If a child hits their head during sports and afterward has a headache, dizziness or feels dazed, don't let them play again that day; if there is repeated vomiting, growing drowsiness or a worsening headache, go to the emergency department right away

Cost

Free. Take the child out of the game, and no more practice or competition that day. The hard part is that when the game is close, the child says “I'm fine,” and the coach and the parents both want to put them back in.

What you get

A concussion is a temporary disturbance of brain function after a blow to the head, usually not visible on scans. A U.S. study followed 69 athletes with sports concussions, average age about 15. The 35 who left the game on the spot took an average of 22.0 days to recover. The 34 who kept playing with symptoms took an average of 44.4 days (P=0.003, unlikely to be chance). Those who kept playing had 8.80 times the chance of recovery dragging past 21 days compared with those who left. The 2022 Amsterdam international consensus conference on concussion in sport issued a consensus statement. It says that anyone with loss of consciousness, seizure, unsteadiness, confusion, behavior change or memory loss should leave the game immediately. These people should not return to competition or training that day. The exception is where an experienced medical professional has examined them on the spot and confirmed it is not caused by concussion. The U.S. Centers for Disease Control and Prevention (CDC) guidance for parents and coaches is more direct: with suspicious symptoms, take them out right away, no more play that day, and wait until a doctor says it is okay. It also says not to judge severity yourself; only a medical professional can assess. It lists signs for going to the emergency department right away: seizures, not recognizing people or places, repeated nausea and vomiting, abnormal behavior, growing confusion or irritability. Also becoming more and more drowsy after passing out and not being able to be woken, slurred speech, weakness or numbness in the arms or legs. And a headache that gets worse and does not ease, pupils of unequal size in the two eyes, or double vision (U.S. / multiple countries).

Notes

Graded B because the two groups, those who kept playing and those taken out, were not assigned by lottery, and the numbers are small. The size of the benefit is rated large, applying the roughly halved recovery days. The consensus also says to cut down on screens for the first two days, and that light activity such as walking is fine, adding gradually as tolerated after 24 to 48 hours. But sports with a risk of collision or falls must wait until a doctor says okay. For helmets when cycling or skiing, see §22.12 (wear a helmet when mountain biking). For an older person who has a problem weeks after bumping their head, see §13.10 (an older person who has bumped their head). The beneficiary is the child.

Evidence grade

B : Supported by research but without a precise number, or based on small or single studies.

Sources

1. Elbin RJ, Sufrinko A, Schatz P, et al. (2016). Removal From Play After Concussion and Recovery Time. Pediatrics, 138(3), e20160910. https://doi.org/10.1542/peds.2016-0910
2. Patricios JS, Schneider KJ, Dvorak J, et al. (2023). Consensus statement on concussion in sport: the 6th International Conference on Concussion in Sport-Amsterdam, October 2022. British Journal of Sports Medicine, 57(11), 695-711. https://doi.org/10.1136/bjsports-2023-106898
3. CDC (2025). Signs and Symptoms of Concussion. HEADS UP. https://www.cdc.gov/heads-up/signs-symptoms/index.html
4. CDC. How to Respond. HEADS UP. https://www.cdc.gov/heads-up/response/index.html

Translated from the Chinese original. Original book, section 30, tip 21. Content may be out of date and rules differ by place. When you actually deal with an agency, a doctor or a court, follow what local officials, doctors and lawyers tell you. Disclaimer