Level 2

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 3 - Physical Education and Wellness Curriculum

ORGANIZING IDEA

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

GUIDING QUESTION

How is safety connected to health?

LEARNING OUTCOME

Students investigate and explain safety and its correlation to health.

Proactive planning includes:

  • awareness of instructions and guidelines

Specific rules or guidelines can:

  • determine a course of action
  • prevent accidents
  • protect safety of self and others

Experiences that involve challenges and taking risks can develop knowledge around safety.

Resources that support personal safety include:

  • safety networks
  • emergency services
  • safety manuals or guidelines

Safety involves prevention that requires proactive planning.

Rules and guidelines can promote safety in various contexts.

Safety is impacted by the environment and behaviours.

Safety of self and others can be met through awareness of supports.

Examine situations that require proactive planning.

Explain the function or purpose of specific rules or guidelines within various contexts.

Generate examples of situations where behaviours would be appropriate and others where they would involve risk.

Identify available resources that support safety.

GRADE 4 - 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 taking responsibility impact safety?

LEARNING OUTCOME

Students analyze and explain responsibility and how it can impact personal and group safety.

Responsibility includes making decisions to ensure self or others are not in unsafe and uncomfortable situations.

Responsibility occurs in a variety of contexts, such as:

  • home
  • learning environment
  • community
  • online

Responsibility includes the opportunity, ability, or right to act independently or make decisions.

Responsibility includes an awareness of surroundings to determine the safety of a situation.

Describe responsibility and its impact on personal and group safety in a variety of contexts.

Examine how responsibility can impact safety in a variety of situations.

Learning Objectives

  1. Identify the importance of protecting your brain and your head.
  2. Describe the activities that could cause a concussion.
  3. Identify the symptoms of a concussion.
  4. Identify red flag symptoms.
  5. 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
  2. If using Egg Drop or Melon Drop experiment, check out required materials.

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 'Concussions and Other Head Injuries Slides Gr. 3&4' 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. 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. 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."

5. 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:

i. The worst headache you have ever had
ii. Vomiting
iii. Neck pain
iv. Seizures
v. 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.

6. 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.

7. 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).

8. 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
iii. Jell-O Brain

Class Discussion Questions

a. You are playing a pick up game of soccer with your friends. During a play, two players collide and one of them is slow to get up after the collision. 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.

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 get a hit to your face, head, neck, or body, you should not tell a grown up.

2 / 5

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

3 / 5

3. Sports activities, falls, and vehicle crashes are leading causes of concussion.

4 / 5

4. The brain is fragile and is the control centre for your body.

5 / 5

5. If you get a concussion you need to rest and limit TV and video games.

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.

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?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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