Total Team Development

Concussion Management Policy

The standard of care for current medical practice requires that any athlete with a suspected concussion is immediately removed from play.

  • A concussion is a traumatic brain injury — there is no such thing as a minor brain injury.
  • A player does not have to be "knocked-out" to have a concussion — less than 10% of players actually lose consciousness.
  • A concussion can result from a blow to head, neck or body.
  • Concussions often occur to players who don't have or just released the puck, from open-ice hits, unanticipated hits and illegal collisions.
  • The youth hockey player's brain is more susceptible to concussion than adult players.
  • In addition, the concussion in a young athlete may be harder to diagnose, takes longer to recover, is more likely to have a recurrence, and can be associated with serious long-term effects.
  • Treatment is individualized, and it is impossible to predict when the athlete will be allowed to return to play — there is no standard timetable.

If your son / daughter appeared to have sustained a head injury, perhaps even a concussion, while participating in a Total Team Development program, you will be referred to suspected head injury protocol provided by USA Hockey at

Parents should be aware that a concussion can happen without there being a direct hit to the head and can happen when the head moves rapidly in an uncontrolled fashion. This is called a coup-contra coup, the front and the back of the brain hit against the inside of the skull.

If there is a direct hit to the head and player loses consciousness, a call to EMS 911 is activated.

At Occurrence Management:
- Initial assessment - general impression of the injury
- Check Airway, Breathing, Circulation
- Check level of consciousness

Observation of the Athlete: By coach, referee or guardian
- Vacant stare
- Delayed verbal motor responses
- Confusion and inability to focus attention
- Behavior or personal changes
- Slurred / incoherent speech
- Memory deficits - cannot answer easy questions
- Loss of consciousness

Early concussion symptoms may include:
Headache, dizziness, lack of awareness of surrounding, nausea or vomiting, sensitivity to light, player just does not feel right.
A concussion is a metabolic rather than a structural change to the brain. Chemical changes within the brain tissue affect brain function instead of bleeding, bruising or swelling to the brain. Trauma can cause a structural condition as well such as a skull fracture or bleeding in the brain.

If any "one" of these symptoms is present, then the athlete will be instructed to seek medical follow-up and will not be able to return to play until he or she has documentation from a doctor.

It is important to note that pediatric athletes can take longer than older athletes to recover because of brain development.