**Update: I have now written John Sutter, President of US Youth Soccer, and asked him to remove this document and replace with current, best practices**

NOTE: My thoughts in red text below. Disclosure: I am parent and a social worker, not an athletic trainer or a doctor. From the parent’s eye, here are the obvious holes I see in this NEW Policy which was uploaded Feb 2015. Am I being too harsh? Let me know…

I do not have permission to post this. But since this important protocol is only supplied as a downloadable PDF (which you cannot link to), I needed to download it and repost it here.

The lawsuit against US Youth Soccer has merit I believe based this document alone…

US Youth Soccer Concussion_Procedure_and_Protocol_rev_2_15

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Concussion Procedure and Protocol

For US Youth Soccer Events

Concussion: a traumatic brain injury that interferes with normal brain function.  Medically, a concussion is a complex, pathophysiological event to the brain that is induced by trauma which may or may not involve a loss of consciousness (LOC). Concussion results in a constellation of physical, cognitive, emotional, and sleep-related symptoms. Signs or symptoms may last from several minutes to days, weeks, months or even longer in some cases.

CONCUSSION SIGNS, SYMPTOMS, AND MANAGEMENT AT TRAINING AND COMPETITIONS

Step 1:

Did a concussion occur?

Doesn’t ask if there was a blow to the body and head, jerking of the head?!?  With this protocol as spelled out, most kids on the team would have a concussion based on these descriptions alone.

Evaluate the player and note if any of the following signs and/or symptoms are present:

(1)   Dazed look or confusion about what happened.

(2)  Memory difficulties.

(3)   Neck pain, headaches, nausea, vomiting, double vision, blurriness, ringing noise or sensitive to sounds.

(4)   Short attention span.  Can’t keep focused.

(5)   Slow reaction time, slurred speech, bodily movements are lagging, fatigue, and slowly

answers questions or has difficulty answering questions.

(6)   Abnormal physical and/or mental behavior.

(7)   Coordination skills are behind, ex: balancing, dizziness, clumsiness, reaction time.

THE SECTION ABOVE IS MISSING: 

  • Repeats things 
  • Cannot call events before 
  • Cannot call events after
  • Feeling tired
  • Sensitivity to light
  • Numbness or tingling
  • Difficulty concentrating
  • Difficulty remembering
  • Feeling fogy/groggy
  • Feeling slowed down
  • Irritable
  • More emotional
  • Doesn’t feel right

AND NO MENTION OF WHAT TO DO IF THESE SIGNS ARE PRESENT? HOLD THEM OUT? PUTTING THEM BACK IN THE SECOND HALF AFTER A REST? THIS IS SUPPOSED TO BE THE “MANAGEMENT PLAN” AS STATED ABOVE.

Step 2:

Is emergency treatment needed?

This would include the following scenarios: WOULD THIS BE JUST ONE OF THESE OR MORE, AND IF IT IS AN EMERGENCY WHAT IS COACH SUPPOSED TO DO?

(1)   Spine or neck injury or pain.

(2)   Behavior patterns change, unable to recognize people/places, less responsive than usual.

(3)   Loss of consciousness.

(4)  Headaches that worsen

(5)   Seizures

(6)  Very drowsy, can’t be awakened

(7)  Repeated vomiting

(8)  Increasing confusion or irritability

(9)  Weakness, numbness in arms and legs

      THIS SECTION IS MISSING: 

  • One pupil largers than another
  • Slurred speech
  • Will not stop crying/cannot be consoled
  • Increasing restlessness

AND NO MENTION OF WHAT TO DO IF THESE SIGNS ARE PRESENT? HOLD THEM OUT? PUTTING THEM IN YOUR CAR AFTER THE GAME AND GO TO A HOSPITAL? THIS IS SUPPOSED TO BE THE “MANAGEMENT PLAN” AS STATED ABOVE.

Step 3:

If a possible concussion occurred, but no emergency treatment is needed, what should be done now?

Focus on these areas every 5-10 min for the next 1 – 2 hours, without returning to any activities: DOESN’T SAY “STAY OUT 24 HOURS” – JUST TWO HOURS?

THIS NEXT PART IS JUST STUPID – YOU ARE SUPPOSED TO CHECK THE KID 24 TIMES IN 2 HOURS AND HOW ARE YOU SUPPOSED TO CHECK THESE AS A PARENT OR A COACH?!?

(1)   Balance, movement.

(2)   Speech.

(3)   Memory, instructions, and responses.

(4)   Attention on topics, details, confusion, ability to concentrate.

(5)  State of consciousness

(6)  Mood, behavior, and personality

(7)  Headache or “pressure” in head

(8)  Nausea or vomiting

(9)  Sensitivity to light and noise

OK IN TWO HOURS, NOW DO WHAT?

Step 4:

A player diagnosed with a possible concussion may return to US Youth Soccer play only after release from a medical doctor or doctor of osteopathy specializing in concussion treatment and management. DOESN’T EVEN MENTION “STAY OUT 24 HOURS”

 

Step 5:

If there is a possibility of a concussion, do the following: LOTS OF DETAIL ON WHAT FORMS TO FILL OUT

(1)   The attached Concussion Notification Form is to be filled out in duplicate and signed by a team official of the player’s team.

(2)   If the player is able to do so, have the player sign and date the Form. If the player is not able to sign, note on the player’s signature line “unavailable”.

(3)   If a parent/legal guardian of the player is present, have the parent/legal guardian sign and date the Form, and give the parent/legal guardian one of the copies of the completed Form. If the parent/legal guardian is not present, then the *******KEY POINT BURIED team official is responsible for notifying the parent/legal guardian ASAP by phone or email and then submitting the Form to the parent/legal guardian by email or mail. When the parent/legal guardian is not present, the team official must make a record of how and when the parent/legal guardian was notified.  The notification will include a request for the parent/legal guardian to provide confirmation and completion of the Concussion Notification Form whether in writing or electronically.

(4)   The team official must also get the player’s pass from the referee, and attach it to the copy of the Form retained by the team.

References:

Kissick MD, James and Karen M. Johnston MD, PhD.  “Return to Play After Concussion.” Collegiate Sports Medical Foundation.  Volume 15, Number 6, November 2005. 2005 TEN YEARS AGO?!?! http://www.csmfoundation.org/Kissick_-_return_to_play_after_concussion_-_CJSM_2005.pdf.  April 22, 2011.

National Federation of State High School Associations.  “Suggested Guidelines for Management of Concussion in Sports”.  2008 NFHS Sports Medicine Handbook (Third Edition).  2008 77-82. THIS WAS WRITTEN IN THE DARK AGES: CONCUSSIONS WERE GRADED IN 2008

http://www.nfhs.org.  April 21, 2011. WHY 2011?!? It is a website which should updated?!?

AM I BEING TOO HARSH? HONESTLY, MY KIDS COULD WRITE A BETTER PROTOCOL FOR CONCUSSION SIGNS, SYMPTOMS, AND MANAGEMENT AT TRAINING AND COMPETITIONS. 

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