Discharge Advice – Head Injury

If we’ve sent you the link to this page, that means you’ve had a head injury we’re concerned you might be at risk of, or have, a concussion. Please check the Sport-specific issues section to see if any additional requirements apply to you.

General info

Mild head injury, also known as concussion, is caused by striking the head against an object or by a blow on the head. Common symptoms include headache, nausea, vomiting once or twice, and slight dizziness or sleepiness.

You will have been taken out of competition by the doctor who saw you. This may be frustrating, but is incredibly important to ensure your safety. The ‘second-hit’ syndrome is a potentially lethal complication of repeated head injury which has led to the deaths and permanent disablement of athletes, including in your sport.

Diagnosis of concussion is made on clinical grounds after a sufficient head-strike. The Sport Concussion Assessment Tool v5 (SCAT5) is likely to have been used. This tool is for severity assessment only, and is not used for the actual diagnosis of concussion. It is most useful when compared to a pre-competition baseline score, but is still highly useful as a standalone severity-assessment tool, and can also guide recovery.

Instructions

The doctor who examined you did not find any serious brain or skull injuries during the examination, but it is possible for more serious symptoms to develop later on. You must have someone with you at home for the next 24 hours in case you get worse.

  • Only take prescribed medications. Paracetamol may be taken in the dose recommended for headache
  • Rest for 24 hours. Avoid strenuous exercise for the next 48 hours
  • Eat light meals only for 1-2 days
  • Do not drink any alcohol for at least the next 48 hours

Go to your nearest Emergency Department if you develop:

  • Persistent vomiting
  • Severe or continuing headache
  • Bleeding or other discharge from the ear or nose
  • Numbness of an arm or leg
  • Confusion or unusual drowsiness
  • Dizziness or any fit or seizure
  • Any other marked change from normal

Recovery

You may feel worsening of your concussion symptoms whilst being physically or mentally active. Whilst this is the case you must rest. TV / screen time can exacerbate symptoms and may need to be avoided. Be guided by your symptoms.
If your symptoms persist beyond 1-2 days, you must at least check in with your GP at the one-week mark. If you have a SCAT5 assessment, take it with you. Your doctor will be able to either a) reassure you that you are recovering / recovered, or b) develop a rest and recovery programme to get you back to your normal self in a safe time frame, which could be several weeks.
Rarely, the post-concussion syndrome becomes a long-term problem. See your doctor to manage this.

Sport-specific issues

Concussion in Sport Australia Position Statement (2019)

Equestrian Australia

– EA follows the Concussion in Sport Australia Position Statement (2019) as above
– Mandatory 3-week exclusion from riding and competition after the diagnosis of concussion
SCAT5 will be completed in most cases
– EA Injury Report Form (‘Form 8‘) will be completed
– EA-HSMS-MED-Athlete Concussion Advice form (Form 9) will be issued
– All forms will be emailed to reporting@equestrian.org.au for tracking in MyEA, including medical certificate management, return to competition, etc.
– See the above images for return to sport protocols after a concussion for adults and children under 18 years

Disclaimer

The information or advice contained in this post is created from sources believed to be reliable and accurate to the best of the author’s knowledge, at the time of publication. It is not intended for use outside the specifically stated use, and only by people explicitly directed to follow it by the doctor representing DeployED at an event, who has assessed the person concerned. Consequently, DeployED disclaims any liability arising from the improper or unintended use of this information. This information is provided in good faith.

If your symptoms have not resolved within 48h of the expected timeframe, if they worsen or if new, concerning symptoms develop, seek medical attention promptly.

Follow Dr Stuart McLay:

Emergency Physician

Dr Stuart McLay is passionate about the delivery of exceptional care, everywhere. He is the founder of DeployED, a Fellow of the Australasian College of Emergency Medicine (FACEM - an Emergency Physician), a Core trainee of the College for Intensive Care Medicine, and a Mass Gathering Medicine / Expedition Medicine enthusiast. He's also a husband to 1, and father to 2, and a great annoyance to many.