Your Health

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
• Headache
• Neck pain
• Amnesia
• Dizziness
• 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"
• Confusion
• Drowsiness
• Sadness

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 SCAT 2.

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 cognitive ability.

Here is a brief version of a SCAT 2, which can help identify possible symptoms of a serious head injury:

Memory function

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?

Balance testing

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 motor vehicle.

There are several SCAT 2 programs that can be downloaded to a smart phone or tablet device.

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 Medicine.

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"

	About Wave 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