Concussion

Introduction

The brain is free to move a little within the skull, and can thus be 'shaken' by a blow to the head. This shaking is called concussion.

Among the common causes of concussion are traffic incidents, sports injuries, falls, and blows received in fights.

Concussion produces widespread but temporary disturbance of normal brain activity. However, it is not usually associated with any lasting damage to the brain. The casualty will suffer impaired consciousness, but this only lasts for a short time (usually only a few minutes) and is followed by a full recovery. By definition, concussion can only be confidently diagnosed once the casualty has completely recovered.

A casualty who has been concussed should be monitored and advised to obtain medical aid if symptoms such as headache or blurred vision develop later.

Recognition

• Brief period of impaired consciousness following a blow to the head.

There may also be :

• Dizziness or nausea on recovery.
• Loss of memory of events at the time of, or immediately preceding, the injury.
• Mild, generalised headache.

Your aims

• To ensure the casualty recovers fully and safely.
• To place the casualty in the care of a responsible person.
• To obtain medical aid if necessary.

Treatment

• Check the casualties level of response using the AVPU code:
  • A - Is the casualty alert, eyes open and responding to questions?
  • V - Does the casualty respond to voice, obey simple commands?
  • P - Does the casualty respond to pain (e.g. eyes open or movement in response to being pinched)?
  • U - Is the casualty unresponsive?
• Regularly monitor and record vital signs - level of response, breathing and pulse. Even if the casualty appears to recover fully, watch them for any deterioration in their level of response.
• When the casualty has recovered, place them in the care of a responsible person. If a casualty has been injured on the sports field, never allow them to 'play on' without first obtaining medical advice
• Advise the casualty to go to hospital, if following a blow to the head they develop symptoms such as headache, vomiting, confusion, drowsiness or double vision.

Warning: if the casualty does not recover fully, or if there is a deteriorating level of response after an initial recovery dial 999 for an ambulance.

Related topics

• Cerebral compression 
• Skull fracture

Please note:

These hints are no substitute for thorough knowledge of first aid! St John Ambulance holds first aid courses throughout the country.