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Concussion Checklist For Coaches

Mar 13, 2023 | By Dr. Jennifer Hunnicutt

A Checklist for Coaches Whose Athlete Has Sustained a Sport-Related Concussion

No matter the type of sport or activity you are coaching, concussions are going to happen. And you need to be prepared.

As a coach, you will most likely be the first to respond to an injured athlete. Therefore, it will be your responsibility to take the appropriate steps to ensure their safety.

To help coaches prepare and know what to do when a concussion occurs, we at HEADCHECK Health have created a checklist. This checklist aligns with the CDC guidelines and Canada’s Parachute guidelines to ensure that coaches are taking the appropriate steps to mitigate risk and aid in the safe return-to-play of their athletes. (1,2)

Click Here To Download A PDF Version

Checklist for Coaches of an Athlete with a Suspected Sport-Related Concussion

Immediately remove the athlete from play.
- The following are signs that coaches can look for on and off the field when they suspect an athlete may have sustained a head injury:
  - On the Field
    - Confusion
    - Clumsy movement
    - Lethargy
    - Forgetfulness of the game, play, position, etc.
    - Loss of consciousness
    - Abnormal behavior or aggression
  - Off the Field
    - Mood or behavior changes
    - Loss of memory
  - Athletes may report one or more of the following symptoms:
    - Headache
    - Nausea
    - Dizziness
    - Sensitivity to light or noise
    - Feeling off, foggy, or “not right”
  - The CDC recommends: “When in doubt, sit them out.” (3) In other words, if you suspect your athlete has suffered a concussion, err on the side of caution and remove them from play.
  - Do not return the athlete to play until they have been provided clearance by a qualified healthcare professional who is specialized in concussion management.
- Keep the athlete out of play.
  - Do not try to evaluate the concussion yourself. Each athlete will present differently and should only be evaluated by a qualified healthcare professional.
- Refer the athlete to a qualified healthcare professional as soon as possible.
  - If an athletic trainer is available onsite, have them evaluate the athlete as soon as possible.
  - If an athletic trainer is not available, call the athlete’s parent/guardian and recommend that their child be seen by a healthcare professional that specializes in concussion management (i.e., sports medicine physician).
    - Check out our Checklist for Parents on the HEADCHECK Health Blog.
  - Provide the following information to the parent/guardian:
    - How the injury happened
    - Symptoms that the athlete is/was experiencing
    - Physical signs, such as abnormal behavior, balance, or coordination issues
    - Any loss of consciousness or memory problems
  - Record details of the incident.
    - What happened and what was done related to this head injury?
  - Seek emergent care from first responders, when applicable.
    - The following signs and symptoms may indicate bleeding on the brain or more serious injury. Seek emergent care if one or more of the following are present:
      - Slurred speech, weakness, numbness, or decreased coordination
      - Excessive vomiting or nausea
      - Drowsiness or inability to wake up
      - Convulsions or seizures
      - Unusual and growing behavior, confusion, restlessness, or agitation
      - Loss of consciousness (knocked out)
      - Neck pain
    - Support the athlete during their
      - Concussion recovery takes time and patience. Remember that returning athletes to sport too soon can severely delay their recovery and increase the chances of sustaining another concussion.
      - Support the athlete by following guidance from their athletic trainer, healthcare providers, and parents/guardians.
      - An athlete diagnosed with a concussion will go through a period of being unable to participate in sport and physical activity. This can make the athlete feel frustrated and lonely. So offer opportunities to the athlete to continue to sit-in on practices and cheer on their teammates at games.
    - Do not allow the athlete to return-to-play until re-evaluated by a qualified healthcare professional who can make return-to-play decisions and provide written medical clearance.
      - Do not make return-to-play decisions on your own.
      - Note that in the US, the healthcare professional who can provide medical clearance can vary from state to state. Be sure to check your local state guidelines for who can and cannot provide medical clearance.
    - Follow guidance from the athletic trainer or healthcare provider to have the athlete participate in a gradual return-to-play protocol.
      - Most return-to-play protocols involve a 6- or 7-step progression with each step lasting a minimum of 24 hours. The athlete must pass each step of the progression symptom-free in order to proceed to the next step. (4)
      - These progressions include:
        
        Returning to school and sedentary activities
        
        Gradual return to physical activity (light then moderate then intense physical activity)
        
        Gradual return to sport (practice and contact training, followed by full competition)
      - If at any point during their recovery the athlete demonstrates signs/symptoms of concussion, remember to “when in doubt, sit them out.” And refer appropriately.
    - Decrease risk of subsequent concussions.
      - After one concussion, the risk of sustaining another concussion increases. (5)
      - Make sure the athlete’s helmet and equipment are properly fitted. Do not “size-up.”
      - Teach your athletes proper form and safety at practices and games to minimize risk of head injury. (For example, “heads up” positioning during football tackles.)
      - Ensure playing conditions are safe (proper mats for stunts, padding on goal posts, etc.)
      - Talk with your athletes about concussions. Athletes look to their coaches as role models. Create an environment where athletes can talk to you about head injuries or concussion symptoms. That way you can get them the proper care they need and reduce risk of more serious injury.

Following these steps will help you prepare for concussions and ensure that your athletes with concussions are recovering and returning-to-play safely. Remember that concussion recovery is unique to each individual and takes both time and patience.

Concussion Training

One of the best ways that you can prepare for concussions is to participate in regular training and education. At many schools and organizations, this is mandatory. For those coaches who do not have access to training through their school or organization, the CDC offers free concussion training.

HEADCHECK Health

On a mission to prevent mismanaged concussions, HEADCHECK Health provides end-to-end solutions to execute concussion protocols, mitigate risk, and promote recovery. Contact us today to learn how we can help!

References

A Fact Sheet for High School Coaches. CDC Heads Up. Accessed at: https://www.cdc.gov/headsup/pdfs/custom/headsupconcussion_fact_sheet_coaches.pdf.
Concussion Guide for Coaches and Trainers Parachute Concussion Series. Accessed at: https://parachute.ca/wp-content/uploads/2019/06/Concussion-Guide-for-Coaches-and-Trainers.pdf.
Responding to a Concussion and Action Plan for Coaches. Accessed at: https://www.cdc.gov/headsup/.
Broglio SP, Cantu RC, Gioia GA, et al. National Athletic Trainers’ Association position statement: management of sport concussion. J Athl Train. 2014;49(2):245-265.
Guskiewicz KM, McCrea M, Marshall SW, Cantu RC, Randolph C, Barr W, Onate JA, Kelly JP. Cumulative effects associated with recurrent concussion in collegiate football players: the NCAA Concussion Study. JAMA. 2003 Nov 19;290(19):2549-55. doi: 10.1001/jama.290.19.2549. PMID: 14625331.

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Dr. Jennifer Hunnicutt

Dr. Jennifer Hunnicutt is a licensed athletic trainer with a PhD in Health and Rehabilitation Science, who has worked with all types of athletes, including professionals and Olympians. She has held prominent research positions at Emory Sports Medicine and the NBA Hawks Center in Atlanta, GA, as well as serving on the national network of healthcare providers for U.S. Figure Skating. Now the owner of Hunnicutt Writing and Consulting, LLC, Dr. Hunnicutt collaborates with global institutions, spearheading innovation and research among professionals and businesses in Sports Medicine and Orthopedics. Learn more at https://drhunnicutt.com.

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