Concussion advice for patients seen in the Emergency Department

Download and print as a PDF (80kB pdf)

Overview

• This information gives advice on dealing with concussion. This is a temporary injury to the brain caused by a bump, blow or jolt to the head
• This information is for patients who have been seen by a health professional in the Emergency Department after sustaining a head injury. Please also read our head injury article for advice on when to seek urgent medical attention following a head injury
• Please seek prompt medical advice if you have any concerns

Things to remember

• Do not drive a vehicle until you have made sure that your concentration and reactions are good enough
• Avoid contact sports or other situations where you might sustain another head injury until cleared to do so by your doctor
• It often takes time for your concentration to come back to normal. This can impact on your school/university work so it is important to inform your teacher/tutor of your injury
• Do rest when you are tired
• Do be careful with alcohol. One small drink may have a larger affect
• Do pace your recovery in easy stages

What is concussion?

Concussion is a temporary injury to the brain caused by a bump, blow or jolt to the head. For most people, a concussion is a minor event that has no lasting side effects. However, in some cases the effects can last several weeks or longer.

The first two weeks:

It will probably take a couple of weeks before you feel you are completely ‘back to normal’. You may experience the following symptoms during this time

• Tiredness. Your brain will seem to have less energy. After even a little effort, you may feel exhausted. It is best to rest when you feel like this
• Poor concentration. You may feel less able to concentrate. If there’s something you must do, start when you have rested and are feeling refreshed. Stop as soon as your attention begins to fade
• Forgetting things. You may become forgetful. A concussion can affect your memory. Do not be alarmed, as it will get better. Make a note of important things you want to remember
• Irritability. You may get annoyed or lose your temper more easily. Don’t be alarmed. This is a result of your head injury. Try to notice when it starts to happen, and turn away, go out of the room and take time out. Find ways to relax, and use up your aggression by taking exercise
• Noise sensitivity. Putting up with noise needs brain energy, and people find it difficult after they have been concussed. Children playing, a loud radio, or machinery at work may be unbearable. The only remedy is to avoid the noise
• Dizziness and nausea. You may experience a feeling of unreality or floating, similar to dizziness. This is because a concussion sometimes upsets the balance organs in the ears. You may also notice that a sudden movement of your head can give you vertigo, so that the world seems to spin round and make you feel dizzy. These symptoms will settle with time
• Clumsiness. You may find that you bump into people in the street, or drop things. This is because your brain is reacting more slowly than usual. Avoid situations that might be dangerous, and take special care when crossing the street. Do not drive until fully recovered
• Eye problems. You may find that bright light bothers you and that it helps to wear sunglasses, even indoors. Sight is sometimes a little blurred, either because the eyes are not focusing well, or because they are not lining up correctly. These symptoms should settle – see an optician if things don’t improve
• Headaches. You will probably suffer from headaches. In the early stages, because of the bruising from the injury. Later the headaches are often due to tiredness or stress. Headache pills may not be effective. Take plenty of rest. If the headaches are severe and do not go away, you should see your doctor

What to do if the symptoms do not go away

For about one person in ten, the symptoms of a head injury last longer than two weeks. If your symptoms have lasted for more than two or three weeks, or are particularly severe, you should see your GP.

Sports injuries: when to play again

• Concussion is quite common in some sports, and there may be pressure to play down its effects. It is dangerous to risk a second concussion until all symptoms from the first injury have settled. Many sports bodies have strict rules about this which are for your protection. The minimum time away from sport is two weeks generally with a graduated return to play
• You should be reviewed by your GP/team doctor prior to your return to sport

More than one head injury

• Recurrent head injuries can lead to permanent impairment in brain function and potentially death
• These injuries are additive and should you have had multiple concussions in a year you should follow up with your GP or team doctor to discuss whether you should take a break or stop playing contact sport

General support

For general medical advice please use the NHS website, the NHS 111 service, walk-in-centres, or your GP.

• The BSUH Head Injury Service can be contacted for advice on ongoing symptoms following a head injury: Head Injury Nurse Specialist, Michelle East, telephone 0778 839 8209 or email [email protected]
• The NHS website provides online health information and guidance
• NHS 111 phone line offers medical help and advice from trained advisers supported by nurses and paramedics. Available 24 hours a day. Calls are free from landlines and mobile phones
• There are walk-in and urgent treatment services at Brighton Station, in Crawley and at Lewes Victoria Hospital
• Patient Advice and Liaison Service (PALS) can be contacted with your comments and concerns, and to provide general support