Insurance underwritten by National Union Fire Insurance Company of Pittsburgh, Pa., with its principal place of business in New York, NY. Coverage may not be available in all states.

Coaches’ Clipboard

Signs and Symptoms These signs and symptoms may indicate that a concussion has occurred.

SIGNS OBSERVED BY COACHING STAFF: . Appears dazed or stunned . Is confused about assignment or position . Forgets sports plays . Is unsure of game, score, or opponent . Moves clumsily . Answers questions slowly . Loses consciousness(even briefly) . Shows behavior or personality changes . Can’t recall events prior to hit or fall . Can’t recall events after hit or fall

Next Steps If you suspect that a player has a concussion, you should take the following steps: 1

Remove athlete from play. 2

Ensure athlete is evaluated by an appropriate health care professional. Do not try to judge the seriousness of the injury yourself. 3

Inform athlete's parents or guardians about the known or possible concussion and give them the fact sheet on concussion. 4

Allow athlete to return to play only with permission from an appropriate health care professional. If you think your athlete has sustained a concussion... Take him/her out of play, and seek the advice of a health care professional experienced in evaluating for concussion.

SYMPTOMS REPORTED BY ATHLETE: . Headache or “pressure” in head . Nausea or vomiting . Balance problems or dizziness . Double or blurry vision . Sensitivity to light . Sensitivity to noise . Feeling sluggish, hazy, foggy, or groggy . Concentration or memory problems . Confusion . Does not “feel right”

IMPORTANT PHONE NUMBERS: EMERGENCY MEDICAL SERVICES

Name:

_____________________________________________________________________________________________________________________________

Phone:

______________________________________________________________________________________________________________________________

TEAM PHYSICIAN

Name:

_____________________________________________________________________________________________________________________________

Phone:

____________________________________________________________________________________________________________________________

HOSPITAL

Name:

_____________________________________________________________________________________________________________________________

Phone:

____________________________________________________________________________________________________________________________

For immediate attention, CALL 911

Create Awareness. Prevent Injuries. aHead of the Game!

For more information, visit

www.chartisinsurance.com/ aheadofthegame