Concussion Care Protocol
Step 1: Seek medical care - You may or may not need to receive emergency medical care. If you have any of the following symptoms, then you should be taken to the nearest emergency room immediately: Bleeding or fluid coming out of eyes or ears, bruising around eyes (racoon eyes) or ears, persistent vomitting, headache that gets worse or is persistently severe, worsening symptoms, noteworthy change in symptoms (e.g. athlete was lucid earlier, but is now acting dazed and out of it), loss of consciousness, suspected neck or spine injury, garbled speech, difficulty awakening or arousing, seizures or convulsing, or trouble using arms or legs. If an athlete has any of these symptoms or appears to be doing worse from the time of the injury, then seek emergency medical care.
Most athletes will not need emergency medical care. However, it is advised that you contact your primary care physician to inform them about the injury.
Step 2: Contact the Sport Concussion Program - Generally, athletes should be evaluated 2-3 days after the injury. For the first session, the athlete and parents will meet with the doctor to discuss the injury, any symptoms that the athlete may be experiencing, and what can be expected during recovery. The athlete will take the ImPACT test and post-injury results will be compared with the child’s baseline scores (if available). The first meeting will take approximately 1-1.5 hours. Depending on the severity of the injury, the athlete may need to come back to take follow up testing to continue to monitor recovery. Typically, after the initial visit, follow-up evaluation(s) will occur once the athlete is no longer symptomatic.
Note to Marin County Patients - Dr. Freitag now has limited clinic appointments in Marin on the 1st and 3rd Monday of each month. He will be seeing patients at the Marin Brain Injury Network. If you would like to schedule an appointment in Marin, please contact the main Walnut Creek office. Otherwise, if you are unable to see Dr. Freitag, you may contact the Marin Neuropsychology Center to be scheduled for an evaluation. While Dr. Freitag no longer has a formal affilation with the Marin Neuropsychology Center, we are pleased that the center will continue to provide care to Marin County athletes.
Step 3: Athlete Recovery - Dr. Freitag will instruct the athlete on steps to take to best facilitate recovery. It is important that the athlete rest and avoid physical and mental exertion during this time. Temporarily withdrawing or modifying an athlete's school schedule may be necessary during this time of recovery. If you require any special forms for your school, please bring them with you for Dr. Freitag to sign.
Step 4: Returning to Play and Activities- Once an athlete’s post-injury scores match their baseline scores (or return to normal) and they are symptom free, Dr. Freitag will make the recommendation for a graduated return to play. Your physician may want to provide further medical clearance before supporting a return to play. For athletes who participate in high school athletics governed by the California Interscholastic Federation, they will need a signed release from their regular physician in order to be returned to play.
For more information about the care of a concussed athlete, please read the Post Injury and Recovery Guide.