Concussion Recognition & Management
Module 1 Nebraska Concussion Awareness Act
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Removal from Play

Removal from Play: coach motioning "out" with hand gesture
Removal from Play is taking a young athlete out of the game when a concussion is suspected until evaluated by a licensed health care professional. It also means keeping the young person out of risky activities during treatment and recovery, not just the activity he or she was taking part in when the injury took place.

Unlike many colleges and universities, schools and club sports programs may lack protocols and armies of athletic trainers and medical professionals to help determine when a youth needs to be removed from play. It may fall to you, as a licensed health care professional, to help prevent young athletes from going back in after sustaining a concussion. Young people in your care will need your assistance to help manage their concussion symptoms.

Removal from Play and Return to Play

Why Licensed Health Care Professionals Need to Make the Call

REMOVAL FROM PLAY is an important component
of the Nebraska Concussion Awareness Act
that involves removal, notification, and resumption.

Removal, Notification, & Resumption

Surveys of athletic directors conducted by the Nebraska Department of Health and Human Services have been conducted in 2013, 2015, 2and 2017. The most recent survey found:

The State of Nebraska has completed 3 surveys of concussion practices in the state. The most recent survey (2017), found that

  • Concussion education is made available for 100% of schools;
  • Concussion education is required for 99% of high school coaches.
  • Concussion education is made available for 76% of athletes and 65% of parents, but is only required for 30% of athletes and 15% of parents.

Nebraska law also requires that athletes suspected of experiencing a concussion be removed from play until cleared to return:

  • 88% of responses indicated that athletes are always removed when suspected of concussion;
  • An additional 7% said athletes are often removed and 4% said they are sometimes removed.

Athletes must receive signed clearance from a licensed health care professional:

  • Athletic trainers (37% of the time) and physicians (81% of the time) provided letters.

Nebraska high schools must have a formal return to learn protocol in place for not only concussed athletes, but also concussed non-athlete students. Overall, 84% of respondents indicated that their school had a return to learn policy in place. There were improvements form 2013 and 2015:

  • Larger schools (100% of Class A and 94% of Class B)
  • Smaller schools (85% of Class C and 77% of Class D).

One finding of concern was the number of parents and coaches who were reported to make return to play decisions. This appears to be illegalby the law, and is very poor practice given the subjectivity and inherent conflicts of interest involved. While rural schools have significant resource challenges, it is imperative that schools partner with professionals, develop consultative models and bring licensed health care professionals into the required procedures.
2015 Nebraska Sports Concussion Athletic Director Survey Results

Module 1 Nebraska Concussion Awareness Act
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