A concussion is any direct or indirect hit to the head that can cause a change in behaviour, awareness, and/or physical feeling. A concussion is the most common type of traumatic brain injury (TBI).
Concussions can occur in a number of ways, by a stick, puck or ball hitting the head. You can fall off a ladder, slip on ice and then hit your head on the ground.
You don’t need to be knocked out to have a concussion. Below are some possible symptoms that can alert the player, coaching staff and parents, a player has suffered a concussion:
- Inappropriate playing behaviour (skating the wrong direction, shooting on own net)
- Significantly decreased playing ability from earlier in the game
- Being slow to answer questions or follow directions
- Being easily distracted
- Being unable to do normal activities
- Displaying unusual emotions (crying/laughing)
- Changes in personality
- Irritability and low frustration tolerance
- Anxiety and depressed mood
- Sleep disturbance
Ask the individual a number of questions and determine there answer according to the following:
- Being unaware of time / date / place
- Being unaware of the period or score in the game
- Being generally confused
- How will you feel?
- Being dazed, dinged or stunned
- Having your bell rung
- Having a blank stare
- Felling dizzy
- Seeing stars or flashing lights
- Having ringing in the ears
- Having a headache
- Feeling sick or throwing up
- Noticing blurred vision
- Not seeing everything well
- Having poor coordination or balance
- Having slurred speech
If you have, or suspect you have a concussion, do not play until AFTER you have received a professional medical evaluation.
If you suspect that someone has a possible concussion, implement the four-step concussion action plan:
Concussion Safety First Step:
Remove the athlete from play, even if they say that they can continue to play. Look for signs and symptoms of a concussion if your athlete has experienced a bump or blow to the head or body. When in doubt, keep the athlete out of play.
Concussion Safety Second Step:
The athlete should be evaluated by a health care professional with knowledge and experience in evaluating concussions and concussion symptoms’. Parents, coaches, spectators should not try to judge the severity of the head injury.
If there are no health care professionals immediately available you attempt to perform an initial concussion assessment by using the following concussion guidelines:
- Cause of the injury and force of the hit or blow to the head or body
- Any loss of consciousness (passed out/knocked out) and if so, for how long
- Any memory loss immediately following the injury
- Any seizures immediately following the injury
- Number of previous concussions (if any)
Concussion Safety Third Step:
Promptly inform the athlete’s parents or guardians about the possible concussion. Make sure they are aware that their athlete should be seen by a health care professional experienced in evaluating for concussion.
Concussion Safety Fourth Step:
Keep the athlete out of play the day of the injury and until a health care professional, experienced in evaluating for concussion, says they are symptom-free and it’s OK to return to play.
A repeat concussion that occurs before the brain recovers from the first—usually within a short period of time (hours, days, or weeks)—can slow recovery or increase the likelihood of having long-term problems. In rare cases, repeat concussions can result in edema (brain swelling), permanent brain damage, and even death.
Concussion Awareness Quick Check
The Four R’s
- Respect for all players, especially yourself
- Read the concussion card
- Recognize the symptoms of concussion
- React to it
Prevention for Players
- Respect all players, coaches and officials.
- Make sure your hockey helmet fits and is fastened properly.
- Be aware – play heads-up hockey.
- Wear a properly fitted mouth guard.
- Always use correct body checking techniques and never hit another player from behind or in the head.
ALERT – Repeat concussions can severely affect one’s lifestyle. It is a Hockey Canada Policy not to send a player back on the ice unless that player has fully recovered.
Coach and Safety Person Protocol
- Keep your concussion card handy.
- During the pre-game talk, check and remind players of team attitude.
- Discourage open-ice checks to the head.
- In case of injury, check for symptoms of concussion/neck and spinal injuries.
- Monitor the player for listed symptoms, if present remove the player from the game.
- Permit the player to return to play only on advice of a physician.
- Instruct parents/guardians to inform medical personnel if it is a repeat concussion.
Additional Information – Concussions
* Note that the assessment tools need training to be used properly; they suggest that they only be used by physicians. There are apps that assist in rapid bench assessment of the kids, but really nothing beats knowing the players and being able to tell when they are “off”. When in doubt, they need to be kept off the ice.
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