A concussion can occur at any age, even in infants and toddlers. You can protect your children by learning about the risks of head injuries as they grow and develop, how to recognize the signs of a concussion and when to seek care from your healthcare provider.
The Centers for Disease Control and Prevention (CDC) defines a concussion as a traumatic brain injury that can alter mental status or result in life-changing issues. Concussions can be caused by direct blows to the head when falling down the stairs, being struck by an object such as a baseball or receiving a body hit that causes the head to move back and forth quickly, creating chemical changes and damaging brain cells. Some collusion sports such as hockey, soccer or football have an increased risk of concussions.
Falls are a primary cause of concussions. According to Safe Kids Worldwide, falls are the leading cause of nonfatal injuries to children 0 to 19 years of age. It is estimated that 8,000 children are treated daily in U.S. emergency rooms for fall-related injuries, including brain injuries. Most falls occur at home, on the playground or during sports.
Signs of a Concussion
According to Stop Sports Injuries and CDC websites, concussion symptoms often include the following physical, emotional and cognitive symptoms that can be present initially, persist or be present later during recovery:
* Balance problems.
* Difficulty communicating and concentrating.
* Feeling emotional.
* Feeling mentally foggy.
* Memory difficulties.
* Numbness or tingling.
* Sensitivity to light or noise.
* Sleeping more than usual, or difficulty falling asleep.
* Blurry or double vision.
If your child has one or more of these symptoms, you should suspect a concussion or other serious brain injury. A concussion can occur with or without loss of consciousness. Reevaluate your child often, as symptoms can worsen over hours to days. What to look for is generally the same by may be harder to tell in a young child.
If You Suspect a Concussion
At the time of the head injury, if your child is unconscious, very confused or has other physical or cognitive changes, it may be a more serious head injury, and you should call 911. Be practice and assure that the coach or caregiver has emergency contact information for your child and a plan for concussion or other injury management.
If your child falls at home or at school or is hit in the head during sports or play, watch carefully to determine if your child is acting as usual. It is OK for him to sleep for brain healing, but monitor closely for changes in symptoms such as worsening headache, vomiting, changes in neurological status or persistent issues over a few days.
Rest is key to recovery. Limit screen time, music and activities. If the above symptoms appear or there are other concerns, make an appointment with your child’s provider. A referral to a concussion specialist may be made for management of persistent symptoms and development of a plan for return to school and activities.
Return to Normal Activities
According to the CDC Heads Up Concussion in Youth Sports, children and teens should not return to sports or activities until they are symptom-free — definitely not the same day as the injury. Seek evaluation by a provider experienced in managing concussions. Many states have laws about who can evaluate and clear athletes for return to play after a concussion.
Concussion Management Laws
In May 2009, the State of Washington passed the Zackery Lystedt Law to address concussion management in youth athletics. The Washington law was the first state law to require a “removal and clearance for Return to Play” among youth athletes. Now all 50 states have a Return to Play law. Look at your state for who can provide medical clearance after a concussion, training and education on concussion recognition and management. If your child has a concussion, ask for school policies and guidelines for classroom support and return to sports and activities.
Safe at Home
Use home-safety devices such as window guards, stair gates and guardrails. Assure that infants and young toddlers are supervised and safe on elevated surfaces such as high chairs, changing tables or furniture. Secure dressers, bookshelves and televisions to the wall to prevent tipovers.
Safe at Play
Playground falls are a common cause of concussions. Check that the equipment is safe for your child’s development, and that no repairs are needed. Playground surfaces should be covered with wood chips or sand, not dirt or grass.
Make sure that shoes and other equipment are sized and worn correctly. Helmets should fit properly and be designed for your child’s particular sport. A helmet for skiing is very different from one for biking. Also remember that conditioning and maintaining hydration help to ensure fewer injury risks.
Safe in Transit
Assure your child is wearing a properly fitting helmet when biking, on a scooter or during any other wheeled activity. Be a good role model. Use properly sized seatbelts and properly installed child restraints in your vehicles, as concussions can occur during a crash.
Susan E. Rzucidlo, MSN, CPNP-PC, works as an NP at an outpatient pediatric clinic. In her more than 30 years of pediatric care, Susan has published, advocated for laws for evaluation and management of concussion, and presented to professionals and the public on head injury care and prevention.