Onfield assessment of concussion in the adult athlete.
The onfield and sideline assessment of concussion in the adult athlete is complex, and clinical impression remains the gold standard in diagnosing concussion. Performing this task is often a rapid assessment in the midst of competition, with a time constraint and the athlete eager to play. A standardised objective assessment of concussion, which excludes more serious injuries, is useful in taking decisions for the athlete. This paper reviewed the evidence available for what is the ‘best practice’ for evaluating an adult athlete on the field of play.
Results suggest that sideline concussion assessment tools should include a symptoms checklist, cranial nerves, balance and cognitive assessments as an absolute minimum. The assessment should be performed as soon as possible after the injury, with the understanding that the research related to the timing of the exam is not yet clear and that concussion signs and symptoms evolve over time. Ideally, a standardized sideline assessment tool (i.e. SCAT3) should be used.
It is important to understand that clinical judgement and suspicion should over-rule a ‘negative’ sideline assessment. Athletes with confirmed concussion should be removed from the field of play and not return to play or train on the same day and should be followed closely with serial assessments, whether concussion is diagnosed or not. > From: Putukian et al., Br J Sports Med 47 (2013) 285–288. All rights reserved to BMJ Publishing Group.
The Pubmed summary of the article can be found here.