Concussion – More Than a Knock to the Head
Concussion in Australian Football players has been a much talked about topic across the code since the recent release of the Concussion Management Guidelines by the AFL Medical Officer’s Association.
While not a regular occurrence, (5-6 concussions per 1000 playing hours), many country football clubs will be faced with a scenario over the season where a player has received a knock to the head in the course of play and will be required to be managed in regards to concussion or suspected concussion.
As always, the welfare of the player should be the most important thing for a club to consider as they are faced with this scenario – both at the time of the injury, and in the time afterwards in recovery.
It is critical to acknowledge that concussion is a disturbance of brain function that results from a trauma to the brain. The changes are temporary and the majority of players recover completely if managed correctly. Concussion typically falls into the milder spectrum of traumatic brain injury and reflects a disturbance in brain function. Concussion does not involve structural damage or any permanent injury to the brain tissue.
Common symptoms of concussion include headache, blurred vision, dizziness, nausea, balance problems, fatigue and feeling “not quite right”. Other common features of concussion include confusion, memory loss and reduced ability to think clearly and process information. Loss of consciousness is seen in only 10-20% of cases of concussion in Australian football.
Complications can occur if a player is returned to the field of play before they have recovered from their concussion. No player with concussion should ever be returned to play in the same game.
The identification of concussion can be tricky for those of us without extensive medical training. In the early stages of injury it is not often clear whether you are dealing with a concussion or there is a more serious underlying head injury is present. Generally, initial decisions in this area in country football will be made by the head trainer, unless the club has a medical doctor in attendance.
The industry standard SCAT2 test provides a series of questions and tests that can be conducted on a player to assess their physical signs, brain function and abnormal behavior. A pocket SCAT2 guide (along with the full description of AFL MOA guidelines) has been provided to all WorkSafe VCFL leagues, and this guide should be an important part of the trainer’s first aid kit at every match.
It is important to note that trainers should not be swayed by the opinions of the affected player, other players, coaching staff or any others suggesting a premature return to play.
Conversely, coaches must, in accordance with the AFL Coaches Code of Conduct, not put undue pressure on trainers or players to make such decisions. A major responsibility of coaches is their duty of care towards their players and the players’ safety. This duty is highlighted when players receive a knock to the head and suffer a concussive injury.
The key components to remember in the management of concussion on a matchday:
a) Recognise that a player is concussed or potentially concussed.
b) Do not return the player to the game to give the first aid team the time and space to assess the player. Undertake a comprehensive SCAT2 test on the player.
c) If a player is showing symptoms of headache, vomiting, or confusion – transfer the player to immediate medical evaluation.
d) Ensuring the player has received medical clearance before allowing that player to return to a graded training program.
In the cut and thrust of trying to win a game of sport, nothing is more important than the wellbeing and health of the players. Four points is not worth a lifetime of pain.
If in doubt, sit them out.
Brett Connell
WorkSafe VCFL Operations Manager
