In November 2012, the fourth international conference on concussion in sport was held in Zurich, Switzerland. The purpose of the conference was to update recommendations for concussion management developed at the three previous meetings. The recommendations were then published in the British Journal of Sports Medicine as the 'Consensus statement on concussion in sport'.
The Consensus statement answered a number of key questions. Selected questions and answers are summarised below:
Is a cognitive injury the key component of concussion in making a diagnosis?
The panel agreed that concussion is an evolving injury in the acute phase with rapidly changing clinical signs and symptoms. Because of this evolving process, it is not possible to rule out concussion when an injury occurs associated with a transient neurological symptom. All such cases should be removed from the field of play and assessed for concussion by the treating physician or healthcare provider.
Are the existing tools/examinations sensitive and reliable enough on the day of injury to make or exclude a diagnosis of concussion?
Several well-validated neuropsychological tests are appropriate for use in the assessment of acute concussion in the competitive sporting environment. These tests provide important data on symptoms that clinicians can incorporate into their diagnosis, but should not be solely used to diagnose concussion.
What is the best practice for evaluating an adult athlete with concussion on the field of play?
The on-field evaluation of sports-related concussion is often a challenge given the elusiveness and variability of presentation, difficulty in making a timely diagnosis, specificity and sensitivity of sideline assessment tools, and the reliance on symptoms. Concussion is an evolving injury and signs and symptoms may be delayed. Therefore, erring on the side of caution (keeping the athlete out of participation when there is any suspicion of injury) is important.
Assessments and dissemination
One of the most important aspects of the consensus statement was updates and improvement of a series of standardised concussion assessment tools: the Sports Concussion Assessment Tool v.3 (SCAT3); the Child SCAT3 and the Concussion Recognition Tool (CRT). The authors encourage the use and free dissemination of these assessments and the Consensus statement.
To see Pocket concussion recognition tool please click here
(To help identify concussion in children, youth and adults)
To see Child Sport Concussion Assessment Tool 3rd Edition (Child - SCAT3) please click here
(A standardised tool for evaluating injured children for concussion that can be used in children aged from 5 to 12 years)
To see Sport Concussion Assessment Tool 3rd edition (SCAT3) please click here
(Provided by the BMJ to help medical professionals evaluate injured athletes for concussion)
Reference
McCrory, et al. (2013) Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012.British Journal of Sports Medicine, 47: 250-258.
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