Concussion Policy

The standard of care for current medical practice and the law in most states requires that any athlete with a suspected concussion is immediately removed from play.

·      A concussion is a traumatic brain injury- there is no such thing as a minor brain injury.

·      A player does not have to be “knocked-out” to have a concussion- less than 10% of players actually lose consciousness.

·      A concussion can result from a blow to head, neck or body.  

·      The youth player’s brain is more susceptible to concussion.  

·       In addition, the concussion in a young athlete may be harder to diagnosis, takes longer to recover, is more likely to have a recurrence and can be associated with serious long-term effects. 

·      Treatment is individualized and it is impossible to predict when the athlete will be allowed to return to play- there is no standard timetable.

A player with any symptoms or signs; disorientation; impaired memory, concentration, balance or recall has a concussion. 

Remember these steps: 

1.   Remove immediately from play (training, practice or game)

2.   Inform the player’s coach/parents 

3.   Refer the athlete to a qualified health-care professional 

4.   Initial treatment requires physical and cognitive rest

5.   The athlete begins a graded exertion and schoolwork protocol.

6.   Medical clearance is required for return to play  

Diagnosis

     Players, coaches, parents and heath care providers should be able to recognize the symptoms and signs of a concussion:

Symptoms

•       Headache

•       Nausea

•       Poor balance

•       Dizziness

•       Double vision

•       Blurred vision

•       Poor concentration

•       Impaired memory

•       Light Sensitivity

•       Noise Sensitivity

•       Sluggish

•       Foggy

•       Groggy

•       Confusion

Signs

•       Appears dazed or stunned

•       Confused about assignment

•       Moves clumsily

•       Answers slowly

•       Behavior or personality changes

•       Unsure of score or opponent

•       Can’t recall events after the injury

•       Can’t recall events before the injury

Management Protocol

1.  If the player is unresponsive- call for help & dial 911

2.  If the athlete is not breathing: start CPR

• DO NOT move the athlete

• DO NOT remove the helmet

• DO NOT rush the evaluation

3.  Assume a neck injury until proven otherwise

• DO NOT have the athlete sit up until you have determined:

• no neck pain

• no pain, numbness or tingling

• no midline neck tenderness

• normal muscle strength

• normal sensation to light touch

4.  If the athlete is conscious & responsive without symptoms or signs of a neck injury…

• help the player to the bench area

• perform an evaluation

• do not leave them alone

5.  Evaluate the player on the bench:

• Ask about concussion symptoms (How do you feel?)

• Examine for signs
•  Verify orientation (What day is it?, What is the score?, Who are we playing?)
• Check immediate memory  (Repeat a list of 5 words)
• Test concentration (List the months in reverse order)
• Test balance (have the players stand on both legs, one leg and one foot in front of the other with their eyes closed for 20 seconds)Check delayed recall (repeat the previous 5 words after 5-10 minutes)

6. A player with any symptoms or signs, disorientation, impaired memory, concentration, balance or recall has a concussion.

“When in doubt, sit them out”

• Remove immediately from play (training, practice or game)Inform the player’s coach/parents
• Refer the athlete to a qualified health-care professional
• Medical clearance is required for return to play

7.  If any of the signs or symptoms listed below develop or worsen: go to the hospital emergency department or dial 911.

Ø  Severe throbbing headache

Ø  Dizziness or loss of coordination

Ø  Memory loss or confusion

Ø  Ringing in the ears (tinnitus)

Ø  Blurred or double vision

Ø  Unequal pupil size

Ø  No pupil reaction to light

Ø  Nausea and/or vomiting

Ø  Slurred speech

Ø  Convulsions or tremors

Ø  Sleepiness or grogginess

Ø  Clear fluid running from the nose and/or ears

Ø  Numbness or paralysis (partial or complete)

Ø  Difficulty in being aroused

8.  An athlete who is symptomatic after a concussion initially requires physical and cognitive rest.

•        A concussed athlete should not participate in physical activity, return to school, play video games or text message if he or she is having symptoms at rest.

•        Concussion symptoms & signs evolve over time- the severity of the injury and estimated time to return to play are unpredictable.

9. A qualified health care provider guides the athlete through a Functional Return to School/Play protocol.