Concussion Management, Education, and Return-to-Play Policies in High Schools: A Survey of Athletic Directors, Athletic Trainers, and Coaches

Background: Concussions represent 8.9% to 13.2% of all high school athletic injuries. How these injuries are managed is currently unknown. Hypothesis: There are differences in concussion management and awareness among boys football, boys ice hockey, and boys and girls soccer. Study Design: Descriptive epidemiologic study. Methods: High school athletic directors were contacted via e-mail and asked to complete, and request that their staff complete, an online survey with 4 sections aimed at athletic directors, head coaches, team physicians, and certified athletic trainers. Results: According to coaches, concussion awareness education was provided for football (97%), hockey (65%), and boys and girls soccer (57% and 47%, respectively) (P < 0.01). Use of sideline screening tools was significantly greater for football (P = 0.03). All participants agreed that a player who has suffered a concussion cannot return to play the same day. Conclusion: There is a difference in concussion management and awareness among the 4 sports. Concussion education is well promoted in football but should be expanded in soccer and hockey. Players are not allowed to return to play the same day, and the majority are referred to a physician. Clinical Relevance: Study results highlight the differences in concussion education among sports. Health care providers should address these gaps.