Lesson from Kuechly’s concussion: If in doubt, sit them out!

For the second straight week, Carolina Panthers star linebacker Luke Kuechly will likely miss a game because of a concussion he suffered during the team’s opener on Sept. 13.

After years of criticism for not taking care of its players when it comes to head injuries, the NFL has taken steps to make the game safer, cracking down on helmet-to-helmet hits and implementing a three-step concussion protocol: 1) After rest and recovery, a player must return to his baseline status in a neurological exam before proceeding. 2) The player begins a gradual exercise program. 3) An independent doctor must clear the player to return.

Concussions happen at all levels of sports, including kids’ sports, where there’s less awareness of how to handle them. The following is a list of facts players, parents and coaches need to know about concussions:

Q. Does a player have to black out to have a concussion?

A. One reason athletes, parents and coaches sometimes don’t recognize a problem is because some still believe a player must lose consciousness to get a concussion. “A concussion is caused by a bump, blow or jolt to the head or body that causes the head and brain to move quickly back and forth. Even a ‘ding,’ ‘getting your bell rung,’ or what seems to be a mild bump or blow to the head can be serious,” according to the Centers for Disease Control and Prevention.

Q. How are concussions handled for high school football players?

A. All states now have a concussion-in-sports law. North Carolina adopted the Gfeller-Waller Concussion Awareness Act in 2011. It requires students participating in interscholastic activities who exhibit signs of a concussion be removed from the activity and not return to play the same day. They must be cleared by a medical professional with training in concussion management before returning on a subsequent day.

Q. Do concussions happen the most in football?

A.Yes, but concussions can happen in all sports. A 2011 study on high school sports showed football had the highest rate of concussions followed by girls’ soccer and boys’ and girls’ lacrosse.

Q. What are the warning signs that a child might have a concussion?

A. The warning signs include:

1) headache or pressure in head, 2) nausea or vomiting, 3) balance problems or dizziness, or double or blurry vision; 4) being bothered by light or noise, 5) feeling sluggish, hazy, foggy or groggy; 6) confusion, concentration or memory problems; 7)feeling “not right,” or feeling “down,” according to the CDC website.

Q. When should a child be taken to the emergency room, or 9-1-1 be called?

A. According to the CDC, seek help if the child displays any of these symptoms: a) one pupil (the black part in the middle of the eye) larger than the other; b) drowsiness or cannot be awakened; c) a headache that gets worse and does not go away; d) weakness, numbness or decreased coordination; e) repeated vomiting or nausea, f) slurred speech, g) convulsions or seizures, h) difficulty recognizing people or places, i) increasing confusion, restlessness or agitation; j) unusual behavior, k) loss of consciousness (even briefly).

Q. What’s important in a child’s recovery from a concussion?

A. The child should not return too soon. Dr. Robert Cantu, a leading U.S. expert on head injuries, wrote in his book, “Concussions and Our Kids” that these are key factors to know:

1) It’s never safe to play with a concussion, 2) The best therapy is rest. When a concussion is properly managed, the patient will get better. 3) If a concussion is not properly managed, the patient risks prolonging the symptoms or developing long-term problems like headaches, dizziness or insomnia. 4) And, in rare cases, a patient who returns too soon and gets hit again could suffer second-impact syndrome and die.

Q. Where can an athlete or parent get information about concussions?

A. Experts recommend Heads Up on the CDC website. There you can find tips about recognizing and treating concussions, online concussion training videos, printable fact sheets, and a downloadable app that explains what to do if you suspect an athlete might have suffered a concussion.

Q. I coach youth sports but have never been trained to know when one of my players had a concussion. What can I do?

A. The CDC has facts and tips to help you, plus a free 30-minute online training course. If during a game you’re unsure whether a player suffered a head injury, don’t take chances. Remember: If in doubt, sit them out.

This story was originally published September 26, 2015 at 6:47 PM with the headline "Lesson from Kuechly’s concussion: If in doubt, sit them out!."