ECB Coaches Association links Inside Edge 6 May 2018

34 THE EXPERT’S VIEW If any of the following are noted and no qualified medical professional is available then contacting the emergency services, via 999, immediately is recommended. NECK PAIN INCREASING CONFUSION OR IRRITABILITY REPEATED VOMITING SEIZURE OR CONVULSION WEAKNESS OR TINGLING / BURNING IN ARMS OR LEGS 35 THE EXPERT’S VIEW R E C OV E R A N D R E T U R N Concussion takes time to recover from. It requires a period of rest for the body and the brain then a gradual return to full play. There is an internationally recognised step wise way to do this (See table 2). Crucially, the player should not have any symptoms to pass through all the stages and must be cleared by a qualified health professional before returning to full training. The player needs a 24-hour window for each level and this therefore means no further return to a full training situation for six days. For children and adolescents it is appropriate to extend the amount of time because the brain of children and adolescents brain is still developing. 23 days is the usual minimum time for return to full play in this age group. DETERIORATING CONSCIOUS STATE UNUSUAL BEHAVIOR CHANGE DOUBLE VISION The force of a blow to the head can change chemicals in brain cells. This can affect thinking, behavior, coordination and the player’s mood. In extreme head injuries the player could lose consciousness. The majority of concussion symptoms recover quickly within a few minutes to hours, even so it may actually take several weeks for the chemical changes in the brain cells to recover. No matter whether the player is playing a key role in the match, a player with a suspected concussion should be immediately removed from the field in order to undergo medical assessment. They should not be allowed to return to play until they are assessed medically. This is important for everyone but especially in children and in young adults as their brain is still developing. There can be short term and long term consequences if a player plays on with a concussion. In the short term, during the match or training session, the player is likely to have a poorer reaction time. The player therefore will perform worse than usual impacting the whole team. Their change in coordination also means they are at much higher risk of other injuries (e.g. ankle sprains). A second head injury quickly after a first could result in a condition called Second Impact Syndrome where the brain swells quickly. This condition is rare but can lead to death. In the longer term, symptoms of concussion may persist longer and can have a major effect on the player’s general life. C OAC H E S R O L E Coaches have a key role in setting the culture of their team. They can encourage their players to be open with reporting symptoms and understand there is a structured approach to the assessment and management of all head injuries. “The force of a blow to the head can change chemicals in brain cells. This can affect thinking, behavior, coordination and the player’s mood. In extreme head injuries the player could lose consciousness.” CONTINUE SEVERE OR INCREASING HEADACHE

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