When to Refer to Emergency Department
Players who have suffered a head impact should immediately be referred to the emergency department of a hospital if they have:
- been unconscious for more than two minutes
- exhibit focal neurological signs such as weakness, altered sensation or reflexes
- any deterioration in their level of consciousness
- a seizure
- a worsening headache
- repeated vomiting if over 12 years of age, or even a single episode if younger
- Higher risk athletes or those with co-morbidities
- athlete received inadequate supervision following the injury
In these cases it is important to rule out intracranial bleeding or swelling using MRI or CT scanner.
General guidelines
- LOC greater than 2 minutes
- Focal neurological findings
- Worsening mental status
- Seizure activity
- Worsening headache
- Single emesis for player <12 years of age
- Repeated emesis for older players
Concern is for structural injury requiring radiological assessment (MRI or CT) scan
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