Preventing return to play is the most important part of concussion management. The concussed patient won’t often realise they’ve hit their head hard, but the coaches, ski patrollers, referees and medics will. If someone has hit their head, whether you think it’s serious or not, get them off the field, off the snow, or out of the rink to assess them with a Concussion Recognition Tool.
These tests include questions like: Who scored last? What venue are we playing at? Which half are we in? What did you score on your last run? The patient should then be asked to name the months of the year backward, or remember a sequence of numbers.
If the athlete has ANY neurological signs: Changes in speech (slurring, poor sentences) gait (limping, walking differently) eyes (pupils unresponsive to light changes) the athlete requires emergency medical attention, and must be taken to Queenstown Hospital.
As humans we all subconsciously prioritise immediate pay-off over long term reward or consequence. But with what we now know about the long term consequences of repeated concussion that impulse tell athletes to “man up” and head back out there starts to look pretty irresponsible.
Neurologist Dr Jeffrey Kutcher, who accompanied the US Winter Olympic team says, “If I let somebody go down another run or participate in a hockey game while they’re injured and that injury leads to a more significant injury, it could be life-changing in the negative. That’s what I have to worry about.”
“I understand the gravity of the situation and needing to first and foremost do my job as a neurologist regardless of setting or scenario. It doesn’t matter if it’s a training run or a gold-medal run or any scenario at all. It is the health of the athletes that I’m there for.”
- Take them out of play
- Render first aid (D.R.A.B.C.)
- Assess them using the Concussion Recognition Tool
- If they answer any questions incorrectly they must not return to play – they are concussed
- If they’re concussed they must rest: No TV, no reading, no loud noises, no drinking
- Refer them to the Queenstown concussion clinic by calling us on 03 409 0078 or emailing firstname.lastname@example.org
See the full consensus statement on concussion management in sports here: http://bjsm.bmj.com/content/47/5/250.full