Synopsis
Recognise concussion after direct or transmitted force, exclude dangerous structural injury, provide practical early recovery advice, and guide graded return to learning, work, driving and sport.
- Suspect concussion after direct or indirect force when headache, dizziness, confusion, amnesia, imbalance, visual disturbance, nausea, emotional change or sleep symptoms appear; loss of consciousness is not required.
- First exclude airway, cervical-spine and intracranial emergencies and apply NICE CT criteria; concussion is a clinical diagnosis and routine CT is often normal.
- Remove a suspected player immediately and do not allow same-day return to training or competition, regardless of rapid symptom improvement.
Key red flags
Falling consciousness, seizure, weakness, unequal pupils, repeated vomiting, worsening severe headache, neck pain or clear fluid from nose or ear requires emergency reassessment rather than home concussion management.
Investigation priorities
Diagnose suspected concussion and identify emergency features.
Management branches
A person develops possible concussion after direct or transmitted head force.
- Stop sport or hazardous activity immediately, assess ABC and cervical spine, record GCS, pupils, symptoms, amnesia and observed behaviour.
- Arrange emergency transfer for red flags or NICE CT indications and do not let a concussion screen delay treatment.
Emergency structural injury has been excluded and symptoms are stable or improving.
Key medicines
Paracetamol for acute headacheTake 1 g orally when required up to four times in 24 hours, leaving at least 4 hours between doses; reduce the maximum in adults under 50 kg or with frailty, malnutrition, chronic alcohol excess or hepatic risk.