STEP 2: Concussion Live Course - October 21-22, 2025, in Salt Lake City, UT-Performing an On the Field Assessment

Pdf Summary

This document by Dr. Bryan Murtaugh outlines best practices for performing on-field assessments of suspected sports-related concussions, emphasizing preparation, immediate evaluation, and post-event management.<br /><br />Key recommendations include rehearsing an Emergency Action Plan (EAP) annually, which comprises clear roles for responders, communication protocols, medical equipment readiness, and an evacuation plan. On game day, a pregame medical huddle ensures all personnel understand their responsibilities and the communication strategy.<br /><br />For concussion assessment, the Sport Concussion Assessment Tool 6 (SCAT6) is highlighted as a standardized aid but not a standalone diagnostic tool. SCAT6 involves both immediate on-field and detailed off-field evaluations, suitable for athletes aged 13 and older. The on-field assessment focuses on red flags such as loss of consciousness, balance issues, disorientation, and high-risk injury mechanisms, alongside the Glasgow Coma Scale, cervical spine assessment, coordination and ocular-motor screening, and memory testing (Maddocks questions). Presence of red flags indicates the need for urgent transport.<br /><br />The off-field assessment in a quiet setting involves athlete background, symptom review using a 22-symptom checklist, cognitive screening (orientation, immediate memory via word lists, concentration tests like digit span and months backward), coordination and balance exams (modified BESS and timed tandem gait), and delayed recall after at least five minutes. These components together inform clinical decision-making, as no SCAT6 score alone confirms concussion.<br /><br />Post-assessment advice includes watching for worsening symptoms (severe headache, vomiting, seizures, weakness), recommending initial rest (24-48 hours), limiting physical and cognitive exertion, avoiding substances, ensuring safe return to activity, and hydration and sleep promotion.<br /><br />In summary, concussion diagnosis is a clinical process integrating immediate observations, standardized assessments, and athlete history with ongoing evaluation. Preparedness through EAP, teamwork, and structured assessment protocols are critical for athlete safety.

Asset Subtitle

Bryan T. Murtaugh, MD

Keywords

sports concussion

on-field assessment

Emergency Action Plan

SCAT6

Glasgow Coma Scale

red flags

cognitive screening

post-concussion management

athlete safety

concussion diagnosis