Concussion-Policy-2018 Australia
Concussion-Policy-2018 Australia
in Sport Policy
Issued by Sports Medicine Australia
V1.0 January 2018
Acknowledgements
Sports Medicine Australia (SMA) developed this policy with the
support of the New South Wales Office of Sport. SMA would like
to acknowledge the following people that assisted developing
this resource:
Dr Paul Bloomfield
(Chief Medical Officer, National Rugby League)
Dr Alex Donaldson
(Senior Research Fellow, La Trobe University)
Dr Andrew Gardner
(Clinical Neuropsychologist, University of Newcastle)
Dr David Hughes
(Chief Medical Officer, Australian Institute of Sport)
Dr Warren McDonald
(Chief Medical Officer, Australian Rugby Union)
Disclaimer
The information in this policy is general. Reading or using this
policy is not the same as getting medical advice from your
doctor or health professional. All reasonable attempts have
been made to ensure the information is accurate. However, SMA
is not responsible for any loss, injury, claim or damage that may
result from using or applying the information in this policy.
Risk management:
https://sport.nsw.gov.au/clubs/ryc/governance/risk
Legal issues:
https://sport.nsw.gov.au/clubs/ryc/legal
Who - Who are the people that play a key role to implement the
recommendation in this area.
How - What are the key tools and documents people can use to
implement the recommendations in this area. All relevant tools are
included in this policy.
To keep players healthy and safe, clubs and everyone involved in sport
- players, parents, coaches, officials, teachers, first aid providers, sports
One of the best
trainers and administrators - must take steps to reduce the risks and ways to build
prevent an incident before it occurs.
a healthy and
Key steps to do this are:
safe sporting
1. Education environment is
Educate everyone about how to recognise and manage concussion to educate all
stakeholders.
2. Information
Gather information about previous concussions
3. Designation
Appoint someone to be responsible for ensuring this policy is
implemented
1. Education
One of the best ways to build a healthy and safe sporting environment
is to educate all stakeholders. This can increase knowledge, change
attitudes and improve culture.
1. Recognise
Recognise an injury has occurred
2. Remove
Remove the player from the game or activity
3. Refer
Refer the player to a qualified doctor for assessment.
Visual Signs
Players who sustain an impact to the head, face, neck, or body can If any of these signs are
demonstrate visual signs of a concussion such as: present, remove the
• Lying motionless on the playing surface player from the activity
• Getting up slowly after a direct or indirect blow to the head
immediately. The player
• Being disoriented or unable to respond appropriately to questions
• Having a blank or vacant stare
should not return to
• Having balance and coordination problems such as stumbling activity until assessed
or slow laboured movements by a medical practitioner,
• Having a face or head injury
even if they seem okay.
Symptoms
An athlete may report symptoms of a concussion to a team mate,
parent, teacher, official or coach. Symptoms that suggest a
concussion include:
If any of these symptoms
• Headache are reported to anyone,
• Feeling “Pressure in the head”
• Balance problems
remove the player from
• Nausea or vomiting the activity immediately.
• Drowsiness
The player should not
• Dizziness
• Blurred vision return to activity until
• Sensitivity to light assessed by a medical
• Sensitivity to noise
• Fatigue or low energy practitioner, even if they
• “Don’t feel right” feel okay.
• Feeling more emotional than usual
• Being more irritable than usual
• Sadness
• Being nervous or anxious
• Neck pain
• Difficulty concentrating
• Difficulty remembering
• Feeling slow
• Feeling like “in a fog”
Red Flags
If a player has any of the “Red Flags” set out in the Concussion
Recognition Tool 5, a severe head or spine injury should be
suspected.
Return to Learn
Concussion in Women
Below is an example of some suggested measures forming part of a club concussion checklist which a
club or organisation can use to ensure they have undertaken the appropriate pre-season education and
preparation to recognise and manage concussion.
Where possible, clubs and event organisers should identify and develop a positive relationship with a
local medical practitioner who is willing and available to:
• receive referrals of players with suspected concussion from the club
• provide concussion recognition and management information and training to the club
• work with the club and players to coordinate the return-to-participation process
To reduce the risk of concussion the following pre-season preparation and education
has been implemented:
Concussion Fact Sheets have been: Concussion Recognition Tool 5 has been:
posted on the club website or at the club provided to all coaches, officials
distributed with registration information and designated individuals
emailed to all parents, coaches and officials • included in all first aid kits
Local Hospital:
Below is an example of a club concussion checklist which a club or organisation can use to ensure they
have undertaken the appropriate concussion recognition and management processes in place at
practice and games.
The following procedure should be followed for recognising and managing concussion
at practice and on game day:
• Identify one or more people who are responsible for coordinating all concussion-related activity
• Ensure at least one person has a fully charged mobile phone and the phone number for
emergency services (000)
• Ensure all coaches, officials and first aid providers have access to a Concussion Recognition Tool 5
• Ensure an ambulance is called immediately if any “Red Flags” are raised.
• Ensure all players who are suspected of having a concussion are:
- Removed from participation immediately
- Assessed by someone experience and trained in using the Concussion Recognition Tool 5
- Not allowed to return to participation on the same day
- Supervised and monitored for at least 2 hours following a suspected concussion
- Provided with appropriate information about how to manage a concussion including
return-to-play protocols
- Provided with the contact details of a local medical practitioner with experience
in managing concussion
- Contacted within 48 hours to check they are okay and have all the information they need.
Local Hospital:
low energy
ŵ Drowsiness ŵ Neck Pain ŵ Feeling like
RECOGNISE & REMOVE ŵ “Don’t feel right”
Echemendia RJ, et al. Br J Sports Med 2017;51:872. doi:10.1136/bjsports-2017-097508CRT5
“in a fog“
ŵ Dizziness
Head impacts can be associated with serious and potentially fatal brain injuries. The Concussion Recognition Tool
5 (CRT5) is to be used for the identification of suspected concussion. It is not designed to diagnose concussion.
STEP 4: MEMORY ASSESSMENT
(IN ATHLETES OLDER THAN 12 YEARS)
STEP 1: RED FLAGS — CALL AN AMBULANCE
If there is concern after an injury including whether ANY of the following signs are Failure to answer any of ŵ “What venue are ŵ “What team did you play
© Concussion in Sport Group 2017
observed or complaints are reported then the player should be safely and immediately these questions (modified we at today?” last week/game?”
removed from play/game/activity. If no licensed healthcare professional is available, appropriately for each
call an ambulance for urgent medical assessment: ŵ “Which half is it now?” ŵ “Did your team win
© Concussion in Sport Group 2017
If there are no Red Flags, identification of possible concussion should proceed to the following steps: The CRT5 may be freely copied in its current form for distribution to individuals, teams, groups
and organisations. Any revision and any reproduction in a digital form requires approval by
the Concussion in Sport Group. It should not be altered in any way, rebranded or sold for
STEP 2: OBSERVABLE SIGNS commercial gain.