Statement on Concussion and Brain Injury

The following statement was developed by the American College of Surgeons (ACS) Committee on Trauma’s (COT) Committee on Injury Prevention and Control to educate surgeons, coaches, and legislators about concussions and brain injuries.

The ACS COT supports legislative efforts to improve the care of injured athletes. The statement will be used by ACS advocacy staff when writing letters of support for legislation aimed at the prevention of brain concussions and brain injuries. ACS staff will also include the statement in their advocacy materials when working on these efforts with Fellows.

The statement was reviewed and approved by the Executive Committee of the COT. The COT also asked for and received input from the Advisory Council for Neurosurgery. The College’s Board of Regents approved the statement at its October 2012 meeting.

The ACS recognizes the following facts:

• Multiple mild brain injuries or concussive events may be associated with long-term cognitive and memory impairment.
• Return to play before full recovery from a concussion may facilitate bodily injury because full athletic reflexes, judgment, and balance may still be impaired.
• A repeat head injury before full recovery from a concussion can result in a catastrophic neurological outcome.
• Even mild repetitive head injuries may be deleterious to the long-term well-being of the afflicted patient.

Supported by this evidence, the ACS supports efforts to promote, enact, and sustain legislation and policies that encourage:

• Appropriate head protection when participating in activities, either occupational or recreational, where a risk of traumatic brain injury exists.
• Education of coaches, athletic trainers, and medical personnel present at youth sporting events regarding the recognition and diagnosis of concussions and mild brain injuries.
• Policies that allow for intermittent baseline neuropsychological testing for participants in high-risk sports or activities.
• Immediate removal of a youth athlete from a practice or game when a concussion is suspected.
• Prompt medical assessment of a concussion victim by a healthcare provider familiar with current head injury treatment protocols and testing.
• Clearance by a qualified healthcare provider trained in the evaluation and management of concussions prior to returning to athletic practices, games, or other high-risk activities.