Concussion – Assessment & Management

 

There is no central authority in Australia that provides research and guidance in concussion management, an area that affects many areas of medical practice (including sports medicine, emergency medicine, general practice, neurology and allied health) and various clinical settings. Consequently two Australian guidelines have been released regarding the assessment and management of concussion.

 

Guidelines

 

Guideline 1 – General Concussion Guidelines: The ANZ (Australia & New Zealand) Concussion Guidelines 2025

 

• Produced by a wide craft group reflecting many of the above clinicians involved in concussion assessment, management and research. 

 

Guideline 2 –  Concussion in Sport Guidelines:

1. 1. A detailed Concussion and Brain Health Position Statement 2024, 
   2. and the briefer accompanying Australian Concussion Guidelines for youth and community sport

• Produced by the Australian Sports Commission and Australian Institute of Sport in collaboration with the Australasian College of Sport and Exercise Physicians, Australian Physiotherapy Association, Sports Medicine Australia. 

 

Resources

 

Various tools have been provided in association with these guidelines – some key tools are provided below. 

Head Injury Advice Sheets for Patients/Consumers

• Adults
• Children

There are versions provided from different Australian states.

These generally provide red flags that warrant attending ED. Some also provide information about graduated return to activity for concussion management. However most are likely outdated in one area – they have not been updated to advise light exercise initiated within 24-48hrs of injury, which as described in the guidelines, is a therapy that may improve recovery from concussion. Consequently such education will need to be provided separately. 

 

Return to Activity Protocols – Learning and Sport

 

Guideline 2 – Graduated Return to Sport Framework

 

Guideline 1

• Return to Learn Strategy
• Return to Sport Strategy

 

Note general advice for amateur and community sport, is not to return to full contact sport where a repeated concussion could occur, until 21 days post concussion and must have remained symptom free for at least 14 days. Professional sports may have carefully designed protocols under close supervision for accelerated return to competition.

Concussion Assessment Tools

 

For community sporting groups (non-health practitioners):

• Assessment: Concussion Recognition Tool (CRT6)
  • Where concussion is a possibility, this provides a simple 2 page pdf assessment that allows non-health practitioners to quickly assess concussion.
  • Page 1 is primarily about red flags for clinically important traumatic brain injury that should prompt urgent transport to hospital
  • Page 2 provides the actual concussion assessment tool, with initial management advice of suspected concussion provided. 
• Management Poster: Quick Guide to Managing Concussion in Community & Youth Sport
  • This 1 page poster is useful to display prominently in sports centres and club rooms and educate staff and coaches to follow

 

For clinicians 

For clinicians (usually doctors and physios) seeking to diagnose concussion with a validated tool. Practically this may be most useful for clinicians assessing players with head injuries at community sport venues. Here the focus is to diagnose possible concussion and “if in doubt sit them out”.

 

Sport Concussion Assessment Tools (SCAT)

• The SCAT-6 (for ages 13yo and over)

• The Child SCAT-6

 

Follow up office Concussion Evaluation

For follow-up office evaluation by community health practitioners (often general practitioners, physios and occupational therapists)

• Concussion Office Assessment Tools
  •  SCOAT 6 (for ages 13yo and over)
  • Child SCOAT-6 (for ages 5-12yo)
• These are intended for serial office based assessments over time to provide a multi-modal evaluation of concussion and its resolution, usually commencing >72hrs after the head injury.