A school’s duty of care to its students requires that it exercise “reasonable care” to protect students from risks of harm that are “reasonably foreseeable”.

Given the recent media coverage of the long-term effects of concussion, there would be little doubt that the “reasonable school” should be ensuring that students who suffer such injuries be treated in accordance with recognised guidelines.

So it came as a surprise that a recent study found that 41% of children admitted to the Melbourne Royal Children’s Hospital with head injuries from an organised sports event had not received the internationally recommended treatment for concussion.

The study of more than 90 children admitted to the hospital’s emergency department found that 28% had been allowed to return to play on the day of their injury, while 27% had not been immediately assessed by qualified personnel.

The study also found that 91% of parents were not aware of any concussion or return-to-play guidelines.

"Despite the attempts of sports organisations to improve the management of concussions, on-field concussion management and return to play practices are suboptimal in sport-related head injuries," said the author of the study and Monash University honours medical student Harini Haran.

Signs of concussion

The first step in properly treating head-injuries is ensuring the staff or parents responsible for overseeing sports events are aware of the symptoms of concussion.

The signs of concussion can include a loss of consciousness, amnesia, slowed reaction times, drowsiness, irritability, fogginess to headaches.

Treatment

Melbourne’s Royal Children’s Hospital, where the study was conducted, has published guidelines on how concussion should be treated.

The guidelines follow the six “return to play” steps (taken over a week) that should be completed before a child is allowed to return to play. The child can only advance to the next step if there are no concussion complaints.

The six rehabilitation steps of at least 24 hours each are:

1) No activity, where the child should have a complete mental and physical rest.

2) Light aerobic exercise, where the child can walk, swim or go on an exercise bike to increase their heart rate.

3) Sports-specific exercise, where the child can participate in running drills but cannot engage in any head impact activities.

4) Non-contact training drills, where the child can participate in passing drills in sports games and can start progressive resistance training to aid in exercise and coordination.

5) Full-contact practice, where the child can participate in normal training activities to allow coaching staff to assess their function.

6) Return to normal game play.

If in doubt wherever a child can progress to the next stage or return to play, a doctor should be consulted.

Most of the major sports codes, such as AFL, Rugby League and Rugby Union, have their own published guidelines on the proper treatment and at home care for concussion.

If your school does not have clear policies and procedures in place for dealing with concussion injuries, you may want to think about introducing them.