If you think someone has a concussion, stop whatever activity they’re doing, keep them calm and still, and watch closely for worsening symptoms. Most concussions don’t require emergency care, but every suspected concussion needs to be evaluated by a healthcare provider. The steps you take in the first few minutes and hours matter for both safety and recovery.
Recognize the Symptoms
A concussion doesn’t always look dramatic. The person may not lose consciousness, and symptoms can appear immediately or develop over hours. Knowing what to watch for helps you act quickly.
Physical symptoms include headache, dizziness, balance problems, nausea or vomiting, sensitivity to light or noise, blurry vision, and fatigue. Thinking and memory symptoms are just as telling: the person may seem foggy or groggy, have trouble concentrating, feel mentally slowed down, or struggle to remember what happened right before or after the injury. Emotional changes can also signal a concussion. Unusual irritability, anxiety, sadness, or being more emotional than normal are all common. Sleep disruptions often follow as well, whether that means sleeping much more or much less than usual, or having trouble falling asleep.
You don’t need to see all of these. Even one or two symptoms after a blow to the head, face, neck, or body warrant taking the situation seriously.
Know the Red Flags That Need Emergency Care
Most concussions can be managed with a visit to a doctor’s office, but certain warning signs mean you should call emergency services or go to the emergency room immediately. These suggest a more serious brain injury:
- Headache that keeps getting worse rather than staying stable or improving
- Repeated vomiting
- Seizures
- Loss of consciousness
- Extreme drowsiness or inability to be woken up
- Increasing confusion or inability to recognize people or places
- Slurred speech
- Weakness or numbness in the arms or legs
- Neck pain
- Unusual behavior changes or significant irritability beyond what you’d expect
If any of these appear, even hours after the initial injury, don’t wait. These symptoms can indicate bleeding or swelling in the brain that requires immediate medical attention.
What to Do in the First Few Hours
Remove the person from whatever activity caused the injury. If it happened during a sport, they’re done for the day, no exceptions. Have them sit or lie down in a quiet, comfortable spot. Don’t leave them alone for the first several hours.
For pain relief, acetaminophen (Tylenol) is the safe option. Do not give ibuprofen (Advil, Motrin) or aspirin, because these can increase the risk of bleeding inside the skull. If you’re unsure about any medication, hold off until you’ve spoken with a healthcare provider.
When you do see a provider, bring as much detail as you can: what caused the injury, how hard the impact was, whether the person lost consciousness or had memory gaps right after, whether there were any seizures, and how many concussions they’ve had before. Also mention any medications they take, including over-the-counter drugs and supplements.
How a Concussion Gets Diagnosed
There’s no single blood test or brain scan that confirms a concussion. Healthcare providers diagnose it based on the mechanism of injury and the presence of characteristic signs and symptoms. They’ll look at things like orientation and confusion, balance, memory, and symptom severity. Standardized assessment tools use a checklist of 22 symptoms rated by severity to help distinguish a concussed brain from a healthy one.
A CT scan or MRI may be ordered, but only to rule out something more serious like a skull fracture or brain bleed. These scans typically look normal in a concussion, which is why clinical evaluation matters so much. The information you provide about what happened and what you’ve observed plays a real role in the diagnosis.
Recovery in the First Days
The old advice was to lie in a dark room and avoid all stimulation. Current guidelines are more balanced. In the first day or two, light rest helps, meaning reduced screen time, avoiding loud environments, and skipping intense physical or mental work. But complete isolation isn’t necessary and can actually make some people feel worse.
After those first couple of days, the person can gradually return to light daily activities as symptoms allow. The key principle is simple: if an activity makes symptoms noticeably worse, scale it back. If it feels manageable, it’s generally fine to continue. Most adults recover within a couple of weeks. Children and teenagers often take longer, sometimes up to four weeks or more.
Getting Back to School
For students, returning to the classroom can be harder than returning to physical activity. Concentrating, reading, and taking notes all demand the kind of mental energy that a recovering brain struggles with. Short-term adjustments make a significant difference.
If thinking and memory are affected, helpful accommodations include reducing homework to essential assignments only, providing extra time on tests (ideally no more than one test per day), offering printed class notes, and allowing the student to record lectures on their phone. For physical symptoms like headaches and light sensitivity, schools can provide rest breaks, allow sunglasses indoors, seat the student away from bright windows, and give extra passing time between classes to avoid crowded hallways. If the student is dealing with mood changes, having a designated adult they can talk to and a quiet space to decompress can prevent things from snowballing.
These accommodations should be temporary. As symptoms improve, the school gradually removes them until the student is back to their full routine.
Returning to Sports Safely
Returning to sports too soon after a concussion is one of the most dangerous mistakes you can make. A second impact to an already-recovering brain can cause severe, sometimes catastrophic injury. The international standard is a six-step progression, and each step should take at least 24 hours. If symptoms return at any stage, the person drops back to the previous step.
- Step 1: Return to regular daily activities like school, with clearance from a healthcare provider to begin the process.
- Step 2: Light aerobic activity only, such as 5 to 10 minutes of walking, light jogging, or a stationary bike. No weightlifting.
- Step 3: Moderate activity that increases heart rate with body and head movement, like moderate jogging, brief running, and reduced weightlifting.
- Step 4: Heavy non-contact activity, including sprinting, full weightlifting routines, and sport-specific drills without contact.
- Step 5: Full practice with contact, in a controlled setting.
- Step 6: Return to competition.
At minimum, this progression takes about a week from start to finish, but many athletes need longer. Working with a certified athletic trainer, if available, helps ensure each step is handled safely. No athlete, child or adult, should return to play the same day a concussion is suspected.