When you suspect someone has a concussion
Diagnosing and treating concussions
requires awareness of the problem
on the part of all concerned: players,
coaches and parents. Coaches
must be up to speed on the latest
information about concussions, learn
about the kinds of situations that can
lead to concussions and recognize
potential symptoms in players. Likewise,
players must understand that coaches
watching a game may not always see
a hit on a player than can lead to a
concussion. That's why it is important for
young athletes to tell their coaches any
time a hit leaves them feeling dizzy.
The signs of concussion are:
- Sensitivity to light or noise
- Loss of consciousness
- Seizure or convulsion
- Pressure in the head
- Nausea or vomiting
- Balance problem
- Blurred vision
- Neck pain
- More emotional / irritability
- Nervousness or anxiety
- Fatigue or low energy
- Feeling "slowed down" or "in a fog"
- Difficulty concentrating
- Difficulty remembering
- "Don't feel right"
When a player is showing signs of a
concussion, he or she should be taken
to a quiet room so that a coach
or trainer can conduct a sideline
concussion assessment known as a
The SCAT 2 is a simple checklist test that
can be performed by a non-physician.
The checklist includes 22 symptoms,
such as headache, sensitivity to light
or noise, nausea and confusion. As
well, the SCAT 2 contains a few simple
tests of concentration, memory and
Here is a brief version of a SCAT 2, which
can help identify possible symptoms of
a serious head injury:
Failure to answer all questions correctly
may suggest a concussion.
- What venue are we at today?
- Which period is it now?
- Who scored last in this game?
- What team did you play last game?
- Did your team win the last game?
Instructions for the tandem stance:
Have the person suspected of suffering
a concussion stand heel-to-toe with
their non-dominant foot in back. His or
her weight should be evenly distributed
across both feet. The person should try
to maintain stability for 20 seconds
with his or her hands on their hips
and their eyes closed. Observe
the athlete for 20 seconds. If
they make more than five
errors - such as lifting their
hands from hips, opening
their eyes, lifting toes or heels,
stepping, stumbling or falling
- or remain out of the start
position for more than five
seconds, this may suggest a concussion. An athlete with a suspected
concussion should be immediately removed
from play, urgently assessed medically, should
not be left alone, and should not drive a
There are several SCAT 2 programs that can
be downloaded to a smart phone or tablet
If the SCAT 2 test reveals any hint that a
player may have suffered a concussion, he
or she should be taken to the Emergency
Department, their family doctor, or the
Pan Am Minor Injury Clinic or Legacy Sport
People, especially youth, with suspected
concussions need to be watched as well, in
case their condition worsens.
Dr. Peter MacDonald, Head of Orthopedics
for Pan Am Clinic and Leader of Orthopedics
for the Winnipeg Health Region, says the
problem of concussions in sports creates
special concern in areas where access to
care is more difficult. In rural areas, he says,
there's an even stronger onus on the coach
to make sure that a player with a suspected
concussion gets to a regional hospital where
they can be diagnosed. "Most concussions
don't get diagnosed properly," says
MacDonald. "Most of the time, the kid comes
off the ice and has a bit of dizziness."
Back to "Head start"
Wave is published six times a year by the Winnipeg Health Region in cooperation with the Winnipeg Free Press. It is available at newsstands, hospitals and clinics throughout Winnipeg, as well as McNally Robinson Books.
Read the September / October 2012 issue of Wave