1. Southern California Soccer Officials Association San Diego INJURIES AND CONCUSSIONS

2. Ordinary Injury

3. When player must leave The player shall leave the field and may be replaced who is: Injured and attended to on the field of play OR Deemed injured by the referee Rule 3-3-1-c(2).

4. Ordinary Injury

5. No exceptions Goalkeepers attended to on the field of play or deemed injured by the referee must leave the field.

6. Ordinary Injury A coach or trainer may not enter without approval from a referee. (Once granted, no coaching instruction by either team.)

7. Injury is a substitution opportunity Either team may substitute an unlimited number of players from the bench when a player from either team is injured and removed from the field. Rule 3-3-1c

8. Concussions and Head Injuries

9. Unconscious Rule 3-3-1(c)(3) has been superseded by CIF. Book says: “Any player who exhibits signs, symptoms or behaviors consistent with a concussion (such as loss of consciousness, headache, dizziness, confusion or balance problems) shall be immediately removed from the contest and shall not return to play until cleared by an appropriate health care professional.”

10. CIF Concussion or Head Injury 313. CONCUSSION PROTOCOL A student-athlete who is suspected of sustaining a concussion or head injury in a practice or game shall be removed from competition at that time for the remainder of the day.

11. Also now California law Education Code section 49475 (eff. 1/1/2012) Anyone using school facilities for athletics must adopt and provide to the school district a statement of compliance that: Any athlete who is suspected of sustaining a concussion or head injury in a practice or game shall be removed from competition at that time for the remainder of the day.

12. CIF Concussion Rules Can a player suspected of concussion or head injury return to play if cleared by trainer/doctor on the field? No. Done for the remainder of the day.

13. CIF Concussion Rules Can the coach or trainer determine that a player is suspected of concussion or head injury? Sure. CIF Rule 313 applies to coaches, trainers and referees.

14. CIF Concussion and Head Injuries WHEN CAN THE REMOVED PLAYER PLAY OR PRACTICE AGAIN? A player may not return until (1) the athlete is “evaluated by a licensed health care provider [MD or DO] trained in education and management of concussion” and (2) receives “written clearance to return to play from that health care provider.”

15. Recognizing Concussions CIF Protocol: Remove player “who is suspected of sustaining a concussion or head injury” The referee is not expected to diagnosis whether a player has sustained a concussion or its gravity. But, must decide if a player is suspected of sustaining a concussion or head injury.

16. Recognizing Symptoms of Concussions WHEN IN DOUBT, SIT THEM OUT!

17. Recognizing Concussions IS EVERYONE’S RESPONSIBILITY: COACHES, TRAINERS AND REFEREES Remove the player “who is suspected of sustaining a concussion or head injury”

18. Recognizing Symptoms of Concussions To a coach or player It’s a “dinger” or ”bell ringer.”

19. Recognizing Symptoms of Concussions To a doctor It’s a brain injury.

20. Recognizing Symptoms of Concussions Concussions result from a direct blow to the head, or force transferred to the head, that slams the brain into the skull.

21. Recognizing Symptoms of Concussions Soccer statistics reveal that women’s soccer suffer concussions at twice the rate of men’s soccer.

22. Recognizing Symptoms of Concussions Signs: Dazed, stunned, or confused Unsure of game, score or opponent Moves clumsily – stumbling as they get up Answers questions slowly

23. Recognizing Symptoms of Concussions Unable to answer simple questions What’s your name? Where are you? What team do you play for? What is the score?

24. Recognizing Symptoms of Concussions Examples Goes to the wrong bench Stares at the sky Athletic performance, however, may not be affected!

25. Referee Does Not Need To Observe Symptoms of a Severe Concussions Loss of consciousness Headaches Irregular breathing Vomiting Seizures

26. Recognizing Symptoms of Concussions Less than 10 percent of concussions involve loss of consciousness.

27. Recognizing Symptoms of Concussions PLAYERS WANT TO STAY IN THE GAME “I’m ok” or “I’m fine” Probably isn’t.

28. 1999 Canadian study of college soccer players 62.7% of the soccer players reported symptoms of a concussion during the previous year. 81.7% of those had experienced more than one head injury. Only 19.8% of the concussed soccer players realized they had suffered a concussion..

29. Recognizing Symptoms of Concussions WHEN IN DOUBT, SIT THEM OUT!

30. Recognizing Symptoms of Concussions PLAYERS WANT TO STAY IN THE GAME “Sitting out a few minutes May not be enough

32. Recognizing Symptoms of Concussions Second Impact Syndrome is a condition in which the brain swells rapidly and catastrophically after a person suffers a second concussion before symptoms from an earlier one have subsided. Even the mildest second one can cause SIS. The condition is often fatal, and many who are not killed are severely disabled.

33. CIF: Sit Out for the rest of the day A student-athlete who is suspected of sustaining a concussion or head injury in a... game shall be removed from competition at that time for the remainder of the day.

34. Recognizing Symptoms of Concussions WHEN IN DOUBT, SIT THEM OUT!

35. Recognizing Concussions For more information and resources: www.cifstate.org/health_safety/concussion/school/html