• ‘What’s your name?’ ‘Where are you?’ ‘What’s today’s date?’ ‘Who are you playing?’ ‘What’s the score?’ A player who is unable to answer these questions is likely to be concussed

• ‘Is your neck sore?’ ‘Have you a headache?’ ‘Are you dizzy or weak?’ ‘Do you feel sick?’ ‘Can you see properly?’ ‘Have you any weakness, pins and needles?’ ‘Can you move your hands and legs?’

The following symptoms indicate a Red Zone injury (emergency transfer to hospital).

• Headache

• Neck pain

• Tingling, pins and needles

• Vomiting

• Seizure

• Confusion

• Loss of memory – indicates concussion

Observe

• Look all around the face and skull for any bleeding (especially around eyes or behind ear) or scalp wounds

• Compare both sides of the skull

• Watch out for any depressed areas – skull fractures

Make sure the player is alert.

• Is the player opening their eyes?

• Can the player hold your gaze?

A player who cannot focus or whose eyes are rolling in their head suggests a serious injury

• Is there bruising around the eyes? – Serious head injury

• Are the pupils equal? – Unequal pupils indicate a serious injury

• Is the player shaking uncontrollably? – Go to Seizure section (p. 85)

• How is the player holding their neck? Is it straight or twisted?

• Are they moving all four limbs?

• Is there bruising or swelling of the face? – A serious face injury may also indicate a head injury

• Check the nose and ears to see if there is fluid or blood leaking out – Clear fluid indicates serious head injury

Rule out serious injury

• Look for signs of severe head injury, which are: intense headache, deteriorating level of responsiveness, drowsiness, nausea, vomiting, unequal pupil size, paralysis or loss of function of one side of body (opposite head injury); paralysis or weakness on both sides may indicate a spinal injury (go to Chapter 7)

• Ask player to move arms and legs

• Check sensation of arms and legs

Touch (use gloves)

• Examine head and scalp for possibility of skull fracture

• Examine ears and nose for blood and cerebrospinal fluid leakage

• Examination of the eye: range of motion:

• To check pupils, shine a pen torch into the eyes and check pupil response (Fig. 11.3)

• If the pupil gets smaller, it is responding

• Check both eyes

• Next shine the light in the right eye and look at the left to see if it responds. Repeat the other side

• Get player to follow your finger slowly with their eyes through an ‘H’ pattern (Fig. 11.4)

Skills assessment

If everything is normal at this stage, get the player to stand up, close their eyes and stand still; make sure the player is not falling to one side. If the player can walk and run on the spot without difficulty, they can play on.