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The results of the first 2 rounds were used to develop a Likert\u2010style questionnaire for round 3. If agreement at round 3 was \u226480% for an item, if panel members were outside consensus, or there were &gt;30% neither agree\/disagree responses, the results were carried forward into round 4. The level of agreement and consensus was defined as 90%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Loss of consciousness (LOC) or suspected LOC, motor incoordination\/ataxia, balance disturbance, confusion\/disorientation, memory disturbance\/amnesia, blurred vision\/light sensitivity, irritability, slurred speech, slow reaction time, lying motionless, dizziness, headaches\/pressure in the head, falling to the ground with no protective action, slow to get up after a hit, dazed look, and posturing\/seizures were clinical signs of SRC and indicate removal from play. Video assessment is helpful but should not replace clinical judgment. LOC\/unresponsiveness, signs of cervical spine injury, suspicion of other fractures (skull\/maxillo\u2010facial), seizures, Glasgow Coma Scale score &lt;14 and abnormal neurologic examination findings are indications for hospitalization. Return to play should only be considered when no clinical signs of SRC are present. Every suspected concussion should be referred to an experienced physician.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Consensus was achieved for 85% of the clinical signs indicating concussion. On\u2010field and pitch\u2010side assessment should include the observation of the mechanism, a clinical examination, and cervical spine assessment. Of the 19 signs and red flags requiring removal from play, consensus was reached for 74%. Normal clinical examination and HIA with no signs of concussion allow return to play. Video assessment should be mandatory for professional games but should not replace clinical decision\u2010making. Sports Concussion Assessment Tool, Glasgow Coma Scale, vestibular\/ocular motor screening, Head Injury Assessment Criteria 1, and Maddocks questions are useful tools. Guidelines are helpful for non\u2010health professionals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level V, expert opinion.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.arthro.2023.06.026","type":"journal-article","created":{"date-parts":[[2023,6,28]],"date-time":"2023-06-28T12:56:37Z","timestamp":1687956997000},"page":"449","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":6,"title":["On\u2010Field and Pitch\u2010Side (Sideline) Assessment of Sports Concussion in Collision Sports: An Expert Consensus Statement Using the Modified Delphi Technique"],"prefix":"10.1002","volume":"40","author":[{"given":"Erik","family":"Hohmann","sequence":"first","affiliation":[{"name":"Medical School Faculty of Health Sciences University of Pretoria Pretoria South Africa"},{"name":"Department of Orthopaedic Surgery and Sports Medicine Burjeel Hospital for Advanced Surgery Dubai United Arab Emirates"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Bloomfield","sequence":"additional","affiliation":[{"name":"CMO Manly Sea Eagles NRL Team"},{"name":"World Rugby Concussion Consultant"},{"name":"Former CMO National Rugby League Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiri","family":"Dvorak","sequence":"additional","affiliation":[{"name":"Department of Neurology Spine Unit Schulthess Clinic Zurich Switzerland"},{"name":"Former CMO FIFA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruben","family":"Echemendia","sequence":"additional","affiliation":[{"name":"Psychological &amp; Neurobehavioral Associates State College Pennsylvania U.S.A."},{"name":"Department of Psychology University of Missouri Kansas City Missouri U.S.A."},{"name":"Co\u2010Chair NHL\/NHLPA Concussion Subcommittee"},{"name":"Chair Major 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Rugby Concussion Consultant Team Physician Rugby 7s MO International Hockey Federation"},{"name":"Former Team Physician 7\u2019s Rugby"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louis","family":"Holtzhausen","sequence":"additional","affiliation":[{"name":"Chief of Sports Medicine Director Aspetar Sports Related Concussion Program"},{"name":"Orthopaedic and Sports Medicine Hospital Aspetar Doha Qatar"},{"name":"Section Sports Medicine University of Pretoria Faculty of Health Sciences Pretoria South Africa"},{"name":"Department of Exercise and Sports Sciences University of the Free State Bloemfontein South Africa"},{"name":"Former Team Physician South African Olympic Team and Professional Rugby Cricket and Hockey Teams"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan","family":"Kourie","sequence":"additional","affiliation":[{"name":"Head of Department of Sports Medicine Mediclinic Parkview"},{"name":"Dubai United Arab Emirates"},{"name":"CMO 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