Purpose

The short version

KEY RULE: When in doubt, sit them out and get advice. A person may initially appear well and still develop symptoms later.

1. Immediate response

1. Stop & Protect: Make the area safe and stop participation immediately. Assume a potential spinal injury if significant force was involved; do not move the person unnecessarily, and do not remove helmets unless essential for airway management. 
2. First Aid (DRSABCD): Assess Danger, Response, Airway, Breathing, and Circulation. Apply DRSABCD and provide first aid within your training. Call 000 if the person is unresponsive, not breathing normally, or has any emergency warning signs.
3. Remove from Activity: If concussion is suspected, the participant must not return to play or adventurous activities on the same day—even if symptoms seem to resolve.  
4. Supervise & Monitor: If concussion is suspected, keep the person under continuous observation by a responsible adult for at least 4 hours after the incident.  
5. Inform Parents/Carers: Ensure direct verbal handover to parents or carers.  
6. If in doubt, call for help on 000. 

2. Call Triple Zero (000) now

Call 000 if any of the following is present, develops or worsens:

1. Unconsciousness, reduced responsiveness, difficulty waking, or any seizure/convulsion
2. Worsening or severe headache; repeated vomiting; increasing confusion, agitation, unusual behaviour or marked drowsiness
3. Slurred speech; weakness, numbness, poor coordination, worsening balance, or unequal pupils
4. Blood or clear fluid from the nose or ears; an obvious skull deformity; a penetrating injury; or significant uncontrolled bleeding
5. Neck pain or tenderness following significant force, or signs of a possible spinal injury
6. Breathing problems, rapid deterioration, or any situation in which the responder is seriously concerned.

A serious injury mechanism also matters

Call 000 or seek urgent clinical advice when the injury involved significant force, even if symptoms are not yet obvious. Examples include:

1. A fall from more than the person’s own height or a fall onto a hard surface
2. A high-speed collision, vehicle impact, or being struck by a fast-moving or heavy object
3. A diving, climbing, abseiling, cycling or similar incident with substantial impact
4. Multiple impacts, or an incident where the details are unclear and the person cannot give a reliable account.

HIGHER-RISK CIRCUMSTANCES

Use a lower threshold for urgent medical advice if the person takes anticoagulant or antiplatelet medicine, has a bleeding disorder, is intoxicated, has had recent brain surgery, is very young, or cannot be reliably observed or assessed. Tell 000 or the clinician.

3. If there are no emergency warning signs

1. Remove the participant from any activity with a risk of another impact, fall, immersion, driving, operating equipment or requiring quick judgement.
2. Keep them with a responsible adult and observe for changes. Recheck how they look, feel, speak, move and behave. Symptoms may be delayed.
3. Arrange medical assessment when symptoms are present, the injury mechanism is concerning, the person is not returning to normal, or if you are unsure. Where concussion is suspected, a medical practitioner review should occur as soon as practicable, preferably within 72 hours.
4. Do not leave them alone or send them home without direct handover. If safe supervision or timely medical review cannot be arranged, escalate for clinical advice.
5. Do not give food, drink or medicine to a drowsy, vomiting or seriously injured person. Any medication must be managed under normal Scouts Queensland medication arrangements and professional advice; do not use medication to mask deterioration.

Common symptoms to watch for

1. Headache or pressure in the head
2. Dizziness, nausea, vomiting, blurred/double vision, sensitivity to light or noise
3. Balance or coordination problems
4. Confusion, memory gaps, repetitive questioning, slowed responses or difficulty concentrating
5. Unusual tiredness, irritability, anxiety, emotional change or behaviour that is not normal for the person.

4. Parent/carer or clinical handover

Give a direct verbal handover. 

Do not rely on the participant to pass on the information. 

1. The time, location and activity; exactly how the injury occurred; estimated fall height or force
2. Whether there was loss of consciousness, memory loss, seizure, vomiting, neck pain or other symptoms
3. Changes observed over time and the person’s current condition
4. First aid provided, advice obtained and any medication already administered
5. Advise parents that it is recommended that children with a mild head injury be assessed by a medical practitioner within 72 hours.
6. Explicitly advise carers to seek emergency medical care if delayed symptoms (e.g. vomiting, waking difficulty, increasing headaches, behavioural changes) emerge at home.

AT HOME

A responsible adult should continue monitoring and follow clinical advice.

It is not normally necessary to keep a person awake solely because of a minor head injury, but difficulty waking is an emergency warning sign.

If symptoms appear, persist or worsen, seek medical care urgently.

5. Return to Scouting activities

1. No same-day return: anyone with suspected concussion must not return to physical, adventurous or other risk activity on the day of injury, even if they feel better.
2. Until medically reviewed, avoid activities where impaired balance, concentration or reaction time—or another impact—could cause harm. This includes contact sport, climbing/abseiling, cycling, paddling, swimming, driving and operating equipment.
3. Medical Clearance: Any participant with a concussion must be cleared by a medical practitioner (e.g. GP) before resuming contact, height-based, or high-risk Scouting activities. 
4. Return should be gradual and follow the treating practitioner’s advice. Current Australian community-sport guidance generally uses staged return and minimum timeframes; leaders should not create an independent return-to-activity plan.

6. Remote and isolated activities

1. Before the activity, identify communications, evacuation routes, access points and the nearest appropriate medical care in the activity plan and risk assessment.
2. If warning signs appear or the person deteriorates, activate the planned emergency communication method (for example satellite device, radio or PLB where appropriate) and arrange urgent evacuation.
3. Remoteness lowers the threshold for seeking advice and evacuation because observation, transport and definitive care take longer.

7. Record and report

1. Date, exact time, location and activity
2. Mechanism, estimated force/height and protective equipment worn
3. Initial condition and all signs or symptoms, with times and changes
4. First aid, calls/advice, transport or medical escalation
5. Who supervised the person and the time and content of the parent/carer or clinical handover.

What this guide deliberately does not do

1. It does not encourage volunteer leaders to formally diagnose concussion; such assessments should be made by qualified health practitioners.
2. It does not ask volunteer leaders to perform pupil, limb-strength, sensation or other neurological examinations beyond their training. Obvious abnormality should trigger 000; a seemingly normal result must never be used to rule out injury.
3. It does not prescribe treatment, medication or an individual return-to-activity timetable. Those decisions belong to qualified health practitioners.

Further references and resources