Concussion Checklist

How to tell if someone has a concussion

It is not always easy to know if someone has a concussion.  You don’t have to lose consciousness to have a concussion.  A concussion is a type of traumatic brain injury that is caused by a blow to the head or body, a fall, or another injury that jars or shakes the brain inside the skull.  Although there may be cuts or bruises on the head or face, there may be no other visible signs of a brain injury.

Some people will have obvious symptoms of a concussion, such as passing out or forgetting what happened right before the injury.  But other people won’t.  With rest, most people fully recover from a concussion.  Some people recover within a few hours.  Other people take a few weeks to recover.  In rare cases concussions cause more serious problems.  Repeated concussions or a severe concussion may require surgery or lead to long-lasting problems with movement, learning, or speaking.  Because of the small chance of permanent brain problems, it is important to contact a doctor if you or someone you know has symptoms of a concussion.

The following is a checklist of steps of how to tell if someone has a concussion:

• Check for loss of consciousness
• If unconscious, check the victim’s ABCs:
• Airway
• Breathing
• Circulation
• Do not move them unless absolutely necessary.
• Check the victim for mental awareness. Ask questions, such as:
• What is your name?
• Where are you?
• What happened to you?
• Check the victim’s eyes.  If you have a flashlight, shine the light into their eyes to see if their eyes focus on the light and the pupils react correctly.  The pupils of the eyes focused completely on light should constrict.  If there is no response or they have irregular eye movements, suspect a head injury, stroke, or serious ailment.
• Watch for vomiting.
• Keep the patient awake for a period of time after the injury to see if they are worsening.  Sleepiness or difficulty wakening can be another red flag that things are not good.
• Be aware that sometimes complaints subside only to appear later on with more severity.
• Adults tend to go downhill once they have experienced a concussion.  Children on the other hand may not.  Keep a close watch on younger children for warning signs.

Other steps to take include:

• Observed signs
• Appears dazed or stunned
• Is confused about events
• Repeats questions
• Answers questions slowly
• Can’t recall events prior to the hit, bump, or fall
• Can’t recall events after the hit, bump or fall
• Loses consciousness
• Forgets schedule

Physical Signs

• Headache or “pressure” in head
• Nausea or vomiting
• Balance problems or dizziness
• Fatigue or feeling tired
• Blurry or double vision
• Sensitivity to light
• Sensitivity to noise
• Numbness or tingling
• Does not “feel right”

Cognitive Symptoms

• Difficulty thinking clearly
• Difficulty concentrating
• Difficulty remembering
• Feeling more slowed down
• Feeling sluggish, hazy, foggy, or groggy

Emotional Symptoms

• Irritable
• Sad
• More emotional than usual
• Nervous

Danger Signs

• Be alert for symptoms that worsen over time.  The victim should be seen in an emergency department right away if he or she has:
• One pupil larger than the other
• Drowsiness or cannot be awakened
• A headache that gets worse and does not go away
• Weakness, numbness, or decreased coordination
• Repeated vomiting or nausea
• Slurred speech
• Convulsions or seizures
• Difficulty recognizing people or places
• Increasing confusion, restlessness, or agitation
• Unusual behavior
• Loss of consciousness

It is important to seek emergency care if you believe your family member has experienced a concussion and has any symptoms of a traumatic brain injury.  A repeat concussion that occurs before the brain recovers from the first, usually within a short period of time, can slow recovery or increase likelihood of having long term problems.  In rare cases, repeat concussions can result in edema (brain swelling), permanent brain damage, and even death.