St Marys GJFC Concussion Policy – March 2013
MANAGEMENT OF CONCUSSION
With specific provision for children 7–17 years
For trainers, first-aid providers, coaches, umpires, club officials and parents.
Any player who has suffered a concussion or is suspected of having a Concussion must be medically assessed as soon as possible after the Injury and must not be allowed to return to
play in the same game or train in the same practice session.
A Trainer can apply the principles of first aid, when dealing with any player who is unconscious or injured.
A concussed player must not be allowed to return to school or return to training or playing before having a formal medical clearance.
The child is not to return to play or sport until they have successfully returned to school/learning, without worsening of symptoms. Symptom assessment in the child often requires the addition of parent and/or teacher input.
It is reasonable for a child to miss a day or two of school after concussion.
A. Game-day management
The most important steps in the initial management of concussion include:
1. Recognising the injury;
2. Removing the player from the game
3. Referring the player to a medical doctor for assessment.
1. Recognising the injury –
Visible clues of suspected concussion
Any one or more of the following visual clues can indicate a possible concussion:
• Loss of consciousness or responsiveness
• Lying motionless on ground/Slow to get up
• Unsteady on feet/Balance problems or falling over/Incoordination
• Grabbing/Clutching of head
• Dazed, blank or vacant look
• Confused/Not aware of plays or events
2. Removing the player from the game-
Initial management must adhere to the first aid rules, including airway, breathing, circulation, and
spinal immobilisation.
• Any player with a suspected concussion must be removed from the game.
(See section below for management of the unconscious player.)
• A duty of care must be given when removing any player after a head knock.
• Removing the player from the game allows the first aid provider time and space to assess
the player properly.
• Any player who has suffered a concussion must not be allowed to return to play in the
same game.
Do not be swayed by the opinion of the player, trainers, coaching staff, parents or others suggesting
premature return to play.
3. Referring the player to a medical doctor for assessment
For this reason, ALL players with concussion or a suspected concussion need an urgent medical
assessment (with a registered medical doctor). This assessment can be provided by medical
personnel that maybe present at the venue, local general practice or hospital emergency
department
Management of head injury is difficult for non-medical personnel. In the early stages of injury, it is
often not clear whether you are dealing with a concussion or there is a more severe underlying
structural head injury.
• If a doctor is not available at the venue, then the player should be sent to a local general
practitioner or hospital emergency department.
B. Follow-up management
• A player will not be allowed to return to playing football until a written Medical Certificate
has been provided to St Marys GJFC
• A concussed player must not be allowed to return to school or return to play before having
a medical clearance.
• Return to learning and school take precedence over return to sport.
• In every case, the decision regarding the timing of return to training should be made by a
medical doctor with experience in managing concussion.
• In general, a more conservative approach (i.e. longer time to return to sport) is used in cases
where there is any uncertainty about the player’s recovery (“if in doubt sit them out”).
Return to play
• Players should not return to play until they have returned to school/learning without
worsening of symptoms.
• Players should be returned to play in a graduated fashion.
• The “concussion rehabilitation” program should be supervised by the treating medical
practitioner and should follow a step-wise symptom limited progression, for example:
1. Rest until symptoms recover (includes physical and mental rest)
2. Light aerobic activity (e.g. walking, swimming or stationary cycling) – can
be commenced 24-48 hours after symptoms have recovered
3. Light, non-contact training drills (e.g. running, ball work)
4. Non-contact training drills (i.e. progression to more complex training drills,
may start light resistance training. Resistance training should only be
added in the later stages)
5. Full contact training – only after medical clearance
6. Return to competition (game play)
• There should be approximately 24 hours (or longer) for each stage.
• Players should be symptom-free during their rehabilitation program.
• If they develop symptoms at any stage, then they should drop back to the previously
symptom-free level and try to progress again after a further 24 hour period of rest.
• If the player is symptomatic for more than 10 days, then review by a medical practitioner,
expert in the management of concussion, is recommended
Children are not to return to play or sport until they have successfully returned to school/learning,
without worsening of symptoms. Medical clearance should be given before return to play.
Helmets and Mouth guards *
Note: *This document has been published by the AFL as a position statement on the role of helmets and mouth guards in Australian Football. It is based on advice provided by the AFL Concussion Working Group and AFL Medical Officers’ Association.
– July, 2012
Helmets
• There is no definitive scientific evidence that helmets prevent concussion or other brain injuries
in Australian football.
• There is some evidence that younger players who wear a helmet may change their playing style,
and receive more head impacts as a result. Accordingly, helmets are not recommended for the
prevention of concussion.
• Helmets may have a role in the protection of players on return to play following specific injuries
(e.g. face or skull fractures).
Mouth guards
• Mouth guards have a definite role in preventing injuries to the teeth and face and for this reason
they are strongly recommended at all levels of football.
• Dentally fitted laminated mouth guards offer the best protection. ‘Boil and bite’ type mouth
guards are not recommended for any level of play as they can dislodge during play and block the
airway.
• There is no definitive scientific evidence that mouth guards prevent concussion or other brain
injuries in Australian Football.