What Will the ER Do for a Concussion?

A concussion is a mild traumatic brain injury that can happen after a bump, blow or jolt to the head or body. Some symptoms appear right away, while others may take hours or days to show up.

If you’re wondering what the ER will do for a concussion, your care team will usually check your symptoms, ask how the injury happened, perform neurological and physical exams, decide whether imaging is needed and give you recovery instructions before you go home. Seek emergency care right away for severe or worsening symptoms, loss of consciousness, repeated vomiting, seizures, confusion or changes in speech, vision, balance or alertness.

Keep reading to learn more about how concussions happen, their symptoms, normal concussion treatment and what an ER team can do for you if you have a concussion.

What Will the ER Do for a Concussion?

The ER’s first goal is to determine whether the head injury could involve bleeding, swelling, a skull fracture or another emergency. Not every concussion requires imaging or admission, but your symptoms, exam and injury details help the care team decide what is safest.

If you suspect you or a family member has a concussion, take them directly to the nearest emergency room or dial 911 if it's a life-threatening situation. When you arrive, here’s what you can expect:

• You'll be asked to check in at the front desk to let the medical staff know your situation and what happened.
• You’ll be seen by a triage nurse who may ask you some questions about your health and take your vitals, including heart rate and blood pressure.
• When you are called to a room, your doctor will ask you some more questions about your suspected concussion, such as what happened and the symptoms you're currently experiencing.
• Your doctor will conduct quick neurological and physical exams and cognitive tests that allow them to get a better gauge of whether you have a concussion and its severity.
• You may have imaging tests, such as a CT scan or MRI, if your symptoms, exam or injury history suggest a possible serious brain injury.
• Your doctor will administer or prescribe pain medications as needed.
• Depending on the severity of your concussion, you’ll be held at the hospital for observation for a few hours or admitted for up to a few days to monitor your situation.

When you’re discharged, your doctor will provide you with recovery instructions and advise you to follow up with your primary care provider.

What Is a Concussion?

A concussion is a type of mild traumatic brain injury that can happen when a bump, blow or jolt causes the brain to move rapidly inside the skull. This movement can temporarily affect how the brain works, including memory, balance, mood, sleep, concentration and reaction time.

Common Causes of Concussions

Many people assume contact sports, like football, are the primary reason for concussions. Although sports are one common cause, there are actually several different ways a person can experience a concussion. In reality, any type of activity where there's a risk of falling or having something hit your head has a concussion risk. You don’t have to be knocked unconscious to have a concussion. Any head injury followed by new symptoms should be taken seriously.

Recreational activities that can lead to a concussion include:

• Baseball
• Basketball
• Cheerleading
• Cycling
• Diving/Swimming
• Football
• Gymnastics
• Hockey
• Horseback riding
• Lacrosse
• Martial arts
• Rugby
• Skateboarding
• Skiing
• Snowboarding
• Softball
• Soccer
• Wrestling

After sports, another major cause of concussions (especially among older adults) is falling. Falls can cause you to hit your head hard on the floor or on a stationary object. Falls can occur from:

• Falling off a ladder
• Falling out of bed
• Loss of balance
• Slipping on ice, in the shower or on a wet floor
• Tripping on a cord or other hazard

Other concussion causes include:

• Car accidents
• Head hit by a falling or moving object
• Physical violence

No matter which way you hit your head, it’s always important to take your condition seriously and look for concussion signs.

How Doctors May Assess Concussion Severity

Doctors may assess a head injury based on symptoms, physical exam findings, neurological function, level of alertness, memory, balance and how the injury happened. They may also use standardized tools to evaluate brain function and determine whether you need imaging, observation or specialty follow-up.

Concussions are generally diagnosed into three different categories using a medical tool called the Glasgow Coma Scale.

• If you have a mild concussion, you do not lose consciousness and experience very mild symptoms.
• When you have a moderate concussion, you may have mild to moderate symptoms and lose consciousness for a very short amount of time.
• With a severe concussion, you lose consciousness for more than 15 minutes and will experience severe symptoms.

Several types of concussions are categorized by the symptoms they cause:

• Cognitive Concussions: Impact your thinking and memory skills
• Emotional Concussions: Lead to mental health and mood changes
• Migraine/Headache Concussions: Cause lasting headaches or migraine
• Ocular Concussions: Affect your vision
• Physical or Somatic Concussions: Cause physical symptoms like nausea, vomiting and pain
• Vestibular Concussions: Bring about balance issues and vertigo

Concussion Symptoms to Watch For

Concussion symptoms can affect the body, thinking, mood and sleep. They may appear right away or develop later, so it’s important to keep watching for changes after a head injury. Depending on the type and severity of your concussion, there are many different symptoms you may experience. Some of the most common signs of a concussion include:

• Balance problems
• Blurry vision
• Concentration issues
• Depression or anxiety
• Dizziness or lightheaded
• Drowsiness
• Feeling foggy
• Headache or head pain
• Irritability
• Light sensitivity
• Loss of consciousness
• Memory problems
• Mood swings
• Nausea and vomiting
• Neck pain
• Ringing in the ears (tinnitus)
• Sensitivity to noise
• Sleeping more or less than usual
• Slurred speech
• Trouble sleeping

Not everyone will experience every symptom, but it’s important to know what signs to look for.

When to Go to the ER for a Concussion

Call 911 or go to the nearest emergency room right away after a head injury if you or a loved one has:

• Any amount of loss of consciousness
• A headache that is very severe or worsens over time
• Blood or fluid coming out of the nose or ears
• Blurry or double vision
• Confusion
• Extreme nausea or vomiting
• Inability to stay awake
• Numbness in an area of the body
• One eye pupil is larger than the other
• Seizures
• Speaking issues
• Stiff neck
• Uncontrollable crying in young children
• Walking or balance problems

Even mild concussions cause brain damage and, if left untreated, can lead to serious health effects and negatively impact your brain function, so it’s important to seek treatment right away.

Concussion Discharge and Recovery Instructions

Recovery instructions may vary by age, symptoms and injury severity. Follow the plan your ER provider gives you and ask when to follow up with your primary care provider, pediatrician, sports medicine specialist or neurologist.

If you visit the ER for a concussion and are discharged the same day, your healthcare provider will send you home with some instructions to follow that will help loved ones monitor your condition and keep your symptoms from worsening.

Typical concussion discharge and recovery instructions include:

• Avoid alcohol and recreational drugs.
• Don't take over-the-counter pain relievers like aspirin or ibuprofen unless specifically instructed to do so by your doctor.
• Get as much rest and sleep as possible.
• Have an adult stay with you for the first 12 to 24 hours after your concussion to monitor for any new or worsening symptoms.
• Limit your screen time to keep intense lights from bothering you.
• No driving yourself (have someone drive you home from the ER).
• Stay hydrated, even if you’re nauseated.

Your provider may recommend avoiding sports, strenuous exercise, heavy lifting, driving, alcohol or activities that increase symptoms until you are medically cleared. Your doctor should medically clear you before returning to work or driving.

Concussion Complications

A concussion impacts your brain health, so it’s very important to follow your doctor’s recovery instructions. Allowing yourself time to fully recover can help reduce your risk of long-term complications.

One such potential complication is post-concussion syndrome, where many of the same symptoms you had from your concussion do not go away, such as:

• Anxiety or depression
• Chronic headaches
• Concentration issues
• Constant dizziness or vertigo
• Impaired vision
• Insomnia
• Irritability
• Light or noise sensitivity
• Memory loss
• Nausea
• Problems learning new things

Other possible complications can include:

• Alzheimer's disease and other types of dementia
• Anxiety
• Chronic insomnia
• Chronic traumatic encephalopathy (CTE) due to repeated concussions
• Depression
• Inability to exercise or be active
• Parkinson's disease
• Personality changes
• Post-traumatic stress disorder (PTSD)
• Seizures
• Stroke

After a concussion, your focus should be solely on healing and communicating any potential concerns to your doctor.

How to Help Prevent Future Concussions

There's no denying that concussions, no matter how mild, are serious and can cause major health concerns. The good news is that with a little caution, you can help keep yourself and your loved ones safe.

When playing any type of sport or engaging in physical activity:

• Always wear a properly fitted helmet.
• Choose playgrounds with a soft surface on the bottom, rather than a hard surface like concrete.
• Do some exercises to strengthen your neck muscles.
• Follow all safety rules when playing any kind of sport.
• Pick recreational activities with a limited possibility of a head injury or concussion.

And when at home, in the office or just walking down the street:

• Fit showers and bathtubs with grab bars.
• Install childproof safety items like gates for stairs and window guards.
• Keep an eye out for tripping hazards, like electrical cords, curbs or rocks in your path.
• Make sure there's good lighting anywhere you walk, either inside or outside.
• Place a railing for stairs and any other area that may cause a fall.
• Practice proper car safety, such as always wearing a seat belt and using properly-sized car seats for kids.
• Use nonslip mats under bathroom mats and throw rugs.

Implementing these simple safety tips minimizes your risk of a concussion.

Recover Safely With Expert ER Care at AdventHealth

If you suspect a concussion or notice concerning symptoms after a head injury, seek medical care right away. AdventHealth ER teams are available 24/7 to evaluate head injuries, provide guidance and help you take the safest next step. Find your nearest AdventHealth emergency room to help you be prepared for any emergency.