Concussions – More than a Blow to the Head
As June is Brain Injury Awareness Month, we want to discuss a prevalent, yet commonly misunderstood form of brain injury. While few would argue that a brain injury can significantly impact lives and work, concussions tend to be thought of as less severe. In fact, a concussion is a type of traumatic brain injury (TBI) which occurs when “the brain is shaken back and forth inside the skull” (Brain Injury Canada). This can cause “the brain to bounce around or twist in the skull, creating chemical changes in the brain and sometimes stretching and damaging brain cells” (Brainline). One doesn’t have to hit their head to suffer a concussion; it can also result from a blow to the neck, face or any part of the body that, in turn, jars the head.
First, the Statistics
According to the House of Commons Standing Committee on Health, formed in November 2018, there are approximately 210,000 concussions reported in Canada annually–a number that doesn’t include concussions that go un-reported (either because people don’t realize they have one, or don’t understand how serious they are). Just as we bump our knees and our elbows frequently, we also bump our heads and jar other parts of our bodies. We don’t have to be extreme athletes or involved in a major car accident to suffer from a concussion. Their prevalence is significant, their impact even more so, and neither employers nor employees should take them lightly!
Despite the staggering number above, an online survey commissioned by the Public Health Agency of Canada last year found that awareness and knowledge of concussions in Canada is, by comparison, low. Half of all Canadians report having little or no knowledge; 50% know where to find available resources on avoiding one; 40% said they can recognize symptoms; and 25% don’t know how they are treated.
Concussions can be mild to very severe, and those impacted will experience it differently, depending on severity. Symptoms may be immediate or might not show up for a few days, or until regular activities are resumed. Depending on severity, some of the more common symptoms include:
- Physical – Headache &/or neck pain; nausea; vomiting; dizziness or difficulty balancing; fuzzy or blurred vision (seeing stars); lack of energy; sensitivity to light/noise; difficulty falling asleep and/or sleeping more or less than usual
- Cognitive – difficulty concentrating or thinking clearly; slowed reaction time; forgetfulness (especially with new information), confusion
- Emotional – Irritability, nervousness or anxiety, generally feeling more emotional than usual
Regardless of how one occurred and initial symptoms, concussions are very serious and should be treated as such–particularly as people often don’t understand the symptoms and/or may downplay them. This may occur in the workplace, for example, if an employee is embarrassed by how they were injured, wants to maintain composure, or is in shock. Further, given the intricacy of symptoms, concussions may be difficult to see by others, especially as symptoms may not appear right away and will come and go.
Regardless of how severe it looks or feels, anyone with a head-related injury must seek immediate and specialized medical help. How concussions are originally treated can have a significant impact on recovery, both in the short and long term. While emergency personnel or general practitioners may be the first point of contact, they may not be specialized in this area, and a concussion can’t be seen on routine x-rays, CT scans or MRIs.
Impact on Work
While not taking care of concussions can lead to significantly longer recovery time and even permanent brain damage, immediate and proper care can significantly reduce recovery time. It’s important for employers and employees to know that concussions do and will have an impact on work, and both must be patient where head injuries are involved. While symptoms and associated recovery requirements will differ, those suffering from a concussion should generally do the following:
- Reduce screen time (computers, phones, tablets, TVs)
- Limit exposure to bright lights and loud sounds
- Avoid physically or cognitively demanding activities
- Return to regular activities gradually
- Avoid unnecessary movement of the head and neck
- Get lots of rest (both at night and through day); take lots of breaks
- Stay hydrated
- Eat more protein and foods rich in Omega 3s
- Avoid alcohol and drugs, except medication approved by doctor
What Should Employers Do?
If an employee does suffer from a concussion, whether at work or otherwise, below are some guidelines on how to support them:
- As noted above, ensure they seek immediate medical attention
- Ensure they take the necessary time off–As the most critical time for rest is immediate and symptoms may not show up right away, the minimum time off should be 48 hours until a concussion is ruled out. If a concussion is diagnosed and treated properly, the average recovery time is 2 – 4 weeks; however, in many cases, symptoms will persist well beyond
- Obtain a detailed medical certificate before the employee is permitted to return to work
- Upon medical clearance, support employees with gradual return to work, modified duties and other accommodations, as outlined on the medical certificate; this may be part-time hours to start, reduction in screen time, less physical duties, allowing them to take frequent rest breaks, etc.
- Refer to this Concussion Awareness Training Tool, as well as the resources provided below
- Be compassionate and patient!
Employers can also refer employees to the following resources:
- Advance Concussion Clinic on Broadway in Vancouver
- GF Strong Centre specializes in early response concussion services, as well as ongoing rehab
- Equinox Integrative Wellness offers concussion management services in West Vancouver
- Foundation for Integrated Health in North Vancouver
- Fraser Health Concussion Clinic for those living in the Fraser Health region
- Refer to resources provided by Parachute Canada and the Centre for Brain Health
While you may be unable to prevent your employees from suffering concussions outside of the workplace, through safety measures and raising awareness, you can certainly do much to prevent them in the workplace. Additionally, by raising awareness on the impact of concussions, you may in turn be able to reduce their impact–both on the lives of your employees and in your workplace.