Grade by Grade
B. Active Living / C. Movement Competence · Active Living and Movement: Motivated, Fit, Safe and Skilful

Concussions and Helping When Someone Is Hurt

B3 A1.1 A1.4About 40 minutes
Learning goals
  • I can explain what a concussion is and how it can happen.
  • I can recognize signs of a possible concussion in myself and in others.
  • I can describe what to do if I or someone else might have a concussion or another injury.
  • I can give clear information to a grown-up or a 911 operator, and comfort a friend who is hurt.

Words to know

concussion
A brain injury caused by a hit to the head, face, neck or body that makes the brain move quickly inside the skull.
symptom
A sign that something is wrong, like a headache or feeling dizzy.
skull
The hard bone that surrounds and protects the brain.
emergency
A very serious situation where someone needs help right away.
return to learn / return to play
Going back to school work and to activity slowly, one step at a time, after a concussion.
empathy
Understanding and caring about how someone else feels.

Remember from Grade 3

You learned some signs of a concussion and that a person who might have one should stop and not play again that day. You learned STOP, GET, STAY for injuries, and when to call 911.

This year you will learn how concussions happen, more about the signs, the steps for getting better, and how to give clear information when someone is hurt.

What happens in a concussion?

Your brain is soft. It sits inside your hard skull, surrounded by fluid.

A hit can make the brain move quickly and bump or twist inside the skull. That can change how the brain works for a while. That is a concussion.

Important facts:

  • The hit can be to the head, face, neck, or even the body (like a hard fall or a body check) if it makes the head snap back and forth.
  • Most concussions happen without being knocked out.
  • You can't see a concussion from the outside, and it doesn't show up on a regular X-ray.
  • Symptoms can start right away, or hours or even a day later.
NormalAfter a hard hitskullfluidbrainhitThe brain moves fast andbumps the inside of the skull.Fluid cushions the brain.
Fluid cushions the brain inside the skull. A hard hit can make the brain move fast and bump the skull: that is how a concussion happens.
Kind of signExamples
BodyHeadache, dizziness, feeling sick or throwing up, blurry or double vision, bothered by light or noise, balance problems
ThinkingFeeling confused or foggy, trouble remembering what happened, trouble paying attention, slow to answer
FeelingsMore upset, cranky, sad, nervous or teary than usual
SleepVery tired, sleeping much more or much less than usual
Possible signs of a concussion. A person might have just one or many.

What to do: Stop, Tell, Check, Return

If you, or someone you are playing with, might have a concussion:

1 STOPright away2 TELLa grown-up3 CHECKby doctor4 RETURNslowlyNever back in the game the same day.
Four steps for a possible concussion: stop right away, tell a grown-up, get checked by a doctor or nurse practitioner, and return to school and play step by step. Never go back in the game the same day.
  1. STOP playing right away. Don't "walk it off".
  2. TELL a grown-up (a coach, teacher or parent). If it is a friend, tell a grown-up for them.
  3. CHECK: The person should be checked by a doctor or nurse practitioner. A grown-up should stay with them and watch them.
  4. RETURN slowly. People with a concussion get better by going back to learning first and then to activity, one step at a time, with a plan from their doctor.

Get help right away (911) if the person is knocked out, has a headache that is getting worse, keeps throwing up, has a seizure, is very sleepy or confused, or has weakness or tingling in arms or legs.

Telling is caring

Sometimes players hide a concussion because they want to keep playing or don't want to let the team down. But playing with a concussion can make it worse and take longer to heal. Telling a grown-up about yourself or a friend is the brave and caring choice. It is not tattling.

Helping with other injuries

Remember STOP, GET, STAY from Grade 3. Now add clear information. When you get a grown-up or call 911, say:

  1. Who is hurt.
  2. What happened ("She fell off the climber and hit her head").
  3. Where you are (your address, the park name, or a landmark like "beside the splash pad").
  4. How the person is now ("He is awake but very dizzy").

Then listen and do what the grown-up or operator tells you. Don't move someone who may have hurt their head, neck or back.

If a friend has asthma and is struggling to breathe, help them get their inhaler and get a grown-up fast. If a friend with a serious allergy has trouble breathing or swelling, get a grown-up right away: it is an emergency.

Be a caring friend

Being hurt can be scary and embarrassing. Show empathy:

  • Stay calm and use a kind voice: "Help is coming. I'm right here."
  • Keep others from crowding around.
  • Later, check in: "How are you feeling?"
  • If a friend is getting better from a concussion, include them in quiet activities and be patient. They may need breaks, less noise or less screen time.
Worked example

Let's respond to a collision

During a recess soccer game, Jayden and Mei bump heads going for the ball. Mei says, "I'm fine!" but she is holding her head and asks, "What's the score?" three times. What should happen?

  1. Notice the signs: holding her head (maybe a headache) and asking the same question again and again (trouble remembering, a thinking sign).
  2. STOP: Mei stops playing, even though she says she's fine.
  3. TELL: A friend runs to tell the teacher on duty right away. Jayden should be watched too; he also hit his head.
  4. Give clear information: "Mei and Jayden bumped heads. Mei keeps asking the score and is holding her head."
  5. CHECK and RETURN: The school calls her family. She should be checked by a doctor or nurse practitioner, not play again today, and return step by step.
  6. Show empathy: stay with her and say, "Help is coming."

Mei shows possible concussion signs, so she stops, a grown-up is told, she is checked by a doctor or nurse practitioner, and she returns slowly. Saying "I'm fine" does not mean she is fine.

Worked example

Let's decide: emergency or not?

Decide what to do in each case. (A) Theo scrapes his knee on the pavement. (B) Ava falls from the top of the climber, is not answering and won't open her eyes.

  1. (A) A scrape hurts but is not an emergency. Tell a grown-up, who can help wash it with clean water and cover it.
  2. (B) Not answering after a fall is an emergency. Don't move her. Shout for a grown-up. If no grown-up is near, call 911.
  3. For (B), tell the operator who (Ava, 9 years old), what (fell from the climber), where (the park name and the street), and how she is (not answering).

(A) Tell a grown-up for first aid. (B) Emergency: get a grown-up immediately or call 911, and don't move her.

Hands-on activity

Concussion card and help-call practice

You need: an index card or paper, coloured pencils, a pretend phone and a grown-up.

  1. Make a concussion card. On the front write STOP, TELL, CHECK, RETURN. On the back, list 6 signs of a concussion: 2 body, 2 thinking, 1 feelings, 1 sleep.
  2. Role play: Your grown-up pretends to fall and hit their head while playing catch. Act out what you would do and say. Use the who, what, where, how script.
  3. Switch: You pretend to be hurt and say "I'm fine!" Your grown-up shows what to do anyway.
  4. Make sure you can say your home address and a landmark near your favourite park.

Remember: Only call 911 for real emergencies. Use a pretend phone for practice.

Your turn

1

What is a concussion?

2

Do you have to be knocked out to have a concussion?

3

Name one body sign and one thinking sign of a concussion.

4

What are the four steps for a possible concussion?

5

Can a person with a possible concussion go back into the game later that day?

6

What four things should you tell a grown-up or 911 operator?

7

Do it and check: Say your home address out loud, then a landmark near your park.

More practice: warm-up

1

What hard bone protects your brain?

2

True or false: a concussion always shows on the outside, like a bump.

3

Name one feelings sign of a concussion.

4

A friend hides a headache after a fall because they want to keep playing. Is telling a grown-up tattling?

5

Should you move someone who might have hurt their neck?

More practice: on your own

1

Ella fell hard on her back during skating and her head snapped back, but it didn't hit the ice. Could she have a concussion? Explain.

2

Noah bumped his head at hockey practice and felt fine. The next morning he has a headache and the lights bother him. What should happen?

3

Write what you would say to a 911 operator if your grandpa fell on the ice at the outdoor rink and can't get up.

4

A classmate is coming back to school after a concussion. Name two ways to be a good friend.

5

Why do people with a concussion go back to learning before going back to sports?

Challenge

1

Your team's best player gets hit in the head, says she's okay, and the game is tied with 2 minutes left. Some teammates say, "Let her keep playing!" What do you do and say?

2

Sort these into emergency (911 or get a grown-up immediately) or tell a grown-up soon: (1) a small cut on a finger, (2) a friend who hit their head and keeps throwing up, (3) a twisted ankle, (4) a friend with a serious peanut allergy whose lips are swelling.

3

Why might someone feel embarrassed or scared after getting hurt in front of others, and how can friends help with those feelings?

Check your understanding

Quiz

1.

What causes a concussion?

2.

Which is a possible sign of a concussion?

3.

A friend hits their head and says, "I'm fine!" What should you do?

4.

When can someone with a possible concussion go back into the same game?

5.

What are the four steps for a possible concussion?

6.

When calling 911, which information is most important?

7.

Which situation is an emergency?

For parents and teachers

Big idea: Grade 4 students learn to recognize possible concussions and respond to injuries during physical activity: what a concussion is, how it can happen (including from a hit to the body), signs that may appear right away or later, and the steps of stopping, telling an adult, medical assessment and a gradual return to learning and activity. They also practise giving clear information when getting help.

About concussions: In Ontario, Rowan's Law and school board concussion procedures guide concussion awareness, removal from activity and return to learning and play. Anyone with a suspected concussion should stop right away, not return to activity that day, and be assessed by a medical doctor or nurse practitioner. Return to school and activity should be gradual and follow medical advice. Seek emergency care for worsening headache, repeated vomiting, seizures, increasing drowsiness or confusion, weakness or tingling in the limbs, or loss of consciousness.

How to help at home:

  • Make the concussion card together and keep it in a sports bag.
  • Practise the who, what, where, how script with a toy phone. Make sure your child knows your address.
  • Talk about why telling an adult about an injury is caring, not tattling.

Common difficulties:

  • Believing you must be knocked out to have a concussion. Most concussions don't involve losing consciousness.
  • Pressure to keep playing. Praise your child for putting health first.
  • Worry. Some children feel anxious about injuries. Reassure them that grown-ups are there to help and that most injuries get better with care.

First aid note: Children's role is to get help, give information and comfort. Adults handle first aid, medicines and epinephrine auto-injectors (unless a child has been trained to use their own).

Social-emotional learning: Recognizing your own and others' feelings after an injury builds emotional awareness; comforting and including a hurt friend builds empathy and healthy relationships.