concussion precautions: what do you tell your patients?

6 Oct


Some rapid-fire pearls to help you discuss the next steps with your concussion patients:


On the day of:

NO RETURN TO PLAY (or activities with the potential for contact/re-injury)


Next few days: 

  • limit activity and cognitive load (e.g. no video games, limit workload for students, etc)
  • limit meds (acetaminophen is ok), if possible


Overall graduated return to protocol recommendations (usually 24-hrs between stages):


  1. no activity
  2. light exercise (<70% maximal HR)
  3. sport-specific exercise (e.g. running/skating)
  4. non-contact training (e.g. passing drills)
  5. full-contact practice
  6. return to play


What it means:

  1. recovery time
  2. increasing HR
  3. adding movement
  4. coordination & cognitive load
  5. restore confidence and assess functional skills
  6. normal game play


If symptomatic at any stage, go back to the previous level, then try again in 24 hrs. 


References: emdocs article; Mccrory P, et al. “Consensus Statement on Concussion in Sport—the 4th International Conference on Concussion in Sport Held in Zurich, November 2012.” Clinical Journal of Sport Medicine 23.2 (2013): 89-117.; NATA position statement; picture


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