Concussion management is a big talking point in sports medicine today, past failures and potential future illness being the big driver for change.

What is it
Concussion is a traumatic brain injury resulting in a disturbance of brain function. We normally think of concussion as loss of consciousness (being knocked out) but this actually occurs in less than 10% of concussions. Although not a requirement for diagnosis, loss of consciousness is a clear indication that a concussion has been sustained.

It can be caused by a direct blow to the head (think sports like rugby, boxing etc)  but can also occur when blows to other parts of the body result in rapid movement of the head (whiplash type injuries like in a car accident)

How to Recognise Concussion
Whether we are coaching, officiating or parents watching sport we need to all be aware of the signs, symptoms and dangers of concussion.

If any of the following signs or symptoms are present following a head injury the player should at least be suspected of having concussion and be immediately removed from play or training.

Any one or more of the following clearly indicate a concussion:
• Seizure (fits)
• Loss of consciousness – confirmed or suspected
• Unsteady on feet or balance problems or falling over or poor coordination
• Confused
• Disorientated – not aware of where they are/who they are/the time of day
• Dazed, blank or vacant look
• Behavioural changes g. more emotional or more irritable

Any one or more of the following may suggest a concussion:
• Lying motionless on ground
• Slow to get up off the ground
• Grabbing or clutching of head
• Injury event that could possibly cause concussion

Presence of any one or more of the following signs and symptoms may suggest a concussion:
• Headache
• Dizziness
• Mental clouding, confusion, or feeling slowed down
• Visual problems
• Nausea or vomiting
• Fatigue
• Drowsiness/feeling like “in a fog“/difficulty concentrating
• “Pressure in head”
• Sensitivity to light or noise

What questions you ask adults and adolescents
Failure to answer any of these questions correctly is a strong indication of concussion or at least suspected concussion.
“What venue are we at today?” “Which half is it now?”
“Who scored last in this game?”
“What team did you play last week/game?” “Did your team win the last game?”

What questions you ask children (12 years and under)
Failure to answer any of these questions correctly is a strong indication of concussion or at least suspected concussion.
“Where are we now?”
“Is it before or after lunch?”
“What was your last lesson / class?” or “Who scored last in this game?” “What is your teacher’s name?” or “What is your coach’s name?”
Recognise and remove and if in doubt, sit them out.

The IRFU have a great return to play post concussion protocol on their website but if an athlete is having recurring symptoms when attempting to get back to play, they may need some guidance on the best way to do this!

Information taken from ‘The World Rugby Concussion Guidance Document’