USA Hockey Concussion Management Program
Michael Stuart MD
Alan Ashare MD
The standard of care for current medical practice and the law in many states requires that any athlete with a suspected concussion is immediately removed from play.
- A concussion is a traumatic brain injury- there is no such thing as a minor brain injury.
- A player does not have to be “knocked-out” to have a concussion- less than 10% of players actually lose consciousness.
- A concussion can result from a blow to head, neck or body.
- Concussions often occur to players who don’t have or just released the puck, from open-ice hits, unanticipated hits and illegal collisions.
- The youth hockey player’s brain is more susceptible to concussion.
- In addition, the concussion in a young athlete may be harder to diagnosis, takes longer to recover, is more likely to have a recurrence and be associated with serious long-term effects.
- Treatment is individualized and it is impossible to predict when the athlete will be allowed to return to play- there is no timetable.
A player with any symptoms or signs; disorientation; impaired memory, concentration, balance or recall has a concussion.
Remember these steps:
- Remove immediately from play (training, practice or game)
- Inform the player’s parents
- Refer the athlete to a qualified health-care professional
- Treatment begins with complete physical and cognitive rest
- When free of symptoms, the athlete begins a graded exertion protocol.
- Medical clearance is required for return to play
Players, coaches, parents and heath care providers should be able to recognize the symptoms and signs of a concussion:
- Poor balance
- Double vision
- Blurred vision
- Poor concentration
- Impaired memory
- Light Sensitivity
- Noise Sensitivity
- Appears dazed or stunned
- Confused about assignment
- Moves clumsily
- Answers slowly
- Behavior or personality changes
- Unsure of score or opponent
- Can’t recall events after the injury
- Can’t recall events before the injury
1. If the player is unresponsive- call for help & dial 911
2. If the athlete is not breathing: start CPR
- DO NOT move the athlete
- DO NOT remove the helmet
- DO NOT rush the evaluation
3. Assume a neck injury until proven otherwise
- DO NOT have the athlete sit up or skate off until you have determined:
- no neck pain
- no pain, numbness or tingling
- no midline neck tenderness
- normal muscle strength