How To Identify TBI


Source: James Heilman, MD

While all the research about concussions are important, one of the best things those of us interested in informing the community about TBI can do is make sure everyone is aware of the symptoms and signs of traumatic brain injury as much as we inform them of the reality and dangers.

With the newly revised guidelines issued this year, hopefully reinvigorating coaches that may have gotten slack on TBI awareness, now seems like the perfect time to remind everyone how to identify concussions. Lewis G. Maharam shared his exhaustive list of concussion signs, but before we go into that, he also shared two major rules for TBI.

The first comes in the form of an old saying, “if in doubt set it out.” If you think someone even possibly suffered a concussion, they shouldn’t be returned to the field until they have been evaluated by a doctor. The second rule follows that if a player is diagnosed with a concussion, they shouldn’t return to activity until they have been completely cleared.

Those two rules are key in preventing “second impact syndrome”, a condition exponentially more risky than a single concussion, and is often fatal. SIS, as it is known, occurs when a person suffers a second TBI before while their brain is still vulnerable from the first TBI.

Now that the main rules are out of the way, here is Dr. Maharam’s list of concussion symptoms.

1. Any one of the following visible symptoms can be a sign of concussion:

  • Lying motionless or slow to get up or loss of consciousness;
  • Balance problems or lack of coordination;
  • Grabbing head;
  • Confusion as to plays or events recently or that day;

2. Any one of the following symptoms:

  • Loss of consciousness;
  • Seizures;
  • Balance issues;
  • Sadness, irritability;
  • Drowsiness;
  • Nausea and or vomiting;
  • Difficulty remembering;
  • Headache/dizziness;
  • Confusion;
  • Feeling a pressure in head
  • Blurred vision;
  • Neck pain;
  • Noise sensitivity;

3. Memory is decreased. Ask questions to discern this function like:

  • Who are we playing and what’s the score?
  • Who scored last?
  • What venue are we playing at?
  • Who did we play last week?
If you think a player has suffered TBI, do not remove a helmet or move a player unless qualified, and always remember, if there is any indication someone suffered a TBI, do not let them put themselves back in danger until they have been examined.

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