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New Concussion Guidelines

New medical guidelines on the identification and treatment of sports related concussions were published today following the 2nd International Conference on Concussion in Sports. 

The new guidelines urge doctors and coaches not to rely on immediate post concussion symptoms in determining when to return an athlete to play. According to the expert panel, a concussion should be suspected any time an athlete exhibits any of the following symptoms: confusion, loss of consciousness, headache, complaints of pressure in the head, balance problems or dizziness, nausea, feeling "dinged" "foggy", "stunned" or "dazed", visual problems such seeing stars or flashing lights or double vision, hearing problems such as ringing in the ears, slurred speech, irritability or emotional upset. Physical signs include unsteady gait, loss of balance, vomiting, poor coordination or balance, slow to answer questions or follow instructions, inappropriate emotional response, vacant stare or glassy eyed.

Any time a player exhibits any of the above symptoms the new guidelines advise that the athlete should not return to play and should receive follow up care.  Because recovery following a concussion is not possible to predict, the player should not return to play until ALL symptoms have resolved.  The article can be found in the British Journal of Sports Medicine. A useful sideline evaluation guide is also included within the article.

The study authors stress the need for follow up stating, "It is recognized, however, that abbreviated testing paradigms are designed for rapid concussion evaluation on the sidelines and are not meant to replace comprehensive neuropsychological testings, which is sensitive enough to detect subtle deficits that may exist beyond the acute episode, nor should they  be used as a stand alone tool for the ongoing management of sports concussions.  It should also be recognized that the appearance of symptoms may be delayed several hours after a concussive episode."

 

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