|
|
Evaluate after any head impact
GENERAL SIGNS / SYMPTOMS
- Any period of lost consciousness (paralytic coma, unresponsive to arousal)
- Vacant stare (befuddled)
- Delayed verbal/motor response (slow to answer questions/follow instructions)
- Confusion, inability to focus (distracted)
- Disoriented (time, date, place, walking direction)
- Slurred or incoherent speech (disjointed or incomprehensible)
- Gross incorordination (stumbling, can't walk straight line)
- Emotions out of proportion (distraught, laughing/crying for no reason)
- Memory gaps (repeating same question, can't memorize/recall 3 of 3 words/objects in 5 minutes)
- Complaints of headaches, dizziness, ringing, seeing stars/colours, vomiting, impaired vision/light sensitivity
SIDELINE EVALUATION
- Test mental status. Ask time, place, person, injury circumstances. Ask for digits backwards or months in reverse order. Check memory for names of teams, recall of 3 words/objects at 0 and 5 minutes, recent news events, game status and strategies.
- Do physical evaluation (grade 1 only, for return to play). 40-yard sprint, 5 push-ups, 5 sit-ups, 5 knee-bends.
- Check other symptoms. Headaches, dizziness, balance, blurred/double vision, nausea - get immediate medical help.
| GRADE |
SYMPTOMS |
RECOMMENDATIONS |
RETURN TO PLAY |
| 1 |
No loss of consciousness.
Transient confusion (inattention, inability to maintain coherent thought or goal-directed movement) Athletes speak of 'ding' or having 'bell rung' and may try to keep playing.
Symptoms or mental abnormalities last less than 15 minutes.
|
Remove from contest.
Examine immediately and at 5 minute intervals. Check for signs (list below).
|
Once there are no symptoms:15 minutes or less
(1 week if multiple grade 1 concussions) |
| 2 |
No loss of consciousness.
Transient confusion (inattention, inability to maintain coherent thought or goal-directed movement) Athletes speak of 'ding' or having 'bell rung' and may try to keep playing.
Symptoms or mental abnormalities last more than 15 minutes.
|
Remove from contest. Disallow return that day.
Examine on-site frequently for signs of evolving mental abnormalities.
Recommend medical exam same day.
Doctor to perform neurologic exam to clear athlete - with no symptoms while at rest and during exertion.
|
1 week
(2 weeks if multiple) |
| 3 |
Any loss of consciousness.
- Brief (seconds)
- Prolonged (minutes)
|
Transport to nearest emergency department - by ambulance if still unconscious or signs of neck pain (cervix/spine immobilized).
Thorough neurologic exam immediately including neuroimaging when indicated.
|
After brief loss (seconds): 1 week
After prolonged loss (minutes): 2 weeks
Multiple: 1 month on advice of physician. |
|
Information on this page is from a Canadian Brain Injury Association. Check with your local or national authority for their guidelines.
If you come across other first aid information from a reliable source, please let us know. While every effort is made to provide accurate information, never rely on written information alone, always consult qualified medical practitioners directly.
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