Concussion

This lesson is for those times when a head injury may have led to one of the more common and serious injuries – concussions.

Even in situations that don't involve a loss of consciousness, a person who exhibits other concussion signs and symptoms are at least mildly concussed. Part of your job is to determine if the victim is concussed and how severe it is by reading the signs and asking open-ended questions.

How to Assess and Treat a Concussion

As always, the first thing you want to do is make sure the scene is safe and that your gloves are on. Make sure you have your rescue mask with a one-way valve handy and begin calling out to the victim.

Are you OK? Can you hear me?

If the patient is conscious and responsive, ask yourself if there are other medical emergencies that would warrant calling 911 and activating EMS? If not, continue with your assessment.

Introduce yourself to the victim: "Hi, my name's _____. I'm a paramedic. I'm going to ask you some questions."

"Do you remember what just happened?"

"Do you know if you hit your head?"

If you suspect a head injury, ask questions about headaches, blurred vision, nausea, while also looking over the victim for concussion symptoms including:

• Eye-tracking – can they follow your finger
• Blurred vision, which indicates swelling in the brain
• Dizziness, loss of balance
• Nausea, vomiting
• Loss of memory
• Dazed and confused

If the victim exhibits any of these symptoms, it's best to call 911 immediately. If they don't, continue assessing them.

"Do you know what day it is?"

"Do you know what year it is?"

If the victim answers those two questions incorrectly, you're likely dealing with someone who has hit their head and may have a concussion. Which as you know by now, deserves a 911 call.

Continue to assess for signs of something more serious. How are the pupils? Is the patient breathing normally? Is the patient still responsive and seemingly alert? And continue to monitor the patient for signs of shock.

Remember, if you begin seeing signs of shock, cover the patient with a blanket or coat and try to keep them as warm as possible. Any signs of shock demand an immediate 911 call.

In concussion cases, the patient will likely require a 24-hour observation period to make sure that symptoms and swelling in the brain are reduced, which is the norm. However, these issues and symptoms can also worsen.

A Word About Injuries to the Head

The problem is that the head lacks the padding often present in other areas of the body. Which means it can easily be injured. And that injury can easily be considered serious.

There are two main types of head injuries – open and closed. An open head injury is one that breaks or penetrates the skull. Excessive bleeding can occur and controlling that bleeding will be vital for a positive outcome.

The other type is a closed head injury. Closed head injuries occur when the brain strikes against the inside of the skull and when the skull remains intact. These injuries are much more difficult to detect as there is a decided lack of visible clues.

The four subtypes of head injuries are:

• Concussion
• Skull fractures
• Penetrating wounds
• Scalp injuries

Let's take a deeper look into the physical, emotional, and behavioral signs and symptoms of a concussion.

Physical symptoms include:

• Headache
• Blurry vision
• Nausea or vomiting
• Dizziness
• Sensitivity to noise or light
• Balance problems
• Feeling sluggish

Emotional symptoms include:

• Irritability
• Sadness
• Heightened emotions
• Nervousness or anxiety

Behavioral symptoms include:

• Sleeping more or less than usual
• Difficulty falling asleep
• Changes in playing habits for kids
• Changes in eating habits

Thinking and remembering skills may also be impacted and include the following symptoms:

• Difficulty thinking clearly
• Difficulty remembering events that occurred just prior to the incident and just after the incident
• Difficulty remembering new information
• Difficulty concentrating
• Feeling mentally foggy
• Difficulty processing information