Concussion Management in the AAGHA
References
a. www.hockeycanada.ca/en-ca/Hockey-Programs/Safety/Concussions.aspx
b. AAGHA Return to Play (RTP) Guidelines
c. Pocket Concussion Recognition Tool (for Trainers).
d. www.impacttest.com
Overview
The AAGHA concussion programme is aligned with Hockey Canada’s and the OWHA’s concussion awareness, and concussion management (including return to play protocols), all of which is founded on the Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich November 2012.
Player Down
Prior to initiating the team's Emergency Action Plan (EAP), the team trainer ("Safety Person" in Hockey Canada) is usually the first person on the scene. The trainer will assess the player using the Pocket Concussion Recognition Tool if a head injury is suspected, and remove the player from play. The trainer, (or manager, or your EAP Control Person) is usually the first person to communicate with the player's family.
The player cannot return to play or practice without a RTP medical note from a physician. This note (or copy) will be retained by the trainer. At the team level, only the trainer can clear the player to RTP based on the AAGHA RTP (Return to Play) Protocol.
Emergency Action Plan
All teams are required to have an EAP. See Hockey Canada website link above.
If the 'Player Down' situation is considered a serious injury, the EAP is initiated. Team staff roles, the organization chart, and wallet cards can be found here.
ImPACT Baseline Testing (not a requirement of the AAGHA)
Some players may have completed the ImPACT Baseline Test - a scientifically validated computerized concussion evaluation system that provides trained clinicians with neurocognitive information that has been medically accepted as state-of-the-art best practices - as part of determining a safe return to play decision (this includes a series of on-line tests of cognitive abilities). When a concussion is diagnosed, once symptom-free the player's baseline test is compared to a post-injury test as it has been shown that even symptom-free athletes may still suffer cognitive impairment. The test comparison helps to identify this possibility. Having undertaken an ImPACT baseline test is analogous to purchasing insurance. A player who has completed the baseline test for another sport or for school activities may bring this to their healthcare provider’s attention. In addition, there are sports medicine clinics that will administer the test for those who wish to undertake it on their own.