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Coaches and Parents: If Concussion Suspected, What To Do Next Is Simple


If an adult experiences an acute, sudden onset of chest pain, most people would say that the decision about whether that person had or is having a heart attack should be made by a doctor, that if you suspect something serious is going on, it should be get it checked out right away by a medical professional, and that no smartphone app or test can - or should -  take the doctor's place.   

The same is true for concussions, say experts: If a parent, coach, or game official has reason to suspect that a player has suffered a concussion playing sports, it should be checked out right away by a medical professional.   No smartphone app or sideline test can diagnose a concussion or determine that no concussion is present. That job needs to be done by a licensed medical provider. End of story.

So, no matter what some may have you think, experts say, parents and coaches need to always keep in mind three things:

  1. If they see a player, either during or after the game or practice, showing any signs of concussion, or the player reports to an adult or even a teammate - either during the game or in the hours or days after a game or practice - that they are experiencing any symptoms of concussion (scroll down for a list of signs and symptoms), a concussion should be suspected. 
  2. If a concussion is suspected, what to do next is very simple: REMOVE the player from the game or practice IMMEDIATELY, ban the player from returning that day, and send the player to a health care professional qualified to diagnose concussions for a complete clinical examination. (Remember: this is the law in all 50 states and the District of Columbia - at least for high school athletes, and for an increasing number of states and local jurisdictions, middle school and elementary-age athletes in school and private sports programs as well)  Put another way, the fact that a parent or coach is checking an athlete for a concussion should be good enough for the parent/coach to remove the athlete from participation until assessed by a medical provider.
  3. No game is more important than a child's health.  Youth athletes are kids. They are not adults. They are not being paid to play sports. It is up to parents and coaches to protect them from harm.  That is an awesome responsibility not to be taken lightly. A coach who is unwilling to follow or enforce these rules should NOT be coaching. 


Signs of possible concussion requiring removal from play 

A concussion should be suspected on the sports sideline, and the athlete immediately removed from play and not permitted to return the same day, if any of the following signs are observed after a direct or indirect blow to the head:

  • loss of consciousness (LOC) 
  • the player was lying motionless on the ground or was slow to get up
  • the player exhibits balance or motor coordination problems (athlete stumbles, has slow/labored movements or unsteady gait)
  • the player is disoriented or confused (inability to respond appropriately to questions; not aware of plays or events)
  • the player exhbits a loss of memory (post-traumatic amnesia)
  • the player has dazed, blank or vacant look on face;
  • player has visible facial injury in combination with any of the other signs.
Indeed, even if a healthcare provider is available to perform a neurocognitive, visual, or balance assessment using a "remove from play" screening tool designed for use by healthcare professionals, such as the Standardized Assessment of Concussion or Sports Concussion Assessment Tool (SCAT3), or the King-Devick test, the most recent international consensus of concussion experts, and the SCAT3 itself, recommend that a player displaying any of these obvious potential signs of concussion should be (1) removed from play, (2) not allowed to return to sport the same day under any circumstances, and (3) referred to a physician for a formal concussion evaluation.  Note also that the final decision regarding concussion diagnosis and/or fitness to play is always a medical decision based on clinical judgment.

Concussion Symptoms 
1. Headache (reported as symptom by 94.2% of high school athletes 
2. Nausea (reported by 31.4% of high school athletes)
3. Vomiting
4. Balance problems
5. Dizziness (reported as a symptom by 75.6% of concussed high school athletes)
6. Fatigue
7. Trouble falling asleep
8. Sleeping more than usual
9. Sleeping less than usual
10. Drowsiness
11. Light sensitivity (reported as a symptom by 36.0% of concussed high school athletes)[
12. Noise sensitivity
13. Irritability
14. Sadness
15. Nervousness
16. Feeling more emotional
17. Numbness or tingling
18. Feeling slowed down (e.g. slower reaction time)
19. Feeling mentally "foggy"
20. Difficulty concentrating (54.8% of concussed high school athletes report this symptom)  
21. Difficulty remembering
22. Visual problems


Posted October 5, 2015