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Jun 8

Proper Management of a Concussion

In the last blog I discussed how to recognise that a concussion has occurred. I identified that recognising a concussion and removing the player from play are the first and most important responsibilities of those present. However, the subsequent management of the player in the following days and weeks is also crucial in their safe recovery and return to play.
Immediate actions with a suspected concussion include:
– The player MUST be immediately removed from activity and MUST NOT return.
– The player MUST NOT be left alone.
– The player MUST NOT drive a vehicle.
– The player MUST always be in the care of a responsible adult, who is informed of the player’s suspected concussion.
– The player should be medically assessed as soon as possible
– The player should avoid activities that require concentration or attention until symptoms have been absent for a minimum of 24 hours.
Criteria for return to play following a concussion are based on the graduated return to play (GRTP) protocol. The GRTP protocol can be found at http://www.irishrugby.ie/downloads/IRFU-Guide-to-Concussion.pdf and gives an in-depth outline of the different stages a player must successfully complete before returning to play. The GRTP protocol for an adult has the following criteria:
Stage 1: Complete Rest x 14 days
Stage 2: Light Aerobic Exercise x 1 day
Stage 3: Non impact sport specific drills x 1 day
Stage 4: Non contact but more intense training drills x 1 day
Stage 5: Full contact practice following medical clearance x 2 days
Stage 6: After 24 hours can return to full play
Players can only move on to the next stage once they have been symptom free during the full period of each stage. If they are not symptom free, they must stay at that stage until they are. The protocol generally takes at least three weeks to return to full play. Other players, parents, coaches and administrators should insist that the above guidelines are always followed and be vigilant for the return of symptoms, even if the GRTP protocol has been successfully completed.