What to do following an incident involving a blow or an impulsive force to the head

If you have experienced a blow to the head, you might be suffering from a mild traumatic brain injury or a concussion (MTBI/concussion). It is important that you watch for the appearance of symptoms:

For all health-related questions, you can contact Info-Santé 811 at any time.

If there are no immediate symptoms

Watch carefully for the appearance of symptoms during a 48-hour observation period:

• refrain from participating in physical, recreational and sports activities
• continue intellectual activities (work, school routine, hobbies, etc.)
• watch carefully for any possible changes in your state of health

Only in cases where you do not develop any symptoms within 48 hours following the incident can you resume all your intellectual, physical and sports activities.

If there are symptoms

Maintain a 48-hour rest period to help healing:

• limit activities to basic day-to-day needs (e.g. getting dressed, doing the dishes, cooking a meal)
• avoid full bed rest during the daytime
• limit intellectual activities (work, school routine, hobbies, etc.) that require concentration, thought and memory
• avoid using screens (telephone, tablet, computer, television set)
• do not participate in physical, recreational or sports activities
• avoid all activities that cause symptoms or make them worse

If you develop symptoms within 48 hours following the incident, you should quickly consult a doctor to get a diagnosis and the appropriate support and guidance at a medical clinic or hospital emergency department to receive a diagnosis and the appropriate support.

During the consultation, it is important that you be accompanied by someone close to you. This person will receive the same information as you but may be in a better position to understand and memorize it because, with an MTBI/concussion, it is highly likely you will not be able to do so. If needed, this person could also transmit the information more accurately to those who will help and support you over the coming days.

• The doctor will ask you about the circumstances of the incident in order to assess if there was a significant blow or impulsive force to the head.
• They will assess you in order to fully understand your symptoms and any possible connection to the incident.
• If applicable, the doctor will diagnose you with MTBI/concussion.
• They will provide you with the relevant and proper information to manage the coming days, including the necessity of adopting good behaviours.
• The doctor will issue the required certificate(s) regarding absence from work, absence from school or non-participation in physical and sports activities, if necessary.
• They will let you know if a medical follow-up is required and if an attestation is needed for returning to work or school or participating in sports.

A 48-hour rest period is recommended to help recovery.

If, after a 48-hour rest, your symptoms have diminished:

• progressively return to your activities (intellectual, physical and sports)
• consider documenting your symptoms and your return to activities using the tools available

If, after a 48-hour rest, your symptoms worsen or new symptoms appear:

• maintain a level of activity that does not exacerbate your symptoms
• consider documenting your symptoms and your return to activities using the tools available
• if, at any time, you are worried or have questions about your state of health, call Info-Santé 811 or make an appointment with a healthcare professional

A progressive return to activities prevents complications, respects the participant’s capacity to recover and helps maintain social ties.

After the initial 48-hour rest period, intellectual and physical activities can be resumed, at the same time and progressively, provided they do not cause symptoms to worsen or return.

• The pace of the progressive return must be adapted to each individual and take into account their prior level of activity and the targeted level.
• Experiencing mild symptoms during the activity is normal. Progressing from one step to the next may be undertaken gradually, provided that symptoms do not worsen.
• If symptoms worsen or return, take an additional day of rest before resuming these activities more gradually.

Tools for further reference:

• Pamphlet produced by the Institut national d’excellence en santé et en services sociaux (INESSS) 
• INESSS video: Symptômes fréquents, signaux d’alerte et période de repos à observer  (in French only)
• INESSS video: Conseils pour la reprise graduelle des activités intellectuelles, physiques et sportives  (in French only)

Tools intended for use by educational institutions in the context of physical and sports activities:

• Concussion Management Protocol
• Concussion Management Protocol Tracking Sheet