{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T12:29:02Z","timestamp":1792326542016,"version":"4.4.0"},"reference-count":82,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Sports Med"],"accepted":{"date-parts":[[2013,1,19]]},"published-print":{"date-parts":[[2013,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The onfield assessment of concussion in the adult athlete is challenging, given the elusiveness of injury, the sensitivity and specificity of the sideline assessment tools and the evolving nature of concussive injury. This paper reviews the evidence related to the onfield assessment and considers questions related to same day return to play, what to do when no physician is available onsite, as well as the benefit of remote notification of potential concussive events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To review the evidence regarding the onfield assessment of concussion in the adult athlete. Additional key issues to consider include same day return to play for the adult athlete with concussion, what to do in a community setting when no doctor is present and whether there is any benefit with remote notification of potential concussive events that occur on the playing field.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources<\/jats:title>\n                    <jats:p>Systematic literature review of concussion assessment and management. PubMed, MEDLINE, Psych Info and Cochrane Library databases were reviewed using the MeSH key words concussion and mild traumatic brain injury combined with athletic injuries. Each was refined by adding the key words \u2018adult\u2019, \u2018sideline assessment\u2019, \u2018onfield assessment\u2019 and \u2018return to play\u2019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>For the MEDLINE search, using \u2018concussion\u2019 and \u2018athletic injuries\u2019 as key words, there were 880 results, and refining by \u2018adult\u2019 there were 292 results. When \u2018traumatic brain injury\u2019 and \u2018athletic injuries\u2019 were combined, there were 210 results. When refining by \u2018adult\u2019, there were 89 results. Many of these results overlapped. Following an initial review, these articles form the basis of the discussion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The onfield evaluation of sport-related concussion is often a challenge, given the elusiveness and variability of presentation, difficulty in making a timely diagnosis, specificity and sensitivity of the sideline assessment tools and the reliance on symptoms. Despite these challenges, the sideline evaluation is based on recognition of injury, assessment of symptoms, cognitive and cranial nerve function and balance. Serial assessments are often necessary and, since signs and symptoms may be delayed, erring on the side of caution (keeping an athlete out of participation when there is any suspicion for injury) is important. A standardised assessment of concussion is useful in the assessment of the athlete with suspected concussion but should not take the place of the clinician's judgement.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bjsports-2013-092158","type":"journal-article","created":{"date-parts":[[2013,3,11]],"date-time":"2013-03-11T19:07:46Z","timestamp":1363028866000},"page":"285-288","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":44,"title":["Onfield assessment of concussion in the adult athlete"],"prefix":"10.1136","volume":"47","author":[{"given":"Margot","family":"Putukian","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Raftery","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Guskiewicz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stanley","family":"Herring","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Aubry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert C","family":"Cantu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mick","family":"Molloy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2013,3,11]]},"reference":[{"key":"2024051403393516000_47.5.285.1","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0b013e318275044f"},{"key":"2024051403393516000_47.5.285.2","first-page":"143","article-title":"Inter Association Task Force recommendations on emergency preparedness and management of sudden cardiac arrest in high school and college athletic programs: a consensus statement","volume":"42","author":"Drezner","year":"2007","journal-title":"J Athl Train"},{"key":"2024051403393516000_47.5.285.3","doi-asserted-by":"crossref","first-page":"20","DOI":"10.3810\/psm.2009.12.1738","article-title":"National athletic trainers\u2019 association. summary of the national athletic trainers\u2019 association position statement on the acute management of the cervical spine injured athlete","volume":"37","author":"Swartz","year":"2009","journal-title":"Phys Sportsmed"},{"key":"2024051403393516000_47.5.285.4","unstructured":"NFL Memo to Team Physicians, Head Athletic Trainers, Independent Neurological Consultants August 12, 2012. http:\/\/www.nflevolution.com\/article\/NFL-Health-and-Safety-Memo?ref=393 (accessed 16 Oct 2012)."},{"key":"2024051403393516000_47.5.285.5","unstructured":"IRB Guidelines for Concussion. http:\/\/www.irbplayerwelfare.com\/ (accessed 3 Jan 2013)."},{"key":"2024051403393516000_47.5.285.6","unstructured":"2012 NHL Guidelines for Concussion. http:\/\/www.nhl.com\/ice\/news.htm?id=556289#&navid=nhl-search (accessed 3 Jan 2013)."},{"key":"2024051403393516000_47.5.285.7","unstructured":"NCAA Men's & Womens Soccer 2012\u20132013 Rules Interpretation. https:\/\/www.arbitersports.com\/Groups\/106254\/Library\/files\/2012%20and%202013%20Men's%20and%20Women's20Soccer%20Rules%20Book.pdf Section 3.5.3. page 18 (accessed 18 Nov 2012)."},{"key":"2024051403393516000_47.5.285.8","unstructured":"Advanced Trauma Life Support for Doctors (ATLS). 8th edn. 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