Concussion Management in a Basketball Game
During a varsity basketball game, a 17-year-old point guard collides with an opponent while going for a loose ball. She falls, hits her head on the floor, and momentarily loses consciousness. She gets up slowly, appears dazed, and complains of a headache and nausea. The referee stops play. The coach runs onto the court to assess her. The athlete is alert but confused about the score and her location. She has no visible bleeding or neck pain. The school's concussion protocol requires immediate removal from play if a concussion is suspected, and evaluation by a healthcare professional before return. The game is tied with 2 minutes left in the fourth quarter, and the coach is tempted to let her play if she "shakes it off." The coach has no medical training beyond basic first aid.
1. What signs and symptoms suggest a concussion, and what should the coach do immediately? Explain why the coach should not allow the athlete to return to play.
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Signs and symptoms of concussion include: loss of consciousness, confusion, headache, nausea, dizziness, and memory problems (e.g., not knowing the score or location). The athlete exhibits several of these: momentary loss of consciousness, dazed appearance, headache, nausea, and confusion. According to the school's protocol and standard concussion guidelines (e.g., CDC, concussion in sport), any athlete with suspected concussion must be immediately removed from play and not allowed to return that day. The coach should: ensure the athlete is safely seated, monitor her mental status, and call for a healthcare professional (athletic trainer or EMS). The coach should not assess for return to play because that requires medical expertise. Allowing her to return risks second impact syndrome, prolonged recovery, and serious brain injury. The coach's role is to prioritize health over the game outcome. The coach should inform the referee and opposing coach that the athlete is being evaluated and will not return.
2. Outline the steps the coach should take after the game to ensure the athlete's safety and follow proper concussion management protocols.
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After the game, the coach should: 1) Ensure the athlete is evaluated by a healthcare professional (e.g., athletic trainer, physician) before leaving the venue. 2) Notify the athlete's parents/guardians about the injury and the need for medical evaluation. 3) Document the incident (time, mechanism, symptoms, actions taken) and provide a copy to the school's athletic director and medical staff. 4) Follow the school's concussion protocol, which likely includes a gradual return-to-learn and return-to-play progression supervised by a healthcare provider. 5) Educate the athlete and parents about signs of worsening symptoms (e.g., severe headache, vomiting, seizures) and when to seek emergency care. 6) Monitor the athlete's academic accommodations if needed. The coach should not clear the athlete for return; only a healthcare professional can do that. The coach's responsibility is to support the protocol and prioritize the athlete's long-term health.