Sideline assessment

All players exhibiting signs or complaining of symptoms suggestive of concussion should be immediately removed from the field of play and be medically assessed. 

The SCAT6© provides the following flow chart to aid decision making when assessing an athlete suspected of having sustained a concussion prior to proceeding to the cognitive assessment and completed in the field of play.

Box 1: Red Flags

• Neck pain or tenderness
• Seizure or convulsion
• Double vision
• Loss of consciousness
• Weakness or tingling/burning in more than 1 arm or in the legs
• Deteriorating conscious state
• Vomiting
• Severe or increasing headache
• Increasingly restless, agitated or combative
• GCS <15
• Visible deformity of the skull

Step 1: Observable signs

• Lying motionless on playing surface
• Falling unprotected to the surface
• Balance/gait difficulties, motor incoordination, ataxia: stumbling, slow/laboured movements
• Disorientation or confusion, staring or limited responsiveness, or an inability to respond appropriately to questions
• Blank or vacant look
• Facial injury after head trauma
• Impact seizure
• High Risk mechanism of injury