When I started out in pediatric practice I often took phone calls in the evening from parents with all sorts of questions about their children who were sick or had fallen or weren’t sleeping. A typical call went something like this:
“Doctor, my son was jumping on the bed and fell off and hit his head. There’s a big bump on his scalp. Could he have a concussion? What should I do?”
“How does he feel now?” I would ask.
“He seems fine. Maybe a little sleepy, but it’s bed time.”
“Did he pass out, even for a few seconds?”
“No, he cried right away and I put ice on the bump.”
“OK,” I would say, “he doesn’t have a concussion then. I suggest you keep him awake for the next four to six hours and then wake him every two hours to check on him.” Some doctors would even suggest shining a light in the child’s eyes to check whether his pupils were “even”—as if parents really knew what that meant.
We now know that most of that advice was wrong.
• The absence of loss of consciousness does not rule out a concussion
• The severity of a head injury or concussion can not be judged at the time of the event
• If a person has a headache after a mild head injury the most important things to do are to rest, be quiet, and sleep.
• Allowing complete rest — both physical and cognitive (meaning in the mind) — is the right thing to do. Checking on a person is natural; awakening him or her is harmful.
• Shining a light in the eyes of a head-injured person is not only annoying, but painful and is likely to disrupt the healing process.
It is critical that everyone—parents, friends, teachers, work colleagues, coaches, bosses, therapists, tutors, and siblings—understand the ramifications of a concussion for the victim. If they do not, the treatment and rest required by the victim will be accelerated or skipped altogether and recovery could be prolonged, sometimes indefinitely.
The above has been excerpted from It’s All in Your Head: Everyone’s Guide to Managing Concussions, a book by Dr. Ann Engelland, a seasoned pediatrician and adolescent medicine physician who works as a school and college physician. It’s All in Your Head: Everyone’s Guide to Managing Concussions will walk you through the steps of evaluating a head injury and will assist in diagnosing, managing, and recovering from a concussion. Based on the simple principle of The Four Rs: Recognize, Respond, Rest, and Reassess, It’s All in Your Head will empower you to support the injured and advocate for the best possible treatment and outcome, whether the injured person is you or someone you care about.
It’s All in Your Head Can be ordered in paperback or for the Kindle on Amazon today.