The Consensus Statement on Concussion in Sport of the 3rd International Conference on Concussion in Sport1 includes a Sport Concussion Assessment Tool 2 (SCAT2)2 for standardized assessment by medical and health professionals (team physicians, certified athletic trainers, neuropsychologists) of sports concussion in athletes ages 10 years and older, and for making return to play (RTP) decisions.
The SCAT2 enables the calculation of theStandardized Assessment of Concussion (SAC) score on the sports sideline and incorporates the Balanced Error Scoring System (BESS). It supersedes the original SCAT published in 2005. Because the full SCAT2 evaluation has not been researched since its release with the Zurich statement, the authors recommend continued reliance on the SAC score until prospective studies are conducted on the SCAT2, a position endorsed by the American Academy of Pediatrics in its 2010 clinical report on sport-related concussions in children and adolescents.3
Although the SCAT2 is designed for use by medical and health professionals (and is the basis for the NFL's new sideline assessment protocol, which was in use during the 2011-2012 season, and the National Hockey League's concussion protocol implemented March 16, 2011), it includes a page of information to be given to the athlete and his parents when, after examination in an emergency room or doctor's office, no sign of any serious complications have been found, and he is allowed to return home, including:
- signs to watch for during the first 24-48 hours requiring immediate hospitalization. Because the onset of symptoms of concussion may be delayed - especially in young athletes - the athlete should not be left alone and should be monitored by a parent or other responsible adult for signs, such as change in behavior, vomiting, dizziness, worsening headache, double vision or excessive drowsiness, requiring immediate hospitalization;
- a list of other important points, including:
- the need for cognitive rest (not taxing brain with activities such as video games, watching television, texting, homework etc.) and avoiding strenuous activity for at least 24 hours
- not consuming alcohol or taking sleeping tablets
- not using aspirin or anti-inflammatory medication( acetaminophen (e.g. Tylenol®) or codeine only for headache)
- not driving until medically cleared, and
- returning to sports only after following a stepwise, symptom-limited progressive exercise program and obtaining medical clearance.
1. Consensus Statement on Concussion in Sport: the 3rd InternationalConference on Concussion in Sport held in Zurich, November 2008. Br.J. Sports Med. 20090: 43:i76-i84.
2. SCAT2, Br. J. Sports Med. 2009; 43; i85-i88.
