IIHF Concussion Protocol

INTERNATIONAL ICE HOCKEY FEDERATIONCONCUSSION PROTOCOL
Introduction
The IIHF Concussion Protocol has been updated using data and research from recent symposia toensure the safety and health of the players competing in the IIHF Championship Program, IIHF
Club Competitions and Olympic Winter Games competitions.
Acute Evaluation/ManagementConcussion symptoms may occur quickly after a blow to the head or body or may evolve over time(hours or even days). Consequently, players diagnosed with a concussion, and those who aresuspected of having a concussion, should be removed from play, monitored and evaluated overtime.
Any player (including goaltenders) or on-ice official who displays one or more of the concussion
signs, or who exhibits/reports one or more of the concussion symptoms, either on the ice or at any
subsequent time after direct or indirect contact, shall be removed as soon as possible from theplaying environment by the team medical staff. Team personnel observing the signs and symptoms
below shall report their observations to their medical staff. The IIHF Medical Supervisor is entitled
to request an examination in the dressing room from the team if he/she observes visible signs ofconcussion.
Concussion Signs (Visible)•••

Lying motionless on the ice – a player lies motionless on the ice or falls to the ice inan unprotected manner (i.e., without stretching out his hands or arms to lessen or
minimize his fall).;
Motor incoordination/balance problems – A player staggers, struggles to get up or
skate properly, appears to lose his balance, trips or falls, or stumbles while getting
up, trying to get up, or skating.;
Disorientation (e.g., unsure of where he is on the ice or location of player bench);

Concussion Symptoms (Player reported)••••

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Balance or coordination difficulties;
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Amnesia for the circumstances surrounding the injury (i.e., retrograde/anterogradeamnesia);
Cognitive slowness;
Light/sound sensitivity;
Disorientation;
Visual disturbance;
Tinnitus.

Please note that the signs and symptoms of concussion listed above, although frequently observedor reported, are not an exhaustive list.
Players or officials suspected of having a concussion shall be evaluated by Team Medical
Personnel (physician, athletic trainer, physiotherapist) in a distraction-free environment. In all
circumstances, the Team Medical Personnel shall assess the player in person and be solely
responsible for determining whether the player is diagnosed with a concussion. If no Team Medical
Personnel are available, the Event Chief Medical Officer (ECMO) shall take over that role.
Return to Play
If Team Medical Personnel conclude after their examination that the player or official shows noevidence of a concussion, the player may return to play.
if on examination there is no evidence of a concussion the player could return to play

A player or official with a suspected or diagnosed concussion shall be immediately removed
from play and cannot return to play on the same day.
Players or officials showing observable signs that are not attributed to an injury to a different part ofthe body shall not return to play and will be re-evaluated on the next day.
After a brief period of rest (24 to 48 hours after injury), the concussed player is encouraged to
become gradually and progressively more active as long as these activities do not cause or worsen
symptoms. The player follows a graduated return to play strategy with at least 24 hours (or longer)
for each stage. If any symptoms worsen during exercise, the athlete should go back to the previousstep.
Stage

AimActivity

Goal of each step

1

Symptom-limited
activity

Daily activities that do not
provoke symptoms.

Gradual reintroduction ofwork/school activities

2

Light aerobic exercise

Walking or stationary cycling
at slow to medium pace. No

Increase heart rate

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resistance training.
3Sport specific exercise

Running or skating drills. No
head impact activities.

Add movement4

Non-contact trainingdrills

Harder training drills.. Theplayer may start progressive
resistance training.

Exercise, coordination andincreased thinking

5

Full contact practice

Following medical clearance,
participate in normal training
activities.

Restore confidence and assess
functional skills by coaching staff

6

Return to Play

Normal game play.

The athlete may return to play when the Team Medical Personnel or ECMO/Host Physician(if no Team Medical Personnel present) verifies normal neurocognitive function andsuccessful completion of the graduated return to play strategy.
The Team Medical Personnel may consult with the IIHF Medical Supervisor, if present, but theTeam Medical Personnel will make the final decision on return to play. If the IIHF MedicalSupervisor does not agree with the decision of the Team Medical Personnel, he/she willcommunicate with the Directorate Chairman who has the authority to remove the playerfrom competition.

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