Concussions in kids are a year round issue. We know that concussions in sports are all too common, especially among kids and teenagers. Whether it’s football, basketball, skiing, soccer, ice skating, hockey, random falls off the couch or car accidents, anyone can get a concussion at any time. Doing something where you might hit your head? WEAR A HELMET! Help to keep your brain safe. You need your brain for the rest of your life. Protect your child’s brain and your own brain. Get that helmet on!
What exactly is a concussion?
A concussion occurs when you bang your head so hard, that your brain sort of jiggles inside, and bangs against the opposite end of your skull that was bashed. The back and forth motion is no good. Jello jiggler anyone? This trauma causes your brain to release chemicals, and can damage cells in the brain. Oftentimes after a blow to the head, we don’t realize that there is an issue until days later when some symptoms may arise. It’s important to take any blow to the head seriously and watch for symptoms closely.
What are symptoms of concussion?
The first concussion symptoms we often see are headache, fatigue, irritability, memory loss and confusion. (A little worse than your typical teenager’s behavior?) Some people will feel dizzy, dazed or overly emotional. They can experience headaches, vomiting, nausea or blurred vision.
Go directly to the ER if you had a bad accident or fall, or if you are vomiting, have worsened headaches, pass out, or have a seizure.
According to the CDC, you should call 911 or go to the Emergency Room with any of the following:
“Dangerous Signs & Symptoms of a Concussion
- One pupil larger than the other.
- Drowsiness or inability to wake up.
- A headache that gets worse and does not go away.
- Slurred speech, weakness, numbness, or decreased coordination.
- Repeated vomiting or nausea, convulsions or seizures (shaking or twitching).
- Unusual behavior, increased confusion, restlessness, or agitation.
- Loss of consciousness (passed out/knocked out). Even a brief loss of consciousness should be taken seriously.
Dangerous Signs & Symptoms of a Concussion for Toddlers and Infants
- Any of the signs and symptoms listed in the Danger Signs & Symptoms of a Concussion list (above)
- Will not stop crying and cannot be consoled.
- Will not nurse or eat”
What to do after a head injury– concussion treatment in kids
Do not let your child keep playing in that football game or take another run down the mountain! Any athlete who sustains a head injury should STOP play, take a break and be evaluated. Do not jump back in the game. This means YOU coach! Do not put your kiddo back in. Let his brain rest. Make sure she can go back in to play safely before giving the green light to return. These days, many athletic programs will do pre-concussion testing, so that if a concussion does happen an official test can be done to decide if it’s safe to go back in to play.
It is important to be checked by a medical professional after a concussion. Your child’s doctor or nurse practitioner will provide you with recommendations to recovery and a Concussion Return to Play protocol.
Diagnosis of concussion in kids
Although post-injury testing and pre-concussion testing can be compared to help with diagnosis if a concussion is suspected, there is no actual definitive test to diagnose a concussion. Your kid’s concussion will not show up on a head CT. So if you go to the ER, they will only be doing imaging of your child’s head to rule out anything more serious, such as a fracture or brain bleed. This is why we need you to take care of that brain! If this seems like it is “just” a concussion, then imaging is likely unnecessary. Let your provider decide. You can always chat with us if you are unsure about what to do or are concerned about a concussion in your kids.
Treatment of concussion in kids
There is no medication treatment for concussion. Instead, treatment focuses on supportive and preventative care.
The CDC outlines 4 steps to recovery post-concussion.
- REST: Resting your brain is the most important part of recovery.
Take it easy for the first few days after injury to really let your brain heal. According to the CDC, these are the best ways to rest your body in the first fews days after injury.
- Early on, limit physical and thinking/remembering activities to avoid symptoms getting worse.
- Avoid activities that put your child at risk for another injury to the head and brain.
- Get a good night’s sleep and take naps during the day as needed.
Once you are feeling a little better, then you can add back some very light activity
- Light Activity: As your child starts to feel better, gradually return to regular (non-strenuous) activities.
- Find relaxing activities at home. Avoid activities that put your child at risk for another injury to the head and brain.
- Return to school gradually. If symptoms do not worsen during an activity, then this activity is OK for your child. If symptoms worsen, cut back on that activity until it is tolerated.
- Get maximum nighttime sleep. (Avoid screen time and loud music before bed, sleep in a dark room, and keep to a fixed bedtime and wake up schedule.)
- Reduce daytime naps or return to a regular daytime nap schedule (as appropriate for their age).
- Moderate Activity: When symptoms are mild and nearly gone, your child can return to most regular activities.
- Help your child take breaks only if concussion symptoms worsen.
- Return to a regular school schedule.
- Back to Regular Activity: Recovery from a concussion is when your child is able to do all of their regular activities without experiencing any symptoms
You may receive a Return to Play Protocol. There is a specific protocol for returning to play. You must REST your brain before going back to any physical activity and be able to be symptom free as you progress to full play. Your provider will outline this for you and give you strict guidelines for returning to play,
Baseline testing for athletes can help diagnose a future concussion in kids
Some medical offices can provide some baseline testing for kids at higher risk for concussion. Call your PCP or ask your sports coach if they have this available for your child. This testing allows the patient to get their brain function tested BEFORE a head injury occurs. This information, including memory, concentration and attention skills can be compared to brain function after an injury occurs. It can help determine if there was a concussion and how severe it is. This must be done by a medical professional who is trained in concussion management. They then can use this information to help guide return to play protocols and recovery needs for your child.
Long term concerns following concussion
Some concussion symptoms can last weeks to months. It is important to keep your child’s brain rested and avoid any further brain injury. Repeated injury to the brain can cause worsened damage.Repeated concussions become harder and harder to recover from. Do your brain a favor and protect it! If you sustain a concussion, don’t bash your head against the wall again and surely don’t jump back into football practice again just yet! Let that brain REST and recover.
Make sure to really question your child after ANY head injury. Don’t let them fool you into thinking they can jump back into the game. Make an effort to be sure they have no symptoms of concussion, and have them checked out after a head injury. I say this all the time, you need your brain forever! Take care of it! No sport or game is worth forever damage to your brain. When in doubt, pull them out. Missing a few games is worth it when it comes to your brain and health.
– Kim Liner, RN, MSN, CPNP
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