How to Treat a Concussion – Medical Steps

What Medical Steps Are Taken When You Get A Sports Related Concussion?

 

Kelly Dike, MS, ATC, is the athletic trainer at South Oldham High School. Based on her keen understanding of how to treat a concussion, she is working with a football player in the photo above.

 

Preseason preparation:

1. In the preseason, all athletes will have a Baseline Impact Test completed. A Baseline Impact Test is a neurological and cognitive test that is given to all the athletes to have a baseline number on what their normal cognitive abilities are based on memory and hand eye coordination. It is about a 45 minute test with multiple sections. It is given on a computer.

Immediately after the sports injury: 

1. If neck pain stabilize the cervical spine.
2. If neurological deficits stabilize the cervical spine.
3. If in doubt stabilize the cervical spine.
4. If the player has a helmet on and shoulder pads, do not remove, stabilize with the equipment in place.
5. EMS needs called and the player placed on a back board with the neck stabilize throughout the moving procedure from the floor to the backboard.
6. If the athlete is wearing a helmet , this will not be removed , the athletes head in the helmet will be secured/taped to the backboard. If there’s no helmet on the athletes head then a stabilization collar will be placed .
7. Until proven otherwise assume the cervical spine injury exists

Questions to ask the athlete:

1. Do you have a neck pain?
2. Assess their orientation status. Ask them if they know their name, where they are, and the date.
3. Do you have any numbness or tingling anywhere.
4. Perform a neurological exam where you asked them to squeeze your hand, wiggle their toes, check their pulses, and try to assess their sensory status via light touch.
5. Ask them to recall the events that occurred at the time of the injury and immediately after the injury.

What typically happens in the emergency department:

1. Emergency department physician will assess the athlete. Based on the situation a CT scan of the head will/ will not be obtained. That is very individual based on the symptoms of the athlete.
2. Most athletes will be discharged to home that day. Typically admission to the hospital is not needed.

The day after the concussion:

1. There will be no sporting activities until the athlete is evaluated by their primary care physician or a neurologist.
2. If it is a significant concussion in a while just must be consult it before the athlete returns to play.
3. If it’s a minor concussion then the primary care physician or pediatrician can see the athlete.
4. Questions that will be answered during a doctors visit is if the athletes having any post concussion symptoms: are you having headaches, blurred vision, difficulty concentrating or any nausea, sensitivity to light, headache increases with loud noises, trouble with balance.

How to Treat a Concussion:

1. Depending on the concussion the athlete may be placed on brain rest. Brain rest is no school, no video games, no watching any TV, and no reading. Just like it sounds: brain rest. If the athlete has a severe concussion they may even be placed in a dark room for a period of time to totally rest the brain.
2. The athlete maybe started on omega-3 vitamins to help heal the brain.
3. Once the athlete is symptom-free: no headaches, blurred vision , difficulty concentrating or nausea, the athlete will be re Impact tested.
4. If the impact test comes back to normal and they have been cleared to return to play from their physician, they are released to return back to sports with conditioning only for the first day, non-contact practice the second day and full contact the third day. This progression of activity occurs only if they remain symptom-free. Symptom-free means no headaches, visual disturbances, or difficulty concentrating.