About Concussions:
New Findings & Information

Dr. Rebecca Demorest specializes in treating pediatric and young adult sports injuries, including sports concussions, in the Pediatric and Young Adult Sports Medicine Clinic at Children's Hospital.

To best manage pediatric concussions she utilizes her own expertise as a primary care pediatric sports medicine specialist along with pediatric neurologists, neurosurgeons, radiologists and neuropsychologists.

WHAT IS A CONCUSSION?

HOW TO RECOGIZE THE SIGNS OF CONCUSSION

WHAT TO DO IF YOU THINK YOUR CHILD HAS A CONCUSSION

ACTION PLAN FOR RETURN TO PLAY

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It's the last thing parents ever want to think about, but unfortunately, concussions do happen and parents need to be aware of new findings on treating children with concussions.

WHAT IS A CONCUSSION?
A concussion is a brain injury caused when the force from a blow to the head or other impact to the body travels to the head. When the force of the impact causes the brain to move around inside the skull---a concussion may occur.

HOW TO RECOGIZE THE SIGNS OF CONCUSSION
Don’t let your child play if they experience or exhibit any of these signs or symptoms after suffering a bump or blow to the head.

• Headache or “pressure” in their head
• Balance problems or dizziness
• Signs of confusion
• Trouble concentrating
• Signs of memory loss (like forgetting sports plays)
• Anxious, irritable, or sad for no apparent reason
• Nausea or vomiting
• Vision changes
• Sensitivity to light or sound
• Fatigue / sleep problems
• Fainting or loss of consciousness

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WHAT TO DO IF YOU THINK YOUR CHILD HAS A CONCUSSION
Immediately take your child to the Emergency Room or your pediatrician’s office for further evaluation if you are concerned and/or your child is exhibiting worsening symptoms, including: lethargy, deteriorating level of consciousness, seizure, “worst headache of his/her life”, excessive vomiting, neurologic problems on one side of the body, decreased sensation, or if you think your child’s neck was injured.

• Full recovery from a concussion is different for each child--- it may take 1-2 weeks, several weeks, or even months.
  
  
• Sometimes kids may not experience and/or report symptoms until hours or days after the injury. If you think your child may have a concussion, err on the side of caution and keep your child from participating in physical activities, athletics and excessive cognitive activity until they have recovered.
  
  
• Recovery from concussion requires MENTAL and PHYSICAL rest.
  • Resting physically and mentally gives the brain time to heal. A complete rest means limiting mental (cognitive) activities as well as physical activities. This means – no text messaging, no video games, no homework, and possibly limiting school attendance and activities.
    
    
• Do not use ibuprofen for the first 48 hours if your child has a concussion headache.
  • Ibuprofen can act as a blood thinner, so if your child has a head bleed from the concussion, this theoretically could make things worse. You may use acetaminophen to help decrease head pain. After the first 48 hours, ibuprofen or acetaminophen may be used to help with concussion headaches.
    
    
• Your child may be tired and need more sleep. Allow them to take naps and get the rest that they need. Lots of rest helps your child’s brain recover.
  • Many concussed children have problems falling asleep or staying asleep. Make sure they do not do stimulating activity before bedtime and if they are having problems sleeping, consult your physician for evaluation.
    
    
• Make sure your child stays hydrated and eats a snack (combining carbohydrates and protein) every 3-4 hours while recovering from a concussion. Dehydration and low blood sugar may worsen concussion headaches.
  
  
• Avoid attending activities that may increase concussion symptoms such as sporting events, concerts, large gatherings or movies until your child is feeling back to normal.
  
  
• Your child should not return to sports or play until given permission by a healthcare professional with experience evaluating concussions.                            

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ACTION PLAN FOR RETURN TO PLAY
It's important that your child feel 100% well before starting the “return to play” guidelines below. Wait until all concussion symptoms are gone---and that doesn't just mean physical symptoms like headaches or tiredness. In many teens, the physical symptoms get better before the cognitive ones do (such as difficulty thinking or making decisions.)
When your child is behaving normally, no longer using concussion headache medications, has no symptoms and is fully back to school---follow these step-by-step guidelines to ease back into normal sports activity and play.

Step 1: Light cardiovascular activity (15-20 minutes light jogging or biking)
Step 2: Non-contact activity (kicking balls, throwing free throws)
Step 3: Non-contact practice & sports training drills
Step 4: Full contact practice
Step 5: Game play

Your child may proceed to the next step only when he or she is symptom-free for 24 hours following an activity level. If symptoms recur during, after or within the 24 hours following activity, wait until the symptoms are completely gone and begin again at the previous level.

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