Concussion Procedure and Protocol

Concussion: a traumatic brain injury that interferes with normal brain function. Medically, a concussion is a
complex, pathophysiological event to the brain that is induced by trauma which may or may not involve a loss of
consciousness (LOC). Concussion results in a constellation of physical, cognitive, emotional, and sleep-related
symptoms. Signs or symptoms may last from several minutes to days, weeks, months or even longer in some


Step 1:
Did a concussion occur?
Evaluate the participant and note if any of the following signs and/or symptoms are present:
(1) Dazed look or confusion about what happened.
(2) Memory difficulties.
(3) Neck pain, headaches, nausea, vomiting, double vision, blurriness, ringing noise or sensitive
to sounds.
(4) Short attention span. Can’t keep focused.
(5) Slow reaction time, slurred speech, bodily movements are lagging, fatigue, and slowly
answers questions or has difficulty answering questions.
(6) Abnormal physical and/or mental behavior.
(7) Coordination skills are behind, ex: balancing, dizziness, clumsiness, reaction time.

Step 2:
Is emergency treatment needed?
This would include the following scenarios:
(1) Spine or neck injury or pain.
(2) Behavior patterns change, unable to recognize people/places, less responsive than usual.
(3) Loss of consciousness.
(4) Headaches that worsen
(5) Seizures
(6) Very drowsy, can’t be awakened
(7) Repeated vomiting
(8) Increasing confusion or irritability
(9) Weakness, numbness in arms and legs

Step 3:
If a possible concussion occurred, but no emergency treatment is needed, what should be done now?
Focus on these areas every 5-10 min for the next 1 – 2 hours, without returning to any activities:
(1) Balance, movement.
(2) Speech.
(3) Memory, instructions, and responses.
(4) Attention on topics, details, confusion, ability to concentrate.
(5) State of consciousness
(6) Mood, behavior, and personality
(7) Headache or “pressure” in head
(8) Nausea or vomiting
(9) Sensitivity to light and noise

Step 4:
A participant diagnosed with a possible concussion may return to Premier Hoops only after release
from a medical doctor or doctor of osteopathy specializing in concussion treatment and

Step 5:
If there is a possibility of a concussion, do the following:
(1) Write a report of potential concussion and sign it
(2) If the player is able to do so, have the player sign and date the report. If the player is
not able
to sign, note on the player’s signature line “unavailable”.
(3) If a parent/legal guardian of the player is present, have the parent/legal guardian sign and
date the report, and give the parent/legal guardian one of the copies of the completed report. If
the parent/legal guardian is not present, then the team official is responsible for notifying the
parent/legal guardian ASAP by phone or email and then submitting the report to the parent/
legal guardian by email or mail. When the parent/legal guardian is not present, the trainer must
make a record of how and when the parent/legal guardian was notified. The notification will
include a request for the parent/legal guardian to provide confirmation and completion of the
Concussion Notification Report whether in writing or electronically.
(4) Player Pass
Premier Hoops must obtain the player’s pass from the a medical doctor or doctor of osteopathy
specializing in concussion treatment and management and attach it to the copy of the report retained
by the team.

Kissick MD, James and Karen M. Johnston MD, PhD. “Return to Play After Concussion.” Sports Medical
Foundation. Volume 15, Number 6, November 2005. April 22, 2011.
National Federation of State High School Associations. “Suggested Guidelines for Management of
Concussion in Sports”. 2008 NFHS Sports Medicine Handbook (Third Edition). 2008 77-82. April 21, 2011.