Level 3

Concussions & Other Head Injuries

Every year in Alberta, there are an average of 33,673 emergency department visits for children up to 14 years old for head injuries. Of those diagnosed with a head injury, 15% are concussions and the remaining are injuries such as fractures, scalp wounds, brain bleeds and other traumatic brain injuries.

A: CONCUSSION

A concussion is the most common form of head injury. Any blow to the head, face or neck, or a blow to the body that jars the head, could cause a concussion. It cannot be seen on X-rays, CT scans or on MRIs. A concussion can affect the way a person may think and remember things, and can cause a variety of physical, emotional, cognitive and sleep-related symptoms.1

In Alberta in 2018, there were 4,376 emergency department visits of children 14 years old and younger diagnosed with a concussion. The leading causes of these injury-related concussion visits were falls (42%) and sports-related (33%).

For children between 5 and 9 years old, there were 1,214 emergency department visits that resulted in diagnoses of a concussion, and over half of these visits were due to a fall.

For children and youth aged 10-14 years old, there were 2,541 emergency department visits with a diagnosis of concussion. Of these, 46% were sports-related and 28% were due to a fall.2

If a concussion is suspected, the person should stop the activity right away and should be diagnosed by a medical doctor. There is a higher risk of more severe, longer-lasting concussion symptoms, as well as an increased risk of other injury if the person continues the activity.1

A concussion can have significant impacts on a person’s physical, mental, and emotional health as well as their sleep patterns. These symptoms can affect daily activities and can last a short time of several weeks or, if not managed appropriately, could last for several months. Some signs and symptoms may be delayed for hours or days after an injury.

SIGNS & SYMPTOMS OF A CONCUSSION¹

Physical

  • Headache
  • Pressure in the head
  • Dizziness
  • Nausea or vomiting
  • Blurred vision
  • Sensitivity to light or sound
  • Ringing in the ears
  • Balance problems
  • Feeling tired or low energy
  • Drowsiness
  • “Don’t feel right”

Cognitive

  • Not thinking clearly
  • Feeling slowed down
  • Feeling like “in a fog”
  • Problems concentrating
  • Memory problems

Emotional

  • Easily upset or angered
  • Sadness
  • Nervous or anxious
  • Feeling more emotional

Sleep-Related

  • Sleeping more or less than usual
  • Having a hard time falling asleep

SIGNS & SYMPTOMS OF A CONCUSSION¹

Physical

  • Headache
  • Pressure in the head
  • Dizziness
  • Nausea or vomiting
  • Blurred vision
  • Sensitivity to light or sound
  • Ringing in the ears
  • Balance problems
  • Feeling tired or low energy
  • Drowsiness
  • “Don’t feel right”

Cognitive

  • Not thinking clearly
  • Feeling slowed down
  • Feeling like “in a fog”
  • Problems concentrating
  • Memory problems

Emotional

  • Easily upset or angered
  • Sadness
  • Nervous or anxious
  • Feeling more emotional

Sleep-Related

  • Sleeping more or less than usual
  • Having a hard time falling asleep

Red Flag Symptoms

If a person shows any of the following red flag symptoms, call an ambulance right away. These may be signs of a more serious injury:1

  • Neck pain or tenderness
  • Double vision
  • Weakness or tingling in arms or legs
  • Severe or increasing headache
  • Seizure or convulsion
  • Loss of consciousness (knocked out)
  • Deteriorating conscious state
  • Vomiting more than once
  • Increasingly restless, agitated or combative
  • Growing confusion

For most people after a concussion, encourage initial rest / sleep as needed and limit smartphone / computer and screen use for the first 24-48 hours. In the first 24-48 hours, it is ok to perform mental activities like reading, and activities of daily living as well as walking. Concussion symptoms usually last from one to four weeks, but might last longer. It can take weeks or months to heal for some people, particularly if a person has had a concussion before. Depending on the symptoms and how a person improves, a person’s recovery may be supported by a variety of treatments and a team of health professionals.¹

When should children return to school?
Children returning to school after a concussion may need support because a concussion may affect their ability to learn. To ensure their concussion symptoms do not become worse, some students may require a gradual return to learning and activities, and might need certain accommodations to their schedule and environment. If a particular activity makes symptoms worse, that activity should be stopped and the student should rest until symptoms improve. To ensure the student successfully returns to school, it is important that the health care provider, parents, caregivers, and school staff communicate to plan for the student's successful return.³

Children should successfully return to school before returning to their sports activities.

Many school districts / boards have a concussion protocol.

B: OTHER HEAD INJURIES

Besides concussion, children can experience other types of head injuries that can have long lasting effects. Similar to concussions, these injuries can also occur when participating in sport and recreation activities, or as the result of a fall or motor vehicle crash. One of the most effective strategies for protecting children from head injuries is to use an appropriate helmet. Research indicates that bike helmets can reduce head injury by 48%, serious head injury by 60%, facial injuries by 23% and the total number of killed or seriously injured cyclists by 34%.4

Helmets are designed to protect the wearer’s head based on the type of injuries that may be associated with that activity. As a result, it is not safe to use a helmet designed for one activity for a different activity (e.g., using a hockey helmet for skiing). More information about which helmet to use for which activity, can be found at Parachute’s Which Helmet for Which Activity.

For all grades

Check out the Brain Waves Program video that shares how to present the Brain Waves program that helps support this lesson plan (optional). This video indicates that preparation is required and needs to be done about a week ahead of time.

More information about the Brain Waves presentation, activity books, slideshows and videos can be found here: https://parachute.ca/en/brain-waves-resources that will help support this module.

References

1. Parachute. (2021). Concussion. https://parachute.ca/en/injury-topic/concussion
2. Injury Prevention Centre. (2022). https://injurypreventioncentre.ca/issues/children
3. SPHEReS. (2022). https://myspheres.ca
4. Høye A. Bicycle helmets - to wear or not to wear? A meta-analyses of the effects of bicycle helmets on injuries. Accident Analysis & Prevention. 2018;117:85-97.

GRADE 5 - Physical Education and Wellness Curriculum

ORGANIZING IDEA

Safety: A lifetime of optimal well-being is supported by prioritizing health and safety.

GUIDING QUESTION

How can responsibility lead to a desired outcome? 

LEARNING OUTCOME

Students analyze responsibility and consider the impact on well-being. 

Responsibility is being accountable for actions and decisions and accepting the results or consequences.

Safety of self and others can be enhanced through community programs, such as first aid training, and supports, including health professionals.

Responsibility to ensure the safety of self and others includes following:

  • laws
  • rules
  • practices
  • protocols
  • digital citizenship (responsible conduct and safety)

Personal actions and decisions can affect physical, social-emotional, and financial well-being.

Responsibility includes ensuring the safety of self and others.

Reflect on how the results or consequences of personal actions and decisions can affect the wellbeing of self and others.

Identify laws, rules, practices, and protocols that support safety and well-being in a variety of contexts. 

GRADE 6 - Physical Education and Wellness Curriculum

ORGANIZING IDEA

Safety: A lifetime of optimal well-being is supported by prioritizing health and safety.

GUIDING QUESTION

 In what ways might risk influence the outcome of an action? 

LEARNING OUTCOME

Students examine risk and identify the factors that influence action. 

Risk is the overall assessment and identification of hazards related to personal safety and vulnerability.

Short-term and long-term risk can be managed or reduced through planning, rehearsal, and evaluation.

Aspects of life impacted by risk include: 

  • mental health
  • physical well-being
  • safety

Measured risks can be taken in stages and are more likely when individuals feel safe, respected, and trusted. 

Risk can lead to an increased likelihood of complications in various contexts.

Risk has potential to positively or negatively impact several aspects of life.

Discuss how feelings associated with risk taking affect actions and decisions. 

Describe consequences that may result from risk taking in various contexts. 

Reflect on the positive and negative impacts of risk taking in a variety of contexts.

Learning Objectives

  1. Describe the activities that could cause a concussion.
  2. Identify the importance of protecting your head and brain.
  3. Identify the symptoms of a concussion.
  4. Identify red flag symptoms.
  5. Describe the lobes of the brain and their role.
  6. Identify the steps for recovering from a concussion.

Key Messages

  • Protect your head.
  • A blow to your head, neck or body could cause a concussion.
  • If you think you, or your friend, has a concussion, tell an adult right away.
  • If you have a concussion, it's important to follow medical advice to recover and get back to normal.

Required Materials / Teacher Preparation

  1. Flipchart paper / whiteboard / SMART board / projector.
  2. If using Egg Drop or Melon Drop or Jell-O brain experiment, check out required materials.
  3. A copy of pages 8-10 from the Brain Waves activity booklet for each student, markers for colouring and labelling.
  4. Projector / SMART board to show the following videos:
    a. Brain Anatomy
    b. Smell
    c. Taste
    d. Vision
    e. Hearing
    f. Touch
    g. Concussions
  5. OPTIONAL: Connect with the Injury Prevention Centre, University of Alberta for more information about the Brain Waves program. Brain Waves is a free, informative and fun half-day neuroscience presentation for students in grades 4 to 6 that includes slide decks, videos and other presentation materials, as well as experiments for each of the senses.

Note

The Jell-O brain must be prepared the day before and stored in the refrigerator. It will be used to demonstrate the fragility of the brain that is protected by the skull.

Time Required to Teach Lesson

  • Approximately 45 minutes.

Safety Considerations

  • None.

Note

The activities have been split into two parts based on the type of head injury; concussion or other head injuries. While helmets can be a very effective strategy for preventing serious head injuries, they are not proven to prevent concussions.1

Activities

Overview:

Explain to students that today, they will be learning about head injuries and how to prevent them. Head injuries can include concussions, bumps and bruises, open wounds, fractures and other types of brain injuries. Since concussion is the most common type of head injury, we will talk about them first.

A. Concussion:

1. Upload and present the ‘Brain Safety Stars! Grades 5&6’ presentation to explain the concepts below.

2. The brain is the control centre of the body and needs to be protected. A concussion can be caused by any blow to the head, face or neck, or a blow to the body that jars your head.

a. Explain to the class the 3 main ways a person can get a concussion are falls, motor vehicle crashes and sport activities. Ask children to think of different ways for each of these categories that someone could get a concussion. Examples might include: playing sports, getting into a car crash, crashing into something or someone.

3. Some ways to prevent concussion include:

a. Wear your seat belt.
b. Avoid hitting other people in the head.
c. Fair play and sportsmanship in sports.
d. Know the rules of the game.
e. Remove hazards from the field or play area (e.g., trees, benches).

4. Why is it important to protect your brain? Handout copies of pages 8-10 from the Brain Waves activity booklet so that students can create their own "Thinking First Cap" or 3D cap of the brain for learning about the lobes of the brain and the senses they control. Then, upload and present the Brain Waves video links listed below that explain how the brain works, the different lobes and how they control the senses. Note: speaking notes and detailed activity instructions can be found in the presentation slide deck.

a. Show the following videos which demonstrate the lobes of the brain and how they work to control the senses. Finally, the Concussion video discusses what a concussion is, how to protect your brain and what to do if you get a concussion.

i. Brain Anatomy
ii. Smell
iii. Taste
iv. Vision
v. Hearing
vi. Touch
vii. Concussions

b. OPTIONAL: Connect with the Injury Prevention Centre, University of Alberta for more information about the Brain Waves program. Now would be a good opportunity to conduct the experiments related to each of the senses.

5. What should you do if you think you have a concussion? It’s important to tell an adult right away if your head has been jarred. If you or another student are injured, tell an adult. Once you tell an adult, they can determine if you need to see the doctor. Remember:

a. From Parachute’s Brain Waves program, "STAR - Stop Playing, Tell an Adult, Get Assessed and Rest".
b. "When in doubt, sit it out".

6. Explain to the class, we will be learning about how to identify a concussion. At the end of the presentation, you will be a brain safety star!

a. Ask the class what are some signs or symptoms of a concussion? Use the slidedeck to review various signs and symptoms
b. Review 'Red Flag Symptoms' with the class. Explain that Red Flag Symptoms are dangerous signs of an injury to the brain and the person should be taken to an emergency room or doctor right away. Red Flag Symptoms include:

    1. The worst headache you have ever had
    2. Vomiting
    3. Neck pain
    4. Seizures
    5.  Getting more confused

c. Have the students match the concussion symptoms to the right categories on the Recognize Concussion Symptoms Worksheet or as a class on a flipchart or whiteboard, read the possible symptoms and have the class decide with a thumbs up (correct) or thumbs down (incorrect) which category the symptom should be placed.
d. A medical practitioner must diagnose a concussion. If you are diagnosed with a concussion:

i. Encourage initial rest / sleep as needed and limit smartphone / computer and screen use for the first 24-48 hours
ii. Return to light activity
iii. Return to school
iv. Return to sports activities - this must be after returning to school.

7. Show the 3 minute video about Concussions from Parachute to the class to summarize what was learned today. Other videos about the brain and how it functions can also be found at this site.

B: Other Head Injuries

Let the students know that we are now going to discuss other types of head injuries. Often these injuries are very visible when they occur and can be identified by a doctor using tests such as x-rays, CT scans and MRIs. You can share this image / story to show the head injuries David suffered when he fell off his bike.

8. Some ways to prevent head injuries include:

a. Wearing a helmet for biking, in-line skating, hockey, skateboarding, horseback riding, football, other contact sports, motorcycling, skating, skiing (Note: More information about properly fitting helmets and helmet use for sports activities can be found in the Sports Safety Module).
b. Other ways to prevent head injuries are similar to the ways we can prevent concussion. Do you remember what they are?

i. Wear your seat belt.
ii. Avoid hitting other people in the head.
iii. Fair play and sportsmanship in sports.
iv. Know the rules of the game.
v. Remove hazards from the field or play area (e.g. trees, benches, light standards).

c. Let the class know that you are now going to demonstrate how fragile the brain is by using one of these activities:

i. Egg Drop
ii. Melon Drop
iii. Jell-O Brain

Class Discussion Questions

a. You are visiting your grandparents. While shovelling the snow from the sidewalk, your grandfather slips and falls. When he comes inside, he seems confused and says he has a headache. What should you do?

Let's Review

Today we learned about the importance of protecting our brains and what a concussion is and what to do if we see signs and symptoms of a concussion.

Concussion & Other Head Injuries

Are you ready to review what we learned? Complete the following short-answer questions:

 

1. Define what a concussion is. List at least three symptoms of a concussion.

2. What are red flag symptoms and what should you do if they occur? List at least two red flag symptoms of a concussion.

3. Describe the steps that should be taken to recover from a concussion.

4. What are the three leading causes of head injury for children?

5. Why is it important to protect your brain?

6. Describe the lobes of the brain and their role or function.

ANSWER KEY:

  1. A concussion is a brain injury that is caused by a blow to the head, neck, or face, or by a blow to the body that jars the head. Answers include any three of the following: headache, dizziness, nausea or vomiting, not thinking or feeling ‘right’, sadness, frustration, and changes to sleep.
  2. Red flag symptoms are very serious signs that the brain has been injured and that there is a concussion. Examples of red flag symptoms are: vomiting, becoming more and more confused, a severe headache, seizures and neck pain.
  3. A doctor needs to diagnose a concussion. If one is diagnosed the person should rest for the first 1-2 days and not engage in physical activities or cognitive activities like watching TV or using a phone. No screens allowed. Then the person can return to light activity, return to school and then return to sports activities once feeling better and not experiencing symptoms.
  4. The three leading causes of concussion in children are falls, motor vehicle crashes and sports activities.
  5. The brain is the control centre of the body and controls many things including breathing, thinking, moving, listening, your heart beat and digesting food. Protecting your brain is important because if it gets injured it can affect the things it controls and cause you to feel unwell or be seriously injured.
  6. The brain has 4 important lobes, frontal lobe, parietal lobe, temporal lobe and occipital lobe. Each lobe has a job to do to work our bodies and affect our senses - sight, touch, taste, smell and hearing. The frontal lobe allows us to solve problems; the parietal lobe helps us taste, the temporal lobe allows us to hear and smell and the occipital lobe controls our vision.

Home Connections

Send a letter home to caregivers informing them that their child will be learning about concussions and helmets. Encourage caregivers to learn about how concussions can occur, signs and symptoms of a concussion, and the importance of seeking medical help. A sample letter is located below.

Community Connections

Invite a representative from a local bicycle group or sports store to talk about the importance of helmets and how to wear them correctly. For information about concussions, consider reaching out to sports associations (i.e., minor hockey, soccer, ringette) or coaches to inquire about visiting your class to share their experience regarding concussions.

Sample Letter

(may be printed on school letterhead or used as a template for SchoolZone / SeeSaw)

Dear Parent / Caregiver,

Today our class learned about head injuries, including concussion, the importance of protecting our brains, and what to do if we see signs and symptoms of a concussion.

Every year in Alberta, there are an average of 33,673 emergency department visits for children up to 14 years old for head injuries. Of those diagnosed with a head injury, 15% are concussions and the remaining are injuries such as fractures, scalp wounds, brain bleeds and other traumatic brain injuries.

A concussion is the most common form of head injury. Any blow to the head, face or neck, or a blow to the body that jars the head, could cause a concussion. A concussion can affect the way a person may think and remember things, and can cause a variety of physical, emotional, cognitive and sleep-related symptoms (Parachute, 2021).

As a parent / caregiver, there are things you can do to help prevent head injuries from happening to your child.

  1. Always make sure your child wears the right protective gear for the sport they are playing.
  2. While helmets are not effective for preventing concussions, they are very effective in preventing other serious head injuries. Have your child wear the right helmet for the sport they are playing. More information about which helmet to use for which activity, can be found at:
    https://parachute.ca/wp-content/uploads/2019/06/Which-Helmet-For-Which-Activity.pdf
    For those under 18 years old, wearing a helmet is the law when operating or riding a bicycle.
  3. When travelling in a car, always wear your seatbelt as it will help protect your head and body in the event of a crash. It is also the law in Alberta.
  4. Know the signs and symptoms of concussion and when to see a doctor. If a concussion is suspected, the person should stop the activity right away and should be assessed and diagnosed by a medical doctor. Check out this link from Parachute about concussion signs and symptoms:
    https://parachute.ca/en/injury-topic/concussion and this link https://resources.cattonline.com/files/concussion-information-package-for-parents-caregivers from the Concussion Awareness Training Tool (CATT) for additional information.

By using these strategies, you can help teach your child the importance of preventing concussions.

Sincerely,

[Insert Teacher Name Here]

Additional Resources

Resources available for school professionals:

Concussion Awareness Training Tool (CATT):

Parachute:

Injury Prevention Centre:
https://www.injurypreventioncentre.ca/issues/concussion

School Physical Activity Health & Education Resource for Safety:
https://myspheres.ca/en/fundamental-reading/concussions

CDC - HEADS UP to Schools: Online concussion Training for School Professionals:
https://www.cdc.gov/heads-up/training/school-professionals.html

Resources to share with children and their parents / caregivers:

Concussion Awareness Training Tool (CATT):

 

Public Health Agency of Canada Concussion in Sport Infographic:
https://www.canada.ca/content/dam/phac-aspc/documents/services/publications/diseases-conditions/PHAC-concussion-sport-infographic_may8-eng.pdf

HELMETS:

Parachute:

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