Introduction
Head injury or concussion can occur in various ways in both recreational and competitive paddlesport. This might be through capsize, collision or other impact to the head. It is crucial to be aware of how to recognise and manage these types of incidents. This document aims to provide guidance on the protocols that must be followed when managing suspected sport related concussion occurring in the course of both recreational paddlesport and training or competition organised by or on behalf of Paddle UK. This guidance is aligned to the detailed protocols outlined in the UK Sports Institute (UKSI) Concussion Management Guidelines.
Paddle UK will keep up to date with and consider any protocol published by the International Canoe Federation (ICF), as well as alignment with this where appropriate.
Definition
Paddle UK adopts the definition in the first part of the 2022 Consensus Statement on concussion in sport:
“Sport-related concussion (SRC) is a traumatic brain injury caused by a direct blow to the head, neck or body resulting in an impulsive force being transmitted to the brain that occurs in sports and exercise-related activities. This initiates a neurotransmitter and metabolic cascade, with possible axonal injury, blood flow change and inflammation affecting the brain. Symptoms and signs may present immediately, or evolve over minutes or hours, and commonly resolve within days, but may be prolonged.”
Overarching Principle
The overarching principle when managing head injury or concussion whether actual or suspected is “if in doubt, sit them out”. If a paddler is suspected of having a head injury or concussion, they must be immediately removed from the activity.
Protocol
- Where a head injury or concussion is suspected, immediate care principles apply and must be prioritised over SRC or in FULL Sports Related Concussion-specific assessment. This includes a safe approach followed by systematic assessment of Airway, Breathing, Circulation, Disability (including the risk of spinal injury) and Exposure (often referred to as the “ABCDE assessment”).
- Anyone with suspected concussion should be immediately removed from the field of play and assessed by an appropriate Healthcare Professional or access the NHS by calling 111 within 24 hours of the injury.
- If any of the ‘red flags' below are reported or observed, then the individual should receive urgent medical assessment from an appropriate Healthcare Professional onsite or in a hospital Accident and Emergency (A&E) Department using emergency ambulance transfer if necessary.
- The red flags are:
- Neck Pain or tenderness
- Seizure or convulsion
- Double vision
- Loss of consciousness
- Weakness or tingling/burning in more than 1 arm or in the legs
- Deteriorating conscious state
- Vomiting
- Severe or increasing headache
- Increasingly restless, agitated or combative
- Glasgow Coma Scale <15
- Visible deformity of the skul
Sport Concussion Assessment Tool (SCAT6)
The Concussion in Sport Group (CISG) have developed Guidelines to using the Sport Concussion Assessment Tool 6 (SCAT6)™.
Further Information
Where head injury or concussion is suspected:
- Do not leave the individual unattended as problems could arise over the first 24 – 48 hours
- The individual should not drive
- Avoid alcohol and any prescription or non-prescription drugs such as sleeping tablets, aspirin, anti-inflammatory or stronger pain medication
Training and Competition Organised By Paddle UK
Once the ICF has published its protocol, Paddle UK will provide more detail and work with competition disciplines to clarify any required rule changes.
Incident Reporting
An incident report should be submitted to Paddle UK using the online incident reporting form.
References
- Patricios JS., Schneider KJ., Dvorak J. et al. Consensus statement on concussion in sport: the 6th International Conference on Concussion in Sport – Amsterdam, October 2022 Br J Sports Med 2023;57:695-711