Level 1

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

 

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.

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 1 - 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 boundaries contribute to safety?

LEARNING OUTCOME

Students explain how boundaries connect to safety.

Safety includes understanding the differences between situations that are safe and those that are unsafe or uncomfortable.

Personal and group boundaries can be expressed through

  • rules
  • symbols
  • signs
  • body language

It is important to ask for help in situations that do not feel safe.

Boundaries are expressed to indicate a need or a want related to feelings of safety and security.

Describe differences between safe situations and unsafe or uncomfortable situations.

Discuss needs and wants that connect to feelings of safety and security.

GRADE 2 - 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 safety be promoted in various contexts?

LEARNING OUTCOME

Students examine and apply personal safety in a variety of situations.

Safety strategies are developed for a variety of contexts, such as

  • home
  • school
  • online
  • emergencies

Safety is when individuals are free from physical harm or injury, illness, and emotional harm.

Situations and contexts may present different safety concerns.

Safety strategies and procedures can be practised in a variety of ways.

Safety is needed for survival.
Trusted adults in the school and community can support individuals in unsafe and uncomfortable situations.

Safety involves assessing for potential risk or injury by identifying safe and unsafe situations and substances.

Safety is when individuals are free from physical harm or injury, illness, and emotional harm.

Discuss ways to respond in unsafe or uncomfortable situations.

Classify situations that are safe and unsafe.
Describe situations where substances may be harmful.
Examine how safety can be improved in a variety of situations.

ORGANIZING IDEA

Active Living: Developing physical literacy through movement and active living supports well-being across a lifespan.

GUIDING QUESTION

What makes physical activity meaningful?

LEARNING OUTCOME

Students investigate physical activity and relate it to personal experience.

Preparation and recovery actions can support endurance, improve flexibility, and reduce the risk of injury.
Preparation for and recovery from physical activity include:

  • nutrition and hydration
  • warm-up and cool-down
  • appropriate equipment, clothing, and footwear

Physical activities can be enhanced through preparation and recovery.

Demonstrate appropriate preparation for and recovery from physical activity.

Learning Objectives

  1. Describe the activities that could cause a concussion.
  2. Identify the importance of protecting the brain.
  3. Identify the symptoms of a concussion.
  4. Identify the steps for recovering from a concussion.

Key Messages

  • Keep your brain safe.
  • A blow to your head, neck, or body could cause a concussion.
  • If you think you, or a 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
  2. If using Egg Drop or Melon Drop experiment, check out required materials.

Time Required to Teach Lesson

  • Approximately 30 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 1&2' 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 - though, not all blows cause a concussion.

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. 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. A concussion is a brain injury that can't be seen on X-rays, CT scans or MRIs. 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."

4. 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. 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.

5. Show the 3 minute video about Concussions from Parachute to the class to summarize what was learned today. Click on the link above and look for video #9 called “Concussions - Kelli”. 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.

6. 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).

7. How do helmets help protect the head? Helmets are made specifically for each type of activity. Ask the class what are some different types of helmets they can think of, examples could be: bike helmet, hockey helmet, football helmet.

a. Always wear the type of helmet that is appropriate for the sport you are playing
b. Helmets should fit properly using the 2-V-1 method (more information on this can be found in the Sports Safety Module). 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

Class Discussion Questions

a. Your brain is an important part of your body. What are some ways you can take care of your brain?
Prompts: eating healthy foods, exercising regularly, wearing a helmet, giving your brain a workout by doing puzzles, playing music, reading, or creating art.

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.

Let’s Review: Concussion & Other Head Injuries

Are you ready to review what we learned?
Select ‘true’ or ‘false’ for each question.

1 / 5

1. If you have a hit to your face, head, neck, or body, you should not tell an adult.

2 / 5

2. Vomiting, dizziness and having trouble thinking are not signs of a concussion.

3 / 5

3. Sports activities, falls, and vehicle crashes can hurt your brain.

4 / 5

4. The brain is not the control centre for your body.

5 / 5

5. If you hurt your brain, you need to rest it and spend less time with TV, smartphones, and computers.

Your score is

0%

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
  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.

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?CDC_AAref_Val=https://www.cdc.gov/headsup/schoolprofessionals/training/index.html

Resources to share with children and their parents / caregivers:

Concussion Awareness Training Tool (CATT):

Parachute:

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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