Concussion Management
Signs/Symptoms | On-Field Cognitive Testing
Sideline Tests | Injury and Concussion Home Care
| Signs and Symptoms Evaluation |
Signs observed by staff:
Symptoms reported by athlete:
Athlete should not return to play until evaluated by a medical professional and is symptom-free at rest and with exertion.
| On-Field Cognitive Testing |
ORIENTATION
Ask the athlete the following questions:
ANTEROGRADE AMNESIA
Ask the athlete to remember the following words:
RETROGRADE AMNESIA
Ask the athlete the following questions:
CONCENTRATION
Ask the athlete to do the following:
WORD LIST MEMORY
Ask the athlete to repeat the three words from earlier:
Any failure should be considered abnormal. Consult a physician following a suspected concussion.
Source: www.impacttest.com
| Sideline Functional & Visual Tests |
ROMBERG SWAY ANALYSIS
Request the athlete to stand with feet together and arms folded across the chest. Instruct to keep eyes closed and the head in a forward position.
20-YARD JOG
Request the athlete to jog a distance of 20 yards in a straight line and then return to the starting position using the same path but with eyes closed.
SINGLETON'S TEST
Request the athlete to perform five quick, broad steps forward, quickly turn around 180 degrees, and then perform the Romberg test with eyes closed.
TANDEM ROMBERG
Request athlete to stand with one foot directly in front of the other (heel to toe) and arms folded across the chest. Instruct to keep eyes closed and the head in a forward position.
DYNAMIC VISUAL ACTIVITY
Request the athlete to view letters below held 14 inches away from eyes. Instruct to quickly shake head from left to right while maintaining focus on the letters. Repeat test with rapid up and down motion in head.
Source: Sports Medicine, Policy & Procedures Manual, The University of Texas at Austin, Developed by 360 Balance.
| Injury and Concussion Home Care |
An athlete who has experienced a head injury or concussion may have signs and symptoms that do not become apparent until hours after the initial traumatic event.
At the time of injury, hospitalization may not have been required. However, you should be alert for possible signs and symptoms in the athlete.
Seek medical attention immediately if you observe any changes of these symptoms:
HOME CARE FOR A HEAD INJURY OR CONCUSSION
What is a concussion?
A concussion is a disturbance in the function of the brain caused by a direct or indirect force to the head or body. It results in a variety of symptoms (like some listed below) and may, or may not, involve memory problems or loss of consciousness.
Go to the hospital immediately if any of these signs are visible:
What should I do?
Any athlete suspected of having a concussion should be removed from play for the remainder of the game and seek medical evaluation by a physician prior to returning to play.
The best guideline is to note symptoms that worsen and behaviors that seem to represent a change in your son or daughter. If you have any question or concern about the symptoms you are observing, contact your family physician for instructions, or seek medical attention at the closest emergency department.
A person with a concussion may:
There is no need to:
Do not:
Lights Out on Electronics
The use of computers, TV and phone, including texting, can delay the brain's healing process. Restriction from using these items as well as avoidance of concerts and loud music may improve healing time. During the next few days, limit TV time and only non-violent programs.
Academic Accommodation
The school administrators (principals, counselors and teachers) should be contacted and informed that the student athlete has sustained a concussion. Request "academic accommodation" such as excuse from classes and homework for a few days.
This should occur until the symptoms diminish. Please remind your child to check in with the school nurse prior to going to class on the first day he or she returns to school.
Your child should also follow up with the school's athletic trainer and should be restricted from participating until the symptoms resolve and a physician has cleared them to return to play. Return to play should be gradual and increase in stress over a period of a few days.
If signs or symptoms return with workouts, then restrict from exercise until the athlete is able to work out without symptoms returning.
Physicians recommend neurocognitive testing as a tool to determine safe return-to-play time lines. This online test is easily implemented in the office of a physician certified in ImPACT (www.impacttest.com). For help finding an ImPACT-credentialed physician and for more information about sports therapy, call the Texas Health Ben Hogan Sports Medicine program at 817-250-7500.
This content is provided for information only and is not intended as medical advice. For advice about your specific medical condition, contact your physician.
Note: Physicians on the medical staff practice independently and are not employees or agents of the hospital.
Source: www.impacttest.com, American Academy of Neurology, SCAT