Dr. David Miller discusses some of the issues to consider when taking...
This article originally appeared in Issue 3 of our magazine.
Warning! This article is meant to be a quick overview and not a detailed guide on procedures relating to the treatment of concussions. To be prepared for any emergency, we encourage you to enroll in a certified medical course or, at a minimum, a familiarization course, which will deliver comprehensive knowledge of how to treat different types of concussions.
Recent news has brought the problems of concussions to the forefront of the sports world. However, concussions not only affect overpaid jocks (and seemingly our lawmakers), they can also afflict regular people — so be wary of those clumsy friends you hold so dear.
Concussions are brain injuries caused by a force applied to the head area. Any blow to the head, or even a slight fall, will cause a rapid head movement that displaces the brain from its normal position. This displacement can cause an impact between the brain and inside wall of the skull, causing temporary injury.
Above: Obvious physical signs of concussions include headaches, dizziness, vomiting, impaired motor skills, and fatigue.
Once you suspect a concussion has occurred, remove the victim from any environment that might cause any additional trauma to the head. Obvious physical signs of concussions include headaches, dizziness, vomiting, impaired motor skills, and fatigue.
Look for confusion, temporary amnesia, vision or speech problems, and unresponsiveness. If the victim finds himself suddenly enjoying Justin Bieber or One Direction, this may be another clue. Loss of consciousness can be a sign, but is not a prerequisite for the majority of concussions. More importantly, symptoms are not always seen instantly and can take hours to manifest.
No, not that scat. A tool developed by the professional sports community is the Sport Concussion Assessment Tool (SCAT), and its key points can be used to evaluate concussions. It was originally developed for athletes and is a standardized method of evaluating injured people for concussion. It can be used on people 13 years and older. The SCAT5 is the most current version and it supersedes the previous versions of SCAT. It is available for download from the British Journal of Sports Medicine.
First, take note of the magnitude of each symptom listed on the SCAT card — these can help you differentiate between a mild or severe concussion. Cognitive assessment should also be done, which includes asking the victim simple questions. Test the victim’s short-term memory by making them repeat five random words that you say. Have them recite the months of the year in reverse order, which requires some concentration. Check for correct eye movement and simple arm and hand coordination. Failure to perform one or several of these tasks will further elucidate the degree of injury.
Closely monitor the victim for at least 24 hours after the concussion. Many believe that a victim should never fall asleep after a concussion and should be forced to stay awake. There is very little scientific evidence to support this theory.
The proper treatment for a concussion is rest; therefore, allowing the victim to fully sleep is recommended. However, if the victim does fall asleep, wake them up every two hours to make sure that they can regain consciousness normally. Once awakened, check whether symptoms have worsened and if new ones have appeared. If so, immediate professional medical help may be required.
Physical rest is necessary for proper recovery. More studies have now shown that cognitive rest will also quicken this recovery, so restrain from thinking about complex quantum physics, solving world hunger, or trying to sign up for health insurance. Do not take painkillers immediately as they mask both the symptoms and severity of the concussion. Only after a few days should acetaminophen be taken for headaches — avoid aspirin, Advil, or other non-steroidal anti-inflammatory drugs (NSAIDs) that can cause bleeding at the site of injury.
When alone, suffering any head trauma can be difficult. If your memory is intact, yet you show signs of a severe concussion, you should immediately attempt to contact someone to get medical help. If this is not an option, stop what you are doing and rest. Move yourself to a warm spot away from imminent danger, whether incoming artillery fire or your ex-spouse. Due to the complex neurological nature of concussions, rest is your only form of treatment in a survival setting.
Full recovery is generally expected, given enough time to heal. The danger lies in a secondary injury during the initial healing process, which can cause brain swelling and permanent damage. Take it from your friendly neighborhood NFL quarterback — prevention is a must. Though not all concussions are life threatening, proper measures taken after a concussion will reduce the chances of any future neurological problems.