Remove the athlete from competition
It is important that injured athletes be immediately removed from sports participation. Some athletes may not be aware they have sustained a concussion. Coaches, trainers, fellow athletes, parents and others should be educated about the symptoms of a concussion. Once an athlete sustains a concussion he or she must be evaluated by a medical professional trained in the management of concussion injuries.
Assess their neurological functionWell-meaning observers may or may not be trained to evaluate, so every team or sports venue should ideally identify who will evaluate an injured athlete before the injury occurs. Evaluation should include assessment of cognitive function, cranial nerves and balance.
Go to a hospital if necessaryIf symptoms persist or if no one qualified is able to assess the athlete, he or she should be immediately transported to a hospital. Any athlete who sustains a concussion should be accompanied by an individual who understands the signs and symptoms of a worsening brain injury. If no one is qualified to make this assessment, the athlete should be transported to a hospital.
Just as you place an arm in a sling or use crutches for your leg, the brain also needs rest following an injury. While symptoms persist, the athlete should avoid concentrating, reading, studying, playing video games, watching television, etc. Brain rest means avoiding these activities, and allowing the brain to rest completely.
Once concussion-related symptoms resolve, these activities can be resumed. Recurrence of symptoms means the brain needs more rest. Medical attention should also be sought.
Resume physical activity gradually
Once the athlete has resumed all non-athletic activities without symptoms, a gradual return to sports can begin. This should start with non-contact physical exertion (cardiovascular fitness), followed by a progressive return to sports activity. Any recurrence of symptoms should be a sign to stop the progression. A return to sports needs to be supervised by a trained professional.
Special tests, such as the ImPACT test, have been designed to help assess concussions. Their utility is debated, but they do seem to be helpful. However, they are not a substitute for the other steps mentioned above. Even if an athlete has "passed" their ImPACT test, they may still have symptoms that prevent their return to sports.
It is important to remember that these tests are not an assessment of whether a concussion has occurred nor if one has resolved. A normal ImPACT score does not necessarily mean an athlete should return to sports.