1. WHAT YOU NEED TO KNOW CONCUSSIONS: WHAT YOU NEED TO KNOW Don Muenz, OHSAA Director of Soccer Officiating Development

3. CONCUSSIONS: SIGNS, SYMPTOMS, BEHAVIORS 1. IMMEDIATE STOPPAGE & REMOVAL 2. FOLLOW PROTOCOL FOR POSSIBLE RETURN ANY SIGNS, SYMPTOMS OR BEHAVIORS CONSISTENT WITH CONCUSSION

4. RISKS AT THE FIELD…  WORSENING SYMPTOMS  INCREASED RISK OF FURTHER INJURY  INCREASED RISK OF DEATH CONTINUED PARTICIPATION RISKS:

5. RISKS AT THE FIELD…  SCHOOL-AGE BRAIN DOES NOT RECOVER QUICKLY ENOUGH  NEED FOR EVALUATION  NEED FOR RETURN TO PLAY PLAN WHY SO CAREFUL?

6. CONCUSSIONS:SIGNS, SYMPTOMS, BEHAVIORS 1. IMMEDIATE STOPPAGE & REMOVAL 2. FOLLOW PROTOCOL FOR POSSIBLE RETURN ANY SIGNS, SYMPTOMS OR BEHAVIORS CONSISTENT WITH CONCUSSION

7. S IGNS,S YMPTOMS,B EHAVIORS Appears dazed or stunned Is confused about assignment Forgets plays Is unsure of game, score or opponent Moves clumsily Answers questions slowly Loses consciousness Shows behavior or personality changes Can’t recall events prior to hit Can’t recall events after hit OBSERVED BY OTHERS:

8. S IGNS,S YMPTOMS,B EHAVIORS AS REPORTED BY ATHLETE: Headache Nausea Balance problems or dizziness Double vision or fuzzy vision Sensitivity to light or noise Feeling sluggish Feeling foggy or groggy Concentration or memory problems Confusion

9. WHO ENFORCES THE RULE?  COACHES  CONTEST OFFICIALS  ADMINISTRATORS  MEDICAL PERSONNEL ALL OF THE ADULTS:

10. WHAT DO COACHES DO?  REVIEW AND KNOW SIGNS, SYMPTOMS & BEHAVIORS OF CONCUSSION  PROHIBIT PARTICIPATION IN MATCH OR PRACTICE BY ATHLETE WHO SHOWS SIGNS, SYMPTOMS OR BEHAVIORS  COACH NOT A MEDICAL PROFESSIONAL  HAS NO AUTHORITY TO DETERMINE IF THERE HAS BEEN A CONCUSSION  ENSURES PLAYER’S PARENTS ARE NOTIFIED & STUDENT IS REFERRED TO A MEDICAL PROFESSIONAL

11. WHAT DO CONTEST OFFICIALS DO?  REVIEW & KNOW SIGNS, SYMPTOMS & BEHAVIORS OF CONCUSSION  RESPONSIBLE FOR IMMEDIATE REMOVAL IF THERE ARE SIGNS, SYMPTOMS OR BEHAVIORS THAT MAY INDICATE A POSSIBLE CONCUSSION  DO NOT PERMIT RETURN TO PLAY OF ANY SUCH PLAYER WITHOUT WRITTEN AUTHORIZATION PRESENTED TO HEAD REFEREE  WRITTEN AUTHORIZATION MUST STATE THAT ATHLETE WAS NOT CONCUSSED

12. MORE CONTEST OFFICIALS  NOT EXPECTED TO BE MEDICAL PROFESSIONALS  NO AUTHORITY TO DETERMINE IF THERE HAS BEEN A CONCUSSION  FOLLOW RETURN TO PLAY PROTOCOL

13. THE RETURN TO PLAY PROTOCOL OR “RTP”  TWO OFFICIALS ALWAYS LET COACH & TRAINER KNOW WHAT THEY OBSERVED  GIVE COACH & TRAINER ALL OF THE INFORMATION  REMIND COACH OF RETURN ONLY AFTER WRITTEN AUTHORIZATION FROM AHCP  HEAD REFEREE MAKES COPY OF WRITTEN AUTHORIZATION AND KEEPS IT  HEAD REFEREE SENDS ORIGINAL AUTHORIZATION & OFFICIAL REPORT TO OHSAA, CHECKING “INJURY” BOX ON FORM  REMIND COACH AT PREMATCH CONFERENCE OF THIS PROTOCOL

14. PLAYER RETURNS WITH AUTHORIZATION, BUT….  OFFICIAL AGAIN SEES SIGNS, SYMPTOMS OR BEHAVIORS:  IMMEDIATE STOPPAGE  IMMEDIATE REMOVAL  TWO OFFICIALS TELL COACH & TRAINER WHAT THEY SAW  AHCP’s EVALUATION BEGINS ANEW  OHSAA OFFICIAL REPORT, CHECKING “INJURY” BOX ON WHITE FORM; SEND ORIGINAL AUTHORIZATION

15. MORE CONTEST OFFICIALS  STOP PLAY IMMEDIATELY  REMOVE PLAYER  OHSAA OFFICIAL REPORT, CHECKING “INJURY” BOX ON WHITE FORM IF OFFICIAL BECOMES AWARE THAT PLAYER HAS RETURNED WITHOUT PROPER WRITTEN AUTHORIZATION:

16. WAS PLAYER CONCUSSED?  DETERMINED ONLY BY AHCP  CANNOT RETURN ON DAY OF CONCUSSION UNDER ANY CIRCUMSTANCE!  “WHEN IN DOUBT, HOLD THEM OUT!”  IF EVENT CONTINUES OVER MULTIPLE DAYS, RETURN TO PLAY IS EVENT PHYSICIAN’S DECISION

17. APPROPRIATE HEALTH CARE PROFESSIONAL DECIDES  M.D., D.O. OR LICENSED ATHLETIC TRAINER ONLY  THEIR DETERMINATION OF WHETHER THERE HAS BEEN A CONCUSSION IS FINAL

18. AHCP DETERMINES “NO CONCUSSION”  RETURN TO PLAY ONLY WITH PROPER WRITTEN AUTHORIZATION PRESENTED TO HEAD REFEREE  HEAD REFEREE KEEPS AUTHORIZATION  HEAD REFEREE MAKES COPY OF AUTHORIZATION AND RETAINS  HEAD REFEREE FILES OHSAA OFFICIAL REPORT WITH ORIGINAL WRITTEN AUTHORIZATION IF AHCP DETERMINES “NO CONCUSSION”:

19. THE WRITTEN AUTHORIZATION  MUST BE IN WRITING  SIGNED BY AN AHCP  IF AUTHORIZATION DOES NOT AFFIRMATIVELY STATE PLAYER DID NOT SUFFER A CONCUSSION, PLAYER CANOT RETURN  IF AUTHORIZATION STATES PLAYER SUFFERED A CONCUSSION, PLAYER CANNOT RETURN