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Emergency Department Concussion Advice Leaflet

Concussion can be considered as a minor head injury. It is caused by an impact to the head or body causing the brain to move around in the skull.

There are a number of short and long term symptoms, these can include:

  • Headache
  • Blurred vision
  • Feeling like in a fog
  • Confusion
  • Pressure in head
  • Balance problems
  • “Don’t feel right”
  • Drowsiness
  • Neck pain
  • Sensitivity to light
  • Difficulty concentrating
  • More emotional
  • Nausea or vomiting
  • Sensitivity to noise
  • Difficulty remembering
  • Irritability
  • Dizziness
  • Feeling slowed down
  • Fatigue/low energy
  • Sadness
  • Trouble falling asleep
  • Nervous/anxious

Most symptoms resolve within days. Rest is a very important factor in recovery from concussion. This includes rest from physical activity such as exercise, but also rest from tasks such as concentrating and stimulation from screens or phones.

It is recommended to avoid alcohol, driving and some medications (sleeping tablets and strong pain killers) until symptoms fully settle.

Graduated Return to Activity (education/work) and Sport

Stage 1: Relative rest for 24-48 hours

  • Minimise screen time
  • Gentle exercise

Stage 2: Gradually introduce daily activities

  • Activities away from school/work (can introduce TV, increase reading, games etc

Stage 3: Increase tolerance for mental and exercise activities

  • Increase study/work related activities with rest periods
  • Increase intensity of exercise

Stage 4: Return to study/work and sport training

  • Part time return to education/work
  • Start sport training activities without risk of head impact

Stage 5: Return to normal work/education and full training

  • Return to full work/education
  • If symptom free at rest for 14 days then consider full sport training

Stage 6: Return to sports competition

  • Not before day 21 as long as you are symptoms free for 14 days and during training period in stage 5

Individual sporting bodies e.g. FIFA/RFL/RFU will have their own version

Rest until the following day if this activity more than mildly increases symptoms

Information taken from UK Concussion Guidelines for Non-Elite (grassroots) Sport, April 2023

For a more detailed description of the stages of return and to view the guidance please go to: https://www.sportandrecreation.org.uk/policy/research-publications/concussion-guidelines

Prolonged Symptoms

As mentioned previously, most concussions settle within a month. However, some people unfortunately go on to have prolonged concussions with symptoms lasting months.

If your symptoms are lasting longer than two weeks then call 111. If lasting more than 28 days then you will need to see your GP.

There are some good resources from Headway, a charity for brain injuries: https://www.headway.org.uk

It is vital that you stay with a responsible adult for 24 hours and return to the Emergency Department if you experience any of the following symptoms:

  • Worsening headache
  • Vomiting
  • Excessive drowsiness
  • Any weakness in the arms/legs
  • Increasingly restless, agitated or combative
  • Blood or clear fluid from ears or nose
  • Seizures/convulsions
  • Speech problems

This discharge leaflet has been created in accordance with the NICE Guidance NG232 for Head Injury

Accessible Information

If you need this information in another format or language and are in the hospital, please ask a member of staff. If you are accessing this leaflet online or on your phone you can see our Google Translate automated guidance on the Digital Patient Information Hub home screen.

People with hearing and speech difficulties

You can contact us using the Relay UK app. Textphone users will need to dial 18001 ahead of the number to be contacted.

Smoking

Bradford Teaching Hospitals NHS Foundation Trust is a smoke-free organisation. You are not permitted to smoke or in use e-cigarettes in any of the hospital buildings or grounds.

Published by
, Bradford Royal Infirmary, Duckworth Lane, Bradford BD9 6RJ.

Authors: ,
Date of publication: Sep 2024
Review Date: Sep 2026
MID Ref: 24080119