Recognizing a Concussion

A concussion can be caused by

  1. A hit to the head
  2. A hit to the body
  3. Any force that causes the brain to move back and forth in the skull
  4. a and c
  5. All the above

Incorrect. Concussions can be caused by any force that causes the brain to move back and forth in the skull including hits to the body.

That’s right all the above are true

Most concussion cases involve a loss of consciousness.

  1. True
  2. False

Correct. Only 10% of concussion cases involve a loss of consciousness

Incorrect. Only 10% of concussion cases involve a loss of consciousness

After a hit or fall that could cause a concussion, a child should be watched closely for signs of a concussion before removing them from play.

  1. True
  2. False

Incorrect. A child may not show signs right away. Remove a player immediately after a potential concussion causing incident.

Correct. A child may not show signs right away. Remove a player immediately after a potential concussion causing incident.

Responding to a Concussion

Scenario 1

A player on your child’s team collides with another player, during a game. She falls, is slow to get up and seems a bit unsteady on her feet. The coach takes her out of the game. Her parents are not at the game, so he asks you to monitor her. You take her away from players and spectators. She tells you her head hurts, but has no other symptoms. About 15 minutes later she complains of neck pain and vomits. What should you do next?

  1. Call her parents
  2. Call 9-1-1
  3. Take her home immediately
  4. Continue to monitor her until her parent arrives

Actually, neck pain is one of the red flags and is a medical emergency, you should call 9-1-1

Call 9-1-1: That’s right. Neck pain is one of the red flags and is a medical emergency, you should call 9-1-1

Scenario 2

During a game, you notice a player fall and hit his head hard on the ice. He clutches his head and gets up slowly and continues to play on. No one seemed to notice. What should you do?

  1. Watch the player closely for signs and symptoms of concussion
  2. Trust that the coach saw the incident and will remove the player if he/she thinks it is necessary
  3. Insist the coach remove the player from the game
  4. Assess the player when he is on the bench next

Incorrect. The player should be removed from play immediately and treated as if they have a concussion. The coach does not always see the incident. Parents are important extra eyes.

Correct. The player should be removed from play immediately and treated as if they have a concussion. The coach does not always see the incident. Parents are important extra eyes.

Scenario 3

Your child is lying on the ice. You did not see the incident. The play is stopped, the coach follows basic first aid and assists your child to the dressing room and leaves them in your care. Your child complains of a headache and says they feel dizzy. What should you do next?

  1. Call 9-1-1
  2. Take them to emergency
  3. Make arrangements to see your family doctor that day and monitor closely for red flag symptoms

Any of these responses would be appropriate for this scenario. The important thing is that you’ve recognized the player is injured and needs medical attention ASAP.

Scenario 4

You are watching your child at the playground. Your child falls to the ground and hits his head hard on the ground. Your child gets up and wants to continue to play. What should you do?

  1. Stop your child from playing and monitor him closely for signs and symptoms of a concussion
  2. Let him continue playing and watch him closely for any visual clues of a concussion

That’s right. In the incident you witnessed, his head hit the ground hard. This is enough to consider him as having sustained a concussion and should stop playing.

Actually, In the incident you witnessed, his head hit the ground hard. This is enough to consider him as having sustained a concussion and should stop playing.

Recovering from a Concussion

After being diagnosed with a concussion, a child should be monitored but not woken during sleep.

  1. True
  2. False

Correct - Sleep is an important part of recovering from a concussion. Check on your child at least every 2 hours to ensure they are sleeping comfortably and breathing normally. Only wake your child if you are concerned with their breathing or sleeping.

Incorrect - Sleep is an important part of recovering from a concussion. Check on your child at least every 2 hours to ensure they are sleeping comfortably and breathing normally. Only wake your child if you are concerned with their breathing or sleeping.

During the rest stage of a concussion, a child is safe to participate in the following activities:

  1. Video games
  2. Watching TV
  3. Reading a book
  4. None of the above

Correct - A person with a concussion requires cognitive rest. All these activities require concentration and learning and may put them at risk for further complications and delayed recovery

Incorrect - A person with a concussion requires cognitive rest. All these activities require concentration and learning and may put them at risk for further complications and delayed recovery.

A child with a concussion should rest for 24 hours before returning to activities.

  1. True
  2. False

Correct - a child with a concussion should rest until symptom-free for 24 hours before focussing on return to learn activities. This may take several days or weeks.

Incorrect - a child with a concussion should rest until symptom-free for 24 hours before focussing on return to learn activities. This may take several days or weeks.

Returning from a Concussion

A child should focus on returning to learn and returning to sports at the same time.

  1. True
  2. False

Correct. A child should return to learn before returning to sport. This actually results in a quicker return to sports.

Incorrect. A child should return to learn before returning to sport. This actually results in a quicker return to sports.

Returning to learn and activity is a slow, gradual process.

  1. True
  2. False

Correct - A concussed player that returns to activities too soon or does not follow a gradual or stepwise return is more likely to suffer from delayed recovery or serious complications.

Incorrect - A concussed player that returns to activities too soon or does not follow a gradual or stepwise return is more likely to suffer from delayed recovery or serious complications.

Scenario 1

Your child suffered a concussion a week ago during a hockey game. He tells you he has moved through Stage 1 (No Sporting Activity/Rest) and Stage 2 (Light Aerobic Exercise) with no returning symptoms and shows you his signed Return to Play Communication Tool.

Today he has returned to participate in some skating drills. He seems slow and sluggish, and not really himself. You catch him holding his head. You call him over and ask how he’s feeling. He says he’s feeling great. What do you do?

  1. Take him off the ice and have him move back to Stage 2 until free of symptoms for 24 hours.
  2. Take him off the ice. Have him take a break on the bench. Return him to play after he has rested a few minutes.
  3. Keep him on the ice but have the pace of his drills slowed. He needs some time to get back into it after a week of no exercise.
  4. Keep him on the ice and let him ride it out. He needs to get back into shape quickly and ready for the next game.

A is the best answer. Concussions are serious injuries and we need to err on the side of caution. Your child is showing possible symptoms of concussion.

Scenario 2

A week ago your child sustained a concussion during a soccer game. She has moved successfully through Stages 1 - 4. She has been to the doctor and she has given her clearance to play. She has a game today and is excited to play. Do you let her play?

  1. Yes
  2. No

Incorrect - A player must complete Stage 5 (Full-contact practice) and remain symptom-free for 24 hours before playing in a game

Correct A player must complete Stage 5 (Full-contact practice) and remain symptom-free for 24 hours before playing in a game

Prevent and Educate

Do helmets prevent concussions?

  1. Yes
  2. No

Correct - Helmets protect from serious skull injuries but do not prevent the brain from moving around in the skull.

Incorrect - Helmets protect from serious skull injuries but do not prevent the brain from moving around in the skull.

Do helmets help in reducing the seriousness of a concussion?

  1. Yes
  2. No

Correct. Helmets absorb the energy from the impact and decrease the speed the brain moves around inside the skull.

Incorrect. Helmets absorb the energy from the impact and decrease the speed the brain moves around inside the skull.

Full contact practices that allow athletes to practice hitting helps to reduce concussions.

  1. True
  2. False

Correct - There are ways to teach the skill of full contact without full contact practices. Less full contact opportunities means less overall concussion incidents.

Incorrect - There are ways to teach the skill of full contact without full contact practices. Less full contact opportunities means less overall concussion incidents.

The most effective way to prevent serious concussion associated risks is to create a positive, receptive environment that allows children to freely report concussion symptoms.

  1. True
  2. False

Correct

Incorrect. Actually, creating a positive, receptive environment that allows children to freely report concussion symptoms is the most effective way to prevent serious concussion associated risks.

Now that you have completed the modules on RECOGNIZE, RESPOND, RECOVERY, RETURN, and PREVENTION, answer the questions that follow to assess your learning.

Final Assessment - Part 1

Now that you are better prepared, here’s another opportunity to answer the questions posed at the beginning of the course.



If player #8 was your child, would you know what to do next?

  1. Nothing, she got up on her own and didn’t appear seriously injured
  2. Make sure she is pulled from the field and follow the concussion response protocol
  3. Let her play but watch her closely for any of the signs and symptoms of concussion

Actually player #8 hit her head hard on the ground, was slow to get up and was holding her head. You should consider her to have sustained a concussion.

That’s the safest action to take as she hit her head hard on the ground, was slow to get up and was holding her head.

Actually the signs and symptoms of concussion can be delayed for several hours or days. Player #8 hit her head hard on the ground, was slow to get up and was holding her head. You should consider her to have sustained a concussion.

How would you determine if player #8 had sustained a concussion?

  1. When she gets off the field ask her the memory questions. If she gets 3 out of 4 wrong then she has a concussion.
  2. Check to see if she shows any of the red flags or signs and symptoms of concussion. If she has any, she has a concussion.
  3. Player #8 hit her head hard on the ground. That is enough to consider her to have a concussion.

Actually, the fact that she hit her head hard on the ground is enough to consider her to have a concussion. The memory questions are part of the Concussion Response Protocol used to monitor a child’s condition but should not be used to determine if someone has a concussion.

Actually, a person does not have to show any of the signs or symptoms of a concussion to have one. These can be delayed for hours or even days after an incident. The fact that she hit her head hard is enough for you to consider her to have a concussion and follow the Concussion Response Protocol.

You are right. The fact that she hit her head hard on the ground is enough for you to determine that she sustained a concussion and to follow the Concussion Response Protocol.

If you let player #8 continue to play what could be the consequence of this decision?

  1. Puts her at risk for more serious injuries that includes death
  2. She got up on her own, it’s unlikely she has a major concussion, no major consequences if she continues to play
  3. Second impact syndrome
  4. a and c

d is the correct answer. Letting her play after receiving a hard hit to the head puts her at risk for a more serious injury and Second Impact Syndrome, a dangerous and often fatal injury.

Correct. Letting her play after receiving a hard hit to the head puts her at risk for a more serious injury and Second Impact Syndrome, a dangerous and often fatal injury.

Final Assessment - Part 2

The period of rest following a concussion injury includes limiting activities associated with electronic devices such as texting, video games, using a computer and watching television.

  1. True
  2. False

That’s right. Rest means physical and cognitive rest including activities requiring concentration like those required to use electronic devices.

Actually, rest means physical and cognitive rest including activities requiring concentration like those needed to use electronic devices.

A child who has sustained a concussion should be successfully back at school full-time before starting the return to play protocol.

  1. True
  2. False

That’s right. Returning to activities requiring concentrating and learning should be completed before returning to physical activities.

Actually, returning to activities requiring concentrating and learning should be completed before returning to physical activities.

Depression can be a symptom of concussion in children and particularly adolescents. A child with a concussion may feel depressed due to:

  1. Social isolation
  2. A loss of place
  3. A physical change in their brain
  4. All the above

All the above is the correct answer. A child with a concussion may feel depressed due to social isolation, a loss of place or physical changes in their brain.

Correct. A child with a concussion may feel depressed due to social isolation, a loss of place or physical changes in their brain.

Final Assessment - Part 3

What is the first step in responding to a child with a possible concussion?

  1. Remove the child from the activity
  2. Monitor the child for signs and symptoms
  3. Ask the child the memory questions
  4. Determine if the situation is a medical emergency

Actually, you should first use basic first aid principles to rule out a medical emergency. Once a medical emergency is ruled out, remove the child from the activity. Then monitor the child for signs and symptoms.

Actually, the memory questions are part of monitoring the child. You should first use basic first aid principles to rule out a medical emergency. Once a medical emergency is ruled out, remove the child from the activity. Then monitor the child for signs and symptoms including the memory questions.

You’re right. The first step in responding to an incident that could cause a concussion is to determine if the situation is a medical emergency. Once a medical emergency is ruled out, remove the child from the activity. Then monitor the child for signs and symptoms including the memory questions.

Following a hard hit your child has vomited three times while being monitored. You should call 911 immediately.

  1. True
  2. False

You’re right. Repeated vomiting is a red flag and considered a medical emergency.

Actually, repeated vomiting is a red flag and considered a medical emergency. You should call 911 immediately.

Your child was involved in a concussion causing incident. After ruling out a medical emergency, he was removed from play. He shows no signs or symptoms while being monitored and says he feels fine and is ready to return to the game. Your best response is to:

  1. Explain that he cannot go back into the game until he has been seen by a doctor and been cleared to play.
  2. Let him go back into the game but watch closely for signs or symptoms
  3. Tell him that if he still feels fine in 15 minutes and has no signs or symptoms of a concussion, then he can go back into the game.

This is the correct response. Even when a child who has been involved in an incident that could cause a concussion has no signs or symptoms, the child should not return to play until they’ve been cleared by a medical professional.

Actually, the signs and symptoms of a concussion can be delayed hours or days after the incident. If a child has been involved in an incident that could cause a concussion, the child should not return to play until they’ve been cleared by a medical professional.

Final Assessment - Part 4

A good way to reduce the risk of concussion is to:

  1. Model good sportsmanship
  2. Educate your players and children
  3. Stay informed on concussion information
  4. Ensure your child has the needed safety equipment and that it’s in good condition
  5. All of the above

Though this is a good way to reduce incidents that cause concussions, it takes more than one action to address the risk of concussions. If you also model good sportsmanship and educate your child and stay informed you will further support decreasing concussions

That’s right. It takes more than one action to address the risk of concussions. Modeling good sportsmanship, educating your child, staying informed and ensuring your child has the needed safety equipment and it’s in good condition are good ways to support decreasing concussions.

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