Recognition & Evaluation

After the initial sideline assessment, an athlete with a suspected concussion should not be left alone, should be monitored for deteriorating mental status over the next few hours, and should be further evaluated in a hospital emergency room or doctor's office.

In first 24 to 48 hours after suspected concussion, an athlete should be monitored by a parent or other responsible adult  for signs that require immediate hospitalization.

The SCAT2 is a standardized method of evaluating injured athletes for concussion ages 10 years and older. Although designed for use by medical and health professionals, it includes advice for athletes and parents about signs to watch for in the first 24 to 48 hours after suspected concussion and a list of other important points, including the need for rest and avoiding strenuous activity, and not training or playing sport until medically cleared.

Baseline and post-concussion neuropsychological (NP) testing is now recommended for all athletes in sports with a high risk of concussion (e.g. football, lacrosse, hockey, soccer, basketball), regardless of age or level of performance, but the timing and type of testing may need to be adjusted for children and adolescents.

One of the signs of concussion is poor balance. An athlete's balance and equilibrium can be tested quickly on the sideline through use of the Balance Error Scoring System (BESS), which consists of 3 tests lasting 20 seconds each, performed on two different surfaces, firm and foam.

The emerging model of sport concussion assessment now involves the use of brief screening tools to evaluate post-concussion signs and symptoms on the sideline immediately after a concussion and neuropsychological testing to track recovery further out from the time of injury. One of the tools of value for sideline evaluation is called the Standardized Assessment of Concussion.

Among the symptoms that a concussion victim sometimes experiences is amnesia, which can take two forms: post-traumatic amnesia (PTA) or anterograde amnesia (reduced ability to form new memories) and retrograde amnesia (RGA)(partial or total loss of the ability to recall events that occurred during the period immediately preceding brain injury).

Among the things which increase the anxiety level of parents of children playing contact sports is the fact that many high school programs don't employ athletic trainers who have received training in recognizing the often subtle signs of a concussion. Thus, the fourth point in the Parent's Bill of Rights on Concussions is the right to expect that a certified athletic trainer (ATC) be on staff.