A concussion is a traumatic brain injury that interferes with normal brain function. Medically, a concussion is a complex, pathophysiological event to the brain that is induced by trauma which may or may not involve a loss of consciousness (LOC). A concussion results in a constellation of physical, cognitive, emotional, and sleep-related symptoms. Signs or symptoms may last from several minutes to days, weeks, months or even longer in some cases.

Concussion Form

Our concussion policy and procedures are designed to offer players, parents, and coaches direction in the event of a possible concussion and gives medical professionals a step by step guide for treatment and observation. Our number one goal is to promote and champion the safety of our players.

Concussion Signs, Symptoms, and Management at Training and Competitions

Did a concussion occur?

Evaluate the player and note if any of the following signs and/or symptoms are present:

1. Dazed look or confusion about what happened
2. Memory difficulties
3. Neck pain, headaches, nausea, vomiting, double vision, blurriness, ringing noise or sensitive to sounds
4. Short attention span. Can’t keep focused
5. Slow reaction time, slurred speech, bodily movements are lagging, fatigue, and slowly answers questions or has difficulty answering questions
6. Abnormal physical and/or mental behavior
7. Coordination skills are behind, ex: balancing, dizziness, clumsiness, reaction time

Is emergency treatment needed?

This would include the following scenarios:

1. Spine or neck injury or pain
2. Behavior patterns change, unable to recognize people/places, less responsive than usual
3. Loss of consciousness
4. Headaches that worsen
5. Seizures
6. Very drowsy, can’t be awakened
7. Repeated vomiting
8. Increasing confusion or irritability
9. Weakness, numbness in arms and legs

If a possible concussion occurred, but no emergency treatment is needed, what should be done now?

Focus on these areas every 5-10 min for the next 1-2 hours, without returning to any activities:

1. Balance, movement
2. Speech
3. Memory, instructions, and responses
4. Attention on topics, details, confusion, ability to concentrate
5. State of consciousness
6. Mood, behavior, and personality
7. Headache or “pressure” in head
8. Nausea or vomiting
9. Sensitivity to light and noise

Players shall not re-enter competition, training, or partake in any activities for at least 24 hours.

What Should You Do in the Event of a Possible Concussion

The Concussion Notification Form is to be filled out in duplicate and signed by a team official of the player’s team. The document should be emailed to MedicalClaims@calnorth.org.

If a parent/legal guardian of the player is present, have the parent/legal guardian sign and date the Form, and give the parent/legal guardian one copy of the completed Form. If the parent/legal guardian is not present, then the team official is responsible for notifying the parent/legal guardian ASAP by phone or email and then submitting the Form to the parent/legal guardian by email or mail.

When the parent/guardian is not present, the team official must make record of how and when the parent/legal guardian was notified. The notification will include a request for the parent/legal guardian to provide confirmation and completion of the Concussion Notification Form whether in writing or electronically.

The team official must surrender the player pass to a League representative upon injury. The player pass will not be returned until a Medical Release has been received by CalNorth.
League must send copy of Medical Release to Cal North office (1040 Serpentine Lane, Suite 201, Pleasanton, CA 94556).

Players may wear their jersey, but must not be in full uniform until the League has received the Medical Release and the pass has been returned to the team official.