Dear ABYS coaches,

As an ABYS BU14 coach, and a Pediatrician, I wanted to summarize available guidelines that may be helpful for the sideline evaluation of a head-injured athlete.

Concussion is a relatively common injury in soccer.  One of our responsibilities as coaches, and parents, is to properly identify a child at risk.  One serious, and rare, complication is “Second-Impact Syndrome.”  Second-Impact Syndrome occurs in players who return to competition before the symptoms of a first concussion have completely resolved. A second blow to the head, even a minor one, can result in swelling of the brain that can be fatal.  Another complication is the effects of repeated concussions leading to mounting neuropsychological deficits.  Objective assessment of the injured athlete will lessen the risk of complications and provide for a safe return to play on the pitch.

On-the-field evaluation of an athlete with a head injury should begin with basic life support. Once it has been assured that airway, breathing and circulation are normal, it should be determined whether loss of consciousness has occurred. Momentary loss of consciousness may be difficult to ascertain. Careful observation, as well as questioning of the athlete and teammates on the field, should help to provide this information. Frequently, the injured athlete is confused and may not be the best source of information.

Attached is “Concussion_in_Sports.pdf,” published by the American Academy of Neurology, which is a pocket-sized card to aid a coach or trainer in the sideline evaluation of the head-injured athlete.  This is one example of several sets of guidelines available for the management of concussion.  The full guidelines can be found through the first hyperlink below.  The others are for your reference.

Sincerely,

Lars Kula, MD

http://www.cdc.gov/doc.do/id/0900f3ec8000e819 

http://www.aafp.org/afp/990901ap/887.html 

http://www.physsportsmed.com/issues/2002/08_02/mccrory.htm