Table 2

Discretionary signs of concussion and appropriate action

Clutching the head*
Being slow to get up*
Suspected facial fracture
Possible ataxia
Behaviour change†
Other clinical suspicion
Further evaluation is required.
The athlete should (1) be removed from the arena, (2) undergo an evaluation in a distraction-free environment and (3) only return to sport if the signs are determined to have been from a cause other than concussion (ie, the diagnosis of concussion is ruled out).
  • *NHL discretionary signs slow to get up or clutching the head do not require removal from play. The clinician should exercise his or her medical judgement regarding whether to remove the player for an acute evaluation.

  • †Some codes such as NRL, AFL and WR consider this a definitive removal criterion.

  • AFL,  Australian Football League;  NHL,  National Hockey League;  NRL,  National Rugby League;  WR,  World Rugby.