MANAGEMENT OF CONCUSSION IN COLLISION SPORTS - GUIDELINES FOR THE SIDELINES

During high-risk sports events, it is important for team physicians to be alert to the possibility of concussion in athletes who may not rea lize they have been injured or may want to conceal their injury. If co ncussion is suspected and the player is conscious, history taking shou ld include inquiries about loss of consciousness, loss of memory of ev ents before and after the impact, headache, visual abnormalities, moto r and sensory changes, and back, neck, and extremity pain. In an uncon scious player, the airway, breathing, circulation, and cervical spine should be checked. The cervical spine must be stabilized before the pl ayer is moved if injury to it is suspected. Athletes with such an inju ry and those who have lost consciousness require hospital evaluation. If there is no cervical spine injury, a complete neurologic evaluation should be carried out on the sidelines and the player checked for sig ns of skull fracture. The Colorado Medical Society guidelines for grad ing concussions and deciding when athletes may return to competition a re an excellent aid to clinical judgment.