Combat Concussion

Whilst working as a medic covering a Taekwondo tournament in December 2017 I dealt with an incident of a concussion. The competitor returned this year and I caught up with her to find out what happened after the event. I was not expecting the story that followed.

Carla, a black belt in Taekwondo, was competing in a sparring contest. She was wearing the appropriate safety equipment including head guard and gloves.

I became concerned about the competitor after she received a blow to her head. She became unsteady on her feet and so the bout was stopped. I removed her from the ring, and she began to complain of nausea and photosensitivity. We moved to a quieter area as the noise levels were beginning to become a problem for her. Following a full assessment, my immediate impression was that she was concussed and should not continue in the tournament. 

The assessment revealed that it was difficult for her to answer certain questions. She answered Maddocks questions with no problems, it was when I began filling in her details on my treatment record that she struggled. She was unable to recall her phone number and revealed that she hadn’t been able to remember things for a few days after hitting her head on a concrete archway in a friend’s house.

She began to drop her level of consciousness and I became increasingly concerned, especially as this was her second head injury in the space of a week. Although haemodynamically stable I felt her dropping level of consciousness, nausea and photosensitivity meant I needed to refer Carla to a Doctor as a matter of urgency. I was concerned that this could be a serious head injury, possibly an intracranial bleed. I called 999 and unusually a doctor, nurse and paramedic were on the ambulance that was sent. 

A concussion was diagnosed by the doctor, with the advice to see her own GP on her return to Devon. She left Cardiff that evening with somebody keeping a close eye on her during the long car journey home.

I contacted her in the days following and she said she was feeling tired but generally better. When I caught up with her she told me of her difficult year since.

It was a few weeks after the initial diagnosis of a concussion that her symptoms began to worsen. Whilst attending another Taekwondo tournament, as an observer, her friends became concerned when she became vacant and began slurring her words. They quickly took her to the hospital.

Numerous scans were performed and thankfully there was no evidence of a life-threatening bleed. Following a detailed examination of Carla and her ongoing symptoms, a diagnosis of the post-concussion syndrome was made. She continued to experience impaired vision finding herself unable to focus for any length of time. 

The extreme tiredness that she encountered restricted her everyday life including her ability to return to work. Concentrating on any length of time lead to exhaustion, even the simplest tasks became difficult. The making of simple decisions such as what to eat for tea was now a challenge. Reading and listening to music became impossible. It took four months before she was back at work as a classroom assistant. This was facilitated by her occupational health department who developed an activity/sleep schedule to aid her rehabilitation. 

Her mental health suffered, experiencing emotional discomfort the year since her injury. Thankfully she has been supported through this with counselling sessions and is now taking medication to ease her depression.

Although some symptoms remain, especially travel sickness and tiredness, things are improving and for the first time in over a year, she has returned to exercise. Her involvement with Taekwondo continues, and whilst she has been advised not to spar again, working as an instructor Carla continues to inspire young people to take up the sport. 

When teaching on our First Aid for Sports and Exercise (FASE) and Sports Trauma Management Courses, we stress the importance of recognition and correct management of concussion.

Keeping up to date on any change in guidelines and published research allows us to keep our information current. Hearing directly from someone who has experienced a serious concussion has helped us to understand it’s long-term effects and the impact it can have. 

Kind thanks to Carla Dunne for allowing us to share her story.