A student with a suspected concussion should not be left unattended and should not be sent home alone.

Red Flags requiring immediate medical care

• Loss of consciousness or seizures

• Increasing confusion or irritability

• Severe or increasing headache

• Repeated vomiting

• Unusual behaviour change

• Weakness in arms or legs

• Seizure or convulsion

• Double or blurred vision

• Report of neck pain or spinal cord symptoms - numbness, tingling, muscle weakness

• Personal medical history of bleeding disorder or regular medication use that could result in prolonged bleeding, e.g. Warfarin, Aspirin

• Visible skull deformity

If any ‘red flag’ symptoms occur, the student requires immediate medical care either from an ambulance paramedic, emergency doctor or GP.

If no ‘red flags’ are evident, the care of the student can be handed to parents/whānau and monitored for concussion symptoms. At this time, students and parents should be instructed to access a health practitioner either in person or via telehealth at the earliest opportunity for a concussion diagnosis or clearance.

If symptoms worsen, the student should seek immediate care. If a medical practitioner (often a GP) is not available within 48 hours, the student may see a School Nurse (if applicable), or Physiotherapist who can help support their care and education until medical treatment can be sought. The School Nurse or Physiotherapist should liaise with the student and their parents/whānau and facilitate an appointment with a health practitioner as soon as possible.

What they feel

• Headache

• Pressure in head

• Balance problems

• Blurred/double vision

• Neck pain

• Nausea/vomiting

• Dizziness

• Sensitivity to light and/or noise

• ‘Don’t feel right’

• Fatigue

• Drowsiness

It is important not to ignore these symptoms, as this will prolong recovery. If symptoms worsen, it is important to get immediate medical care – this could indicate a more serious injury

Red flags and symptoms have been reported in line with ACC concussion in sport guidelines published in 2025.

The Brain Injury Screening Tool below was designed by a group of health professionals, academics, Māori advisors, people with lived experience, and service providers to improve assessment and management of suspected brain injury (including concussion). If you complete this, make sure you save a copy to take with you to the doctors.

What happens if the student does NOT develop symptoms within 48 hours?

If no immediate symptoms occur following an incident, students are still required to have 48 hours physical and cognitive rest as symptom onset can be delayed. It is recommended the student sees their health practitioner to confirm whether or not they have sustained a concussion.