872

CONCUSSION RECOGNITION TOOL 5 ©
To help identify concussion in children, adolescents and adults
Supported byHead impacts can be associated with serious and potentially fatal brain injuries. The Concussion Recognition Tool
5 (CRT5) is to be used for the identification of suspected concussion. It is not designed to diagnose concussion.

If there is concern after an injury including whether ANY of the following signs areobserved or complaints are reported then the player should be safely and immediately
removed from play/game/activity. If no licensed healthcare professional is available,
call an ambulance for urgent medical assessment:•••

Neck pain or tenderness •Double vision•
Weakness or tingling/burning in arms or legs •Remember:•••

Severe or increasing
headache
Seizure or convulsion
Loss of consciousness

In all cases, the basic principles
of first aid (danger, response,airway, breathing, circulation)
should be followed.
Assessment for a spinal
cord injury is critical.

•Headache•Blurred vision•More emotional•“Pressure in head”•Sensitivity to light•

More Irritable•

Balance problems••

Sadness•

Nausea orvomiting

Sensitivity
to noise•••

Drowsiness

Fatigue or
low energy

Dizziness“Don’t feel right”

••

•

•

Difficulty
concentrating•

Difficulty
remembering

Nervous oranxious•

Feeling slowed
down

Neck Pain•

Feeling like“in a fog“

STEP 4: MEMORY ASSESSMENT(IN ATHLETES OLDER THAN 12 YEARS)STEP 1: RED FLAGS — CALL AN AMBULANCE© Concussion in Sport Group 2017

Echemendia RJ, et al. Br J Sports Med 2017;51:872. doi:10.1136/bjsports-2017-097508CRT5RECOGNISE & REMOVESTEP 3: SYMPTOMS••••

Deteriorating
conscious state
Vomiting
Increasingly restless,agitated or combative

Do not attempt to move the player(other than required for airwaysupport) unless trained to so do.
Do not remove a helmet or
any other equipment unlesstrained to do so safely.

If there are no Red Flags, identification of possible concussion should proceed to the following steps:

STEP 2: OBSERVABLE SIGNSFailure to answer any ofthese questions (modifiedappropriately for eachsport) correctly may
suggest a concussion:•“What venue are
we at today?”•“What team did you playlast week/game?”•“Which half is it now?”••“Who scored lastin this game?”“Did your team win
the last game?”

Athletes with suspected concussion should:•

Not be left alone initially (at least for the first 1-2 hours).

•

Not drink alcohol.

•

Not use recreational/ prescription drugs.

•

Not be sent home by themselves. They need to be with a responsible adult.

•Not drive a motor vehicle until cleared to do so by a healthcare professional.

The CRT5 may be freely copied in its current form for distribution to individuals, teams, groups
and organisations. Any revision and any reproduction in a digital form requires approval by
the Concussion in Sport Group. It should not be altered in any way, rebranded or sold forcommercial gain.

Visual clues that suggest possible concussion include:•Lying motionless on
the playing surface•

Slow to get up aftera direct or indirect
hit to the head•

Disorientation orconfusion, or an inability
to respond appropriately
to questions•Balance, gait difficulties,
motor incoordination,
stumbling, slow
laboured movements•Blank or vacant look

•Facial injury afterhead trauma© Concussion in Sport Group 2017

ANY ATHLETE WITH A SUSPECTED CONCUSSION SHOULD BE
IMMEDIATELY REMOVED FROM PRACTICE OR PLAY AND SHOULD
NOT RETURN TO ACTIVITY UNTIL ASSESSED MEDICALLY, EVEN
IF THE SYMPTOMS RESOLVE© Concussion in Sport Group 2017

Br J Sports Med: first published as 10.1136/bjsports-2017-097508CRT5 on 26 April 2017. Downloaded from http://bjsm.bmj.com/ on August 25, 2020 by guest. Protected by copyright.