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Concussion can occur when a player receives an impact to the head or body that causes the brain to shake inside the skull. If a player is knocked out or loses consciousness they have obviously sustained a concussion, but it is important to remember that a person can be concussed without losing consciousness.

The Sideline Concussion Checklist is an essential tool to use to determine signs and symptoms of concussion. If a player appears stunned, dazed or confused after an impact ask some of the following questions to check if the player is aware of their surroundings and that their memory is working correctly.

- What ground are we at?
- Which team are we playing today?
- Who are you marking?
- Which half is it?
- What is the score of the game?

If they answer any of the questions incorrectly, or are very slow to respond, it indicates that they have probably sustained a concussion and should not continue to play.

Watch for unsteadiness when they stand up or poor balance and co-ordination as these are also signs of concussion. Players may also complain of other symptoms such as blurred or double vision, ringing in their ears, sensitivity to light and noise. They may experience nausea or vomiting, a headache or feel extremely tired or become irritable. If any of these symptoms are present a player should not return to play.

Players who are concussed are often unaware of their symptoms and may want to continue playing.- they usually do! It is imperative that the Coach / Referee take responsibility for the player’s well-being, assess the player and make an informed choice about whether the player should return to play or not – if any doubt the player must be removed from play.

Even if there are no immediate symptoms of concussion these can show up later, so it is important to keep a close eye on the player. Ensure the player is regularly checked and not left alone during the first four hours after injury. As the coach YOU should make certain that your player has a ‘buddy’ who will make sure he is not left alone for the first four hours” and get him home safely for his parents or guardian to monitor. Give the concussion advice slip (from the concussion checklist) to the player and their guardian so everyone knows what to watch for over the first 24 - 48 hours.

Concussed Players must get urgent medical treatment if they show signs of:

- Worsening headache.
- Increased drowsiness or can’t be woken up.
- Vomiting.
- Increased confusion or agitation.
- Weakness in any limbs.
- Slurred speech.
- Loss of consciousness or seizure.

Players should not return to sport until symptom free AND medically cleared. The IRB’s mandatory stand down period is for a minimum 3 weeks (23 days for U19s). If they return too soon, while symptoms are still present, it will slow recovery and put them at risk of further concussions. If you sustain a second concussion before the previous one has fully resolved the impact will be more severe and can in some instances be fatal.