Managing A Potential Concussion Injury: Club Guidelines
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If a player is involved in an incident that has the potential to induce a concussion injury the following steps should take place:
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If the player is unconscious follow basic DRABC Emergency First Aid guidelines, and call an ambulance.
Note: if there is even the slightest possibility that the player has sustained a serious spinal injury do not move the player unless it is absolutely necessary to do so in order to create or maintain a lifesaving patent airway.
2. If the player is conscious and breathing but a serious spinal injury is suspected do not move the player – call an ambulance, and monitor the player until proper medical help arrives.
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3. If the player is conscious and serious spinal injury is not suspected follow the principles of ‘Recognise, Remove, Remember’ as articulated in the CRT(6), and assess the player using the CRT(6) tool (or the SCAT(6) if a suitably qualified health care practitioner is available). Remember that the overriding principle to be used throughout this assessment process is :
‘When in doubt the player sits out the game!’
4. If a player ‘fails’ the CRT or SCAT(6), or if there is any doubt at all about the players fitness to return to the game/training session, they should be excluded from further participation in the match/training session and be given appropriate ‘post acute injury ‘guidance.
They should also be advised to seek appropriate further medical follow up care as soon as possible, and if this medical follow up appears to require the player attending the nearest A&E they should be driven there (and then home if needs be), and properly supported whilst this medical follow up is taking place.
5. If a player ‘passes’ a CRT or SCAT(6) testing protocol but you still suspect a concussion type of injury is evolving the player should still be excluded from further participation in the match/training session and be given appropriate ‘post acute injury ‘guidance as per step 4 above.
6. If a player has been removed from play but then ‘passes’ a CRT* (but preferably a SCSAT(6)) assessment and are symptom free for 10 minutes then they may warm up for return to play.
(Note that a player ‘passing’ a CRT administered by a lay person still leaves a lot of ambiguity regarding their ‘diagnosed’ status of whether they’re concussed or not, and therefore whether they’re okay to return to play or not. This is why the ‘if in doubt’ principle stated earlier is so important, and why the return to play guidelines below must be observed).
(Further Note: If a player cannot achieve a state of being completely symptom free for a period of ten minutes then they must be sidelined for the rest of the game, and advised to proceed as per step 4 above).
7. If the players symptoms return as they warm up they are sidelined for the remainder of the game, and advised to proceed as per step 4 above.
8. If the players symptoms return after they’ve returned to play they are sidelined for the remainder of the game, and advised to proceed as per step 4 above.
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