior to or after impact Unable to focus attention Disorientated Uncoordinated Emotionally confused Dazed or stunned	Feeling sick Double or fuzzy vision Ringing in the ears Loss of consciousness Headache Pupils different in size Sensitivity to light or noise Feeling sluggish, groggy or dizzy Concentration or memory problems

Signs

Symptoms

A vacant stare
Slow responses
Slurred or incoherent speech
Forgets events prior to or after impact
Unable to focus attention
Disorientated
Uncoordinated
Emotionally confused
Dazed or stunned

Feeling sick
Double or fuzzy vision
Ringing in the ears
Loss of consciousness
Headache
Pupils different in size
Sensitivity to light or noise
Feeling sluggish, groggy or dizzy
Concentration or memory problems

Sideline concussion check cards

The sideline concussion check card lists the signs and symptoms of concussion and provides advice on treatment. It is the size of a credit card, so fits in your pocket for quick reference. It also has an insert detailing the procedures that should be followed in the two days following a suspected trauma to the brain or concussion. The inserts are also available in Māori, Samoan and Tongan.

This is a vital resource. To order a copy, see Publications.

Treatment

Reduce immediate danger - stop play.

If the player is…	then…
unconscious	assume a spinal injury check ABCs: Airways – remove anything blocking airway Breathing – is player breathing? If not, start mouth to mouth resuscitation Circulation – is there a pulse? If not, start Cardio Pulmonary Resuscitation (CPR) stabilise the player's head and neck, then get help take the player from the field on a scoop stretcher or spinal board only when appropriate support (doctor or ambulance crew) has stabilised the neck with a collar.
conscious	check for concussion signs and symptoms.

If the player is…

then…

unconscious

assume a spinal injury
check ABCs:

Airways – remove anything blocking airway
Breathing – is player breathing? If not, start mouth to mouth resuscitation
Circulation – is there a pulse? If not, start Cardio Pulmonary Resuscitation (CPR)

stabilise the player's head and neck, then get help
take the player from the field on a scoop stretcher or spinal board only when appropriate support (doctor or ambulance crew) has stabilised the neck with a collar.

conscious

check for concussion signs and symptoms.

The next 24 hours

A responsible adult should stay with the concussed player for at least the next 24 hours. Alcohol and drugs should be avoided.

Return to sport

A player should not return to training or play for a period of three weeks following concussion. Coaches should sight medical clearance before permitting the player to take part in training or play.

The only exception to the three-week stand-down is a senior player in international competition. These players can return to competition earlier if they are symptom-free and have received clearance from a recognised neurological specialist.

Exercise

A gradual return to low-level aerobic training, followed by non-contact drills and finally contact play, is recommended. Aerobic exercise works your heart and lungs and includes exercises such as cycling, swimming and rowing. Jogging should not be started until symptom-free.

Reduce the risk of concussion

Safe techniques should be practised at all times in high contact sports. Wearing a custom made mouthguard may reduce the risk of concussion. It is important to remember that rugby headgear is not designed to prevent concussion.

For more information, see Concussion (PDF176K).

Last updated:20April2009