Day of injury referral |
1. Loss of consciousness on the field |
2. Amnesia lasting longer than 15 minutes |
3. Deterioration of neurological function* |
4. Decreasing level of consciousness* |
5. Decrease or irregularity in respirations* |
6. Decrease or irregularity in pulse* |
7. Increase in blood pressure |
8. Unequal, dilated, or unreactive pupils* |
9. Cranial nerve deficits |
10. Any signs or symptoms of associated injuries, spine or skull fracture, or bleeding* |
11. Mental status changes: lethargy, difficulty maintaining arousal, confusion, agitation* |
12. Seizure activity* |
13. Vomiting |
14. Motor deficits subsequent to initial on-field assessment |
15. Sensory deficits subsequent to initial on-field assessment |
16. Balance deficits subsequent to initial on-field assessment |
17. Cranial nerve deficits subsequent to initial on-field assessment |
18. Post-concussion symptoms that worsen |
19. Additional post-concussion symptoms as compared with those on the field |
20. Athlete is still symptomatic at the end of the game (especially at high school level) |
Delayed referral (after the day of injury) |
1. Any of the findings in the day of injury referral category |
2. Post-concussion symptoms worsen or do not improve over time |
3. Increase in the number of post-concussion symptoms reported |
4. Post-concussion symptoms begin to interfere with the athlete’s daily activities (sleep disturbances, cognitive difficulties) |