Although some level of injury is inevitable, with proper care the number and severity of injuries can be reduced. A simple policy for identifying and properly responding to head injuries and concussions will reduce the risk to players from the failure to recognize an injury, or from the failure to properly respond to and treat an injury, can be significantly reduced.
A concussion is a minor brain injury caused by a blow to the head or by the violent shaking of the head. A concussion can cause symptoms that include confusion, a loss of consciousness, a loss of equilibrium, disturbances of vision, and headaches. A person may initially report few or no symptoms, but have the symptoms of a concussion develop over subsequent hours or days.
- At the mildest level, a concussion will have symptoms that last less than fifteen minutes.
- A more severe concussion will have symptoms that last longer, and may involve the loss of consciousness.
A person who has suffered a concussion should wait until all symptoms are gone before returning to normal activity.
When a child suffers from a blow to the head or possible concussion, the child should be monitored over the next twenty-four hours by an adult, who can watch for unusual behavioral changes or tiredness, nausea, vomiting, sluggishness, blurred vision, sensitivity to light or noise, loss of memory or concentration, or any other symptom that suggests that the child may have a more significant brain injury than was originally suspected.
A school or sports league should have a formal policy addressing concussions, including:
A Formal Concussion Policy - The policy should be in writing, and should be communicated to coaches, staff, parents, volunteers and participants.
Educational Materials - The concussion policy should be supported by appropriate training materials, potentially including documents or brochures and video materials.
Injury Prevention - Activity-specific information on how head injuries and concussions can be reduced or avoided. Proper protective gear should be available to and used by players, and proper supervisions should be provided.
Removal from Play - Any player who shows signs or symptoms of a concussion should be removed from play.
Compliance Tracking - Injuries should be reported and tracked, to ensure compliance with the policy, to ensure that injured players receive proper care, and to help avoid repeat injuries to children who have suffered previous concussions.
A policy should take consideration of the special risks that arise from repeat concussion, with their potential for a cumulative effect on the brain that could result in severe complications, brain damage, disability or in some cases death. A player who has experienced a concussion should be medically cleared to return to sports participation.
Head Injury Avoidance
Recent studies indicate that head trauma can potentially cause future impairment, even in the absence of a concussion. The likelihood of injury or impairment increases with repeated trauma.
Schools and sports programs should thus consider implementing comprehensive programs to reduce the chance of head trauma, and implement equipment and safety rules that are likely to mitigate the degree of harm that could result from any head trauma that occurs.
Youth sports leagues should have formal educational policies to ensure that all coaches, parents and volunteers know how to identify a possible concussion, and how to respond when a participant appears to have suffered a concussion. They should understand that a child with a possible concussion should be removed from play, and should obtain appropriate medical evaluations and care. Quality educational materials are already available at little to no cost, including:
HEADS UP to Youth Sports - A free educational program from the Center for Disease Control (CDC) on concussion prevention and response. Participants can download a certificate of completion.
NHSF Concussion in Sports Course - A free course prepared in partnership with the CDC
National Alliance for Youth Sport Concussion Training - A free program explaining concussion, approaches to prevention, and how to identify and respond to concussions.
A free app is also available from PAR, to help identify and respond to concussion on the field.
A school or youth sports league that does not adequately protect young athletes from injury can face potential liability for their neglect of their duties. Even if a claim is unsuccessful, a claim or lawsuit may result in increased insurance costs.
Schools and sports programs should thus follow best practices to avoid injuries, including providing appropriate safety equipment, educating players about the rules of the sport and injury avoidance, implementing safety policies, hiring appropriate personnel to support player safety, and making appropriate interventions when a player is injured.