Zurich Consensus and SCAT
Since 2001, four international conferences have been held to address key issues in the understanding and management of concussion in sport. After each of these meetings, a summary document was published to ‘improve the safety and health of athletes who suffer concussive injuries during participation in sport.
The most recent conference was held in Zurich in November 2012 and its consensus statement provides the most up-to date knowledge on concussion in sport.
It also outlines the current best practice management guidelines and provides practitioners with simple clinical tools to help manage a concussion.
Some of the key concepts that arose from the 2012 Zurich meeting include:
• a focus on improved recognition and reporting of concussion
• an emphasis on a conservative management approach, especially on the day of injury, and in children, where the priority is return to school and learning, rather than return to sport.
The Sport Concussion Assessment Tool was produced by the participants of the conference and is referred to by initials “SCAT”.
The latest version, SCAT3, takes approximately 15 to 20 minutes to complete and includes the Glasgow coma scale, a standardised assessment of concussion and a balance assessment as well as coordination testing to arrive at an overall patient assessment.
- The Consensus Statement on Concussion in Sport of the 3rd International Conference on Concussion in Sport in 2008 included a Sport Concussion Assessment Tool 2 (SCAT2) for standardized assessment by medical and health professionals (team physicians, certified athletic trainers, neuropsychologists) of sports concussion in athletes ages 10 years and older.
- In March 2013, the SCAT2 was replaced by the SCAT3 for athletes 13 years and old issued coincident with the Consensus Statement issued after the 4th International Conference on Concussion in Sport held in Zurich in November 2012 (“Zurich statement”), and a modified version (Child SCAT3) was issued for children aged 5 to 12 years.
- The SCAT takes 15-20 minutes to complete and computes a composite score, comprised of the Glasgow Coma Scale, a Standardized Assessment of Concussion (SAC) score (cognitive and physical evaluation, delayed recall), and a balance assessment score (modified Balanced Error Scoring System or BESS).
SCAT3 and Child SCAT3
In recognition of the fact that children’s brains are still developing, the ChildSCAT3 test is used between the ages of five and 12.