CIF State Information Regarding Concussions:

Policies for the management of concussion and head injury for CIF Member Schools: Nationwide data continues to show that many catastrophic head injuries are a direct result of injured athletes returning to play too soon, not having fully recovered from the first head injury. On May 7, 2010, the State CIF Federated Council passed Bylaw 313 that now requires a signed medical release before a student-athlete who is suspected to have sustained a concussion can return to play.   Please use the links and information provided to further educate yourself on the signs, symptoms and actions that all involved in education based CIF sports should take when they suspect any type of head injury.

Bylaw 313 
A student-athlete who is suspected of sustaining a concussion or head injury in a practice or game shall be removed from competition at that time for the remainder of the day.  A student-athlete who has been removed from play may not return to play until the athlete is evaluated by a licensed health care provider trained in the evaluation and management of concussion and receives written clearance to return to play from that health care provider.

What is a concussion?

A concussion is a type of traumatic brain injury (TBI) caused by a bump, blow, or jolt to the head that can change the way your brain normally works. Concussions can also occur from a fall or a blow to the body that causes the head and brain to move quickly back and forth.

Health care professionals may describe a concussion as a “mild” brain injury because concussions are usually not life-threatening. Even so, their effects can be serious.

What are the Signs and Symptoms of Concussion?

Most people with a concussion recover quickly and fully. But for some people, symptoms can last for days, weeks, or longer. In general, recovery may be slower among older adults, young children, and teens. Those who have had a concussion in the past are also at risk of having another one and may find that it takes longer to recover if they have another concussion.

What are the Signs and Symptoms of Concussion?


  • Difficulty thinking clearly
  • Feeling slowed down
  • Difficulty concentrating
  • Difficulty remembering new information


  • Difficulty thinking clearly
  • Feeling slowed down
  • Difficulty concentrating
  • Difficulty remembering new information


  • Difficulty thinking clearly
  • Feeling slowed down
  • Difficulty concentrating
  • Difficulty remembering new information


  • Difficulty thinking clearly
  • Feeling slowed down
  • Difficulty concentrating
  • Difficulty remembering new information

Some of these symptoms may appear right away, while others may not be noticed for days or months after the injury, or until the person starts resuming their everyday life and more demands are placed upon them. Sometimes, people do not recognize or admit that they are having problems. Others may not understand why they are having problems and what their problems really are, which can make them nervous and upset.

The signs and symptoms of a concussion can be difficult to sort out. Early on, problems may be missed by the person with the concussion, family members, or doctors. People may look fine even though they are acting or feeling differently.

See Getting Better, for tips to help aid your recovery after a concussion.

When to Seek Immediate Medical Attention:

Danger Signs in Adults

In rare cases, a dangerous blood clot may form on the brain in a person with a concussion and crowd the brain against the skull. Contact your health care professional or emergency department right away if you have any of the following danger signs after a bump, blow, or jolt to the head or body:

  • Headache that gets worse and does not go away.
  • Weakness, numbness or decreased coordination.
  • Repeated vomiting or nausea.
  • Slurred speech.

The people checking on you should take you to an emergency department right away if you:

  • Look very drowsy or cannot be awakened.
  • Have one pupil (the black part in the middle of the eye) larger than the other.
  • Have convulsions or seizures.
  • Cannot recognize people or places.
  • Are getting more and more confused, restless, or agitated.
  • Have unusual behavior.
  • Lose consciousness (a brief loss of consciousness should be taken seriously and the person should be carefully monitored).

Danger Signs in Children
Take your child to the emergency department right away if they received a bump, blow, or jolt to the head or body, and:

  • Have any of the danger signs for adults listed above.
  • Will not stop crying and cannot be consoled.
  • Will not nurse or eat.


Every school district and youth sports organization should have and practice a sideline protocol for dealing with head injuries.

What to do if an athlete is hurt:

1. Remove the athlete from play immediately and keep them from returning to play if any concussion symptoms are present or it is suspected the athlete has sustained a concussion.
2. Perform a sideline evaluation. If access to an athletic trainer or other medical professional is unavailable, assess the athlete using the SAC and BESS to determine if emergency medical assistance is required.
3. Monitor and re-assess. Consider assigning a staff member to the athlete to look for signs of deterioration.
4. Notify the athletes parents. Make sure they understand the signs and symptoms of a concussion and the timeframe for onset and recovery. Stress the mandatory requirement from medical evaluation.
5. Only allow the athlete to return to play if they have written medical authorization.
6. Verify the athlete is 100% symptom free before allowing them to participate in any activity.
7. Institute a gradual return to play procedure after the athlete is medically cleared. Assess the athlete for return of symptoms.

Take A Free Online Course

1. CDC Concussion Information


2. NFHS Learning Center


Sports-related concussion in high school sports can be serious or even life-threatening situations if not managed correctly. National Federation of State High School Associations (NFHS) and Centers for Disease Control and Prevention (CDC) have teamed up to provide information and resources to help educate coaches, officials, parents and students on the importance of proper concussion recognition and management in high school sports. Mick Koester M.D., ATC, Chair of the NFHS Sports Medicine Advisory Committee and Director of the Slocum Sports Concussion in Eugene, Oregon takes you through this course. In this course you will understand the impact sports-related concussion can have on your players, how to recognize a suspected concussion, the proper protocols to manage a suspected concussion, and steps to help your player return to play safely after experiencing a concussion.

Our Clinic

This clinic provides Concussion (MTBI)/Brain evaluation and treatment. The West Coast Sports Medicine Foundation is a Clinical ImPACT Concussion Consultant.

Comprehensive Concussion evaluation/treatment using the latest concussion assessment tools used by the NFL, NHL and the NCAA.

  • Concussion Evaluation & Diagnosis
  • Detailed plan regarding Concussion recovery and return to school/play/sport/daily activities
  • Consultation with experts in the field of brain injury and concussion management
  • Rehabilitation needs assessment and plan
  • Communication/documentation plan for school/employer/coaches
  • ImPACT Baseline concussion testing
  • ImPACT follow-up care testing (post-concussion testing)
  • S.A.C. testing (standardized assessment of concussion)
  • Detailed information provided to athlete/parent regarding care/instructions/plan


ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing) is the first most-widely used and scientifically validated computerized concussion evaluation system. Developed in the early 1990′s by Drs. Mark Lovell and Joseph Maroon, ImPACT is a 20 minute test that has become a standard tool used in comprehensive clinical management of concussions for athletes of all ages. ImPACT Applications, Inc. was co-founded by Mark Lovell, PhD, Joseph Maroon, MD and Michael (Mickey) Collins, PhD. Given the inherent difficulties in concussion management, it is important to manage concussions on an individualized basis and to implement baseline testing and/or post-injury neurocognitive testing. This type of concussion assessment can help to objectively evaluate the concussed athlete’s post-injury condition and track recovery for safe return to play, thus preventing the cumulative effects of concussion. In fact, neurocognitive testing has recently been called the cornerstone of proper concussion management by an international panel of sports medicine experts. ImPACT can be administered by an athletic trainer, school nurse, athletic director, team coach, team doctor or anyone trained to administer baseline testing. ImPACT is the most widely used computer based testing program in the work and is implemented effectively across high school, collegiate and professional levels of sport participation.

Features of ImPACT

  • Measures players symptoms
  • Measures verbal and visual memory, processing speed and reaction time
  • Reaction time measured to 1/100th of a second
  • Assists clinicians and athletic trainers in making difficult return to play decisions
  • Provides reliable baseline test information
  • Produces comprehensive report of test results
  • Results can be e-mailed or faxed for fast consultation by a neuropsychologist
  • Automatically stores data from repeat testing
  • Testing is administered online for individuals or groups

The test battery consists of a near infinite number of alternate forms by randomly varying the stimulus array for each administration. This feature was built in to the program to minimize the practice effects that have limited the usefulness of more traditional neurocognitive tests. ImPACT takes approximately 20 minutes to complete. The program measures multiple aspects of cognitive functioning in athletes including:

  • Attention span
  • Sustained and selective attention time
  • Non verbal problem solving
  • Working memory
  • Response variability
  • Reaction time