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Now that school has started, children are once again participating in their favorite sport. Coaches educate kids about safety but unfortunately, accidents do happen. An injured arm or leg will sideline the participant until the limb has healed, but what about a bump to the head? How does one know if this is a serious condition and what exactly should be done?

More than 60,000 concussions occur each year in U.S. high school sports, making this one of the more common impairments among young athletes. The Oxford dictionary defines a concussion as an incapacity or temporary unconsciousness due to a head injury. To expound on that a bit, it’s an injury resulting from a trauma or violent blow to the head causing, at least, a temporary loss in brain function. Typically, these traumas are divided into three categories based on severity:

• Grade 1: A mild concussion is when a person remains conscious but might seem dazed.

• Grade 2: A slightly more severe form occurs when the person remains conscious but is confused and does not remember what happened.

• Grade 3: A classic concussion is the most severe and results when a person loses consciousness for a short period of time and cannot recall the event.

Since the initial signs of a concussion are often not overtly obvious, parents and coaches should heed the following early warning signals: Headache, nausea, confusion, vomiting, drowsiness, amnesia, memory loss, impaired speech, unequal pupil size, tinnitus (ringing in the ears), loss of consciousness.

No sports-related concussion is “minor.” The athlete who “plays through” the injury risks more serious damage called second-impact syndrome. This condition arises when the person experiences a second brain injury before the first one has healed. Even if the second is milder than the first, the combination can cause brain swelling and could lead to death within minutes.

So when can an injured child return to activity? The American Academy of Neurology offers this advise:

• Grade 1: Remove from participation and be examined by a trained healthcare professional every five minutes observing other symptoms. Ask the person specific questions testing for orientation (day of the week), concentration (alphabet in reverse order), and memory (outcome of previous game). Monitor for nausea, vomiting, slurred speech, disorientation, unequal pupils, and stiff neck. If no symptoms develop in 20 minutes, the player can return to the game. NOTE: Grade 1 is the only level of severity that a player can return to play after experiencing a concussion.

• Grade 2: Remove from activity and closely watch for signs of increasing brain injury. Monitor closely throughout the night and see a physician the next day. The initial 24 hours are critical, even though serious symptoms can appear later. If nothing develops, the athlete can return to activity in one week.

• Grade 3: Airway, breathing, circulation and cervical spine should be checked first. Then transport by ambulance to the nearest hospital emergency room. The child should not return to practice for at least 30 days or for the rest of the season if he or she has had more than one previous concussion.

Remember, safety first and common sense at all times.

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Kay Sager is a certified fitness and aquatic specialist living at Port of the Islands. She is a personal trainer using land and water fitness and teaches swimming. She also has written articles for Physician and Sports Medicine among other publications. Kay can be reached by e-mail: kswimfit@aol.com.