12 “if in doubt, sit them out” Diagram 5: Medical assessment of concussion – on field Athlete with suspected concussion Signs of concussion: • Loss of consciousness • Seizure or tonic posturing • Confusion, disorientation • Memory impairment • Balance disturbance/motor incoordination • Dazed, blank/vacant stare • Behaviour change, not themselves YES Athlete concussed Immediate and permanent removal from sport Evidence of structural intracranial pathology or spinal injury YES Immediate referral to emergency department NO SCAT 5 Neurological examination Monitor and reassess as appropriate Signs of neurological deterioration: • Worsening headache • Emotionally labile • Altered level of consciousness • Vomiting • Focal neurological signs NO Remove for sideline concussion assessment SCAT 5 Neurological examination Use of video assessment if available(professionalsport) Evidence of concussion Permanent removal from sport No evidence of concussion • Athlete may be returned to sport but must be closely monitored for evolving signs of concussion or more serious head injury • Reassess at half time/full time • If any signs of concussion develop, the athlete must be permanently removed from sport