"If In Doubt, Sit it Out" was the slogan of an NFL concussion training video a couple of years ago, required viewing for NFL players in view of highly publicized cases of depression and encephalopathy in older American football players. Now, the American Academy of Neurology has endorsed more conservative and stringent handling of concussion at the high school level as well, where there is some evidence players may be even more vulnerable to sequelae of TBI.
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A Handout For Sports Personnel: See also HERE.
Use this guide to help you evaluate if someone may have a concussion and needs to see a
licensed health care provider.*
EVALUATE
Know these signs and symptoms of
concussion. Every athlete is unique
and may experience different
combinations of reactions.
Common Signs of Concussion—
Things You Can Observe
• Behavior or personality changes
• Blank stare, dazed look
• Changes to balance, coordination,
or reaction time
• Delayed or slowed spoken or
physical responses
• Disorientation (confused about
time, date, location, game)
• Loss of consciousness (blackout)
(occurs in less than 10 percent of
people with concussion)
• Memory loss of event before,
during, or after injury occurred
• Slurred/unclear speech
• Trouble controlling emotions
• Vomiting
Symptoms of Concussion— Things
the Athlete Tells You
• Blurry vision/double vision
• Confusion
• Dizziness
• Feeling hazy, foggy, or groggy
• Feeling very drowsy, having sleep
problems
• Headache
• Inability to focus, concentrate
• Nausea (stomach upset)
• Not feeling right
• Sensitivity to light or sound
TAKE ACTION
What should I do if an athlete
has a head injury during a
game?
Immediately address safety
concerns. If the person is
unconscious (knocked out),
check his or her Airway,
Breathing, and Circulation
(ABCs).
Airway: Check that the mouth
and throat are not blocked
Breathing: Be sure the person is
breathing normally
Circulation: Check that the
person’s heart is beating
regularly
If you suspect the person may
have a neck injury or if the
person is unconscious:
• Do not move the head,
neck, or spine. This could
worsen any spinal injury to
the neck
• Contact emergency medical
services with any concern
about breathing, circulation,
or spinal injury
• Do not let the athlete return
to play until examined and
cleared by a licensed health
care provider trained in
diagnosing and managing
concussion
SEEK CARE
What should I do if it appears
the athlete has a concussion?
If a concussion is suspected,
remove the athlete from play. If
a concussion is diagnosed, the
athlete should not return to
play for the rest of the day.
• Monitor the athlete for the
next three to four hours. You
may need to monitor for a
longer time
• Notify a licensed health care
provider trained in
diagnosing and managing
concussion
• Do not let the athlete return
to play until evaluated and
cleared by a licensed health
care provider trained in
diagnosing and managing
concussion
When is it okay for the athlete
to return to the game?
Clearance from a licensed
health care provider trained in
diagnosing and managing
concussion is needed before
allowing the athlete to return to
play. The health care provider
may:
• Advise the athlete to return
to physical activity slowly
• Explain the process for this
clearly
• Tell the athlete to increase
activity levels carefully, step
by step
Remember, if the person has
any concussion symptoms, he
or she should not advance to
the next activity level. Before
full return to play, the final
activity level should imitate
game conditions as much as
possible.
