Course 570 - School Safety: Athletics Supervision

Safety guides and audits to make your job as a safety professional easier

Coaching Safety



Each day throughout the United States, hundreds of thousands of young athletes head out to playing fields, ice, and gymnasiums to practice and compete in many different sports. Many agree that sports are a great way for kids to stay healthy. However, medical researchers have discovered young athletes, especially kids and teenagers, often don’t know their limitations, even if they have a concussion. Therefore, it is the coaches’ responsibility to help recognize and make the call to take the athletes off the field or court if they think the player may have a concussion.

Understanding Concussions

Concussions and Youth Sports

A concussion is a type of traumatic brain injury caused by a bump, blow, or jolt to the head. Concussions can also happen if a hard blow to your body causes your head and brain to move rapidly back and forth. This sudden movement can cause the brain to bounce around or twist in the skull, causing stretching and damage to the brain cells and creating chemical changes in the brain.

These chemical changes can make the brain more susceptible and vulnerable to other injuries. During this time, the brain is more sensitive to any increased stress or injury, until it fully recovers.

Since you cannot “see” a concussion, like with a broken limb, CAT scans and MRIs are normal with most concussions.

Consequences of Concussions

Potential Consequences of Concussions

Concussions affect people differently. Most athletes with a concussion recover fairly quickly, but some will have symptoms for days or even weeks. A more serious concussion can last for months or longer.

If athletes do not give their brain enough time to recover, it can be dangerous. A second concussion that occurs before the brain completely recovers from the first can slow recovery or increase the chance for long-term problems.

Danger Signs

As a coach, your first job is to be ready to jump in when a player seems “off.” Remember, you cannot see a concussion, and there isn’t just one indicator of a concussion. Recognizing a concussion requires coaches to watch for different signs and symptoms. As a coach, you need to make sure and ask others to report if they see any of the following things happen to the athletes:

  1. A forceful bump, blow, or jolt to the head or body that results in fast movement of the head.
  2. Any concussion signs or symptoms. This could include a change in the athlete’s behavior, thinking, or physical functioning.

Athletes who show or report one or more of the symptoms below, or even just don’t “feel right” after a bump, blow, or jolt to the head or body, may have a concussion.

Appears dazed or stunned Headache or “pressure” in head
Confused about assignment/position Nausea or vomiting
Forgets an instruction Balance problems or dizziness
Unsure of game, score, or opponent Double or blurry vision
Answers questions slowly Sensitivity to noise
Shows mood, behavior, or personality changes Concentration or memory problems
Can’t recall event prior or after hit or fall Feeling sluggish, hazy, foggy, or groggy

Signs and symptoms of a concussion mostly show up soon after the injury. However, you may not see the full effect of the injury for possibly hours or even days. For example, an athlete may only seem confused or dazed immediately afterwards, but an hour or so later they may not even remember the event.

You must assess the player and make sure someone supervises him or her for least two hours after you suspect a concussion.

Medical Emergency

Types of concussions and when to visit the emergency room with concussion symptoms.

If the signs or symptoms get worse, you should consider it a medical emergency. In uncommon cases, a dangerous blood clot may form on the brain in an athlete who has suffered a concussion. This blood clot can then squeeze the brain against the skull. Call emergency medical providers or take the athlete to the emergency department right away if after a bump, blow, or jolt to the head or body, he or she exhibits one or more of the following danger signs:

  • one pupil larger than the other
  • drowsiness or inability to wake up
  • a headache that does not go away or gets worse
  • weakness, numbness, or decreased coordination
  • repeated vomiting or nausea
  • slurred speech
  • convulsions or seizures
  • inability to recognize people or places
  • increasing confusion, restlessness, or agitation
  • unusual behavior
  • loss of consciousness

Suspecting a Concussion

Return to Play

Pulling someone from a game or practice can be tough, but if you suspect a concussion, it is necessary to keep them safe. Here are some steps to follow:

Remove the athlete from play. If an athlete has experienced a bump or blow to the head or body, you must look for signs and symptoms of a concussion. When in doubt, you should sit them out.

Make sure the athlete sees a health care professional who is experienced in evaluating for a concussion. Do not try and judge the severity of the injury on your own.

Inform the parents or guardians of the incident. Give them the Centers for Disease Control fact sheet on concussions. This fact sheet can help parents monitor for signs or symptoms that appear to worsen once the athlete is at home or returns to school.

Keep the athlete out of the play the day of the injury. Wait until an experienced health care professional says it is okay for the athlete to return.

Returning to Play

Concussions affect each person differently. Most athletes with a concussion recover quickly; however, some will have symptoms that last for days and possibly weeks. A more serious concussion can last for months or even longer.

The return to sports should be gradual. Athletes should only return under the supervision of a knowledgeable health care professional.

A licensed health care professional should monitor both the physical and cognitive activities—such as concentration and learning— until they give you and your athlete the green light.

Hidden Threats for Student Athletes

There are several other hidden threats for student athletes, besides concussions. One study says a young athlete dies from a cardiac incident once every three days in the United States. Moreover, in hot months, heat stroke often causes the death of a young athlete every other day on average.

Heat Stroke

Heat Stroke

One of the most preventable and treatable causes of death among student athletes is heat stroke, which is often brought on by intense activity in extreme temperatures. Researchers at the University of North Carolina found 31 high school football players died of heat stroke complications between 1995 and 2009. In 2011, six high school players died.

Here are some common signs of heat stroke:

  • confusion
  • irrational behavior
  • collapsing

To avoid heat stroke, take the following precautions:

  • Slowly get acclimated to the heat. Start with shorter workouts and then gradually increase the intensity and duration of the workouts.
  • Be fit. In other words, get in shape before pushing even harder in extreme heat.
  • Hydrate before, during and after workouts.
  • Rest in the shade.
  • Use cold wet towels or mist.
Cardiac Arrest

Sudden Cardiac Arrest

Sometimes sudden cardiac arrest happens in seemingly healthy athletes. In these cases, if often means the athlete has an undiagnosed condition, such as an enlarged heart or cardiomyopathy.

Many health professionals suggest athletic teenagers and young adults be screened for potential heart problems. The American Heart Association recommends a 12-point screen test that looks at family and personal history, as well as a physical exam. If a health professional finds those problems sooner than later, it may help prevent catastrophic cardiac events.


Before beginning this quiz, we highly recommend you review the module material. This quiz is designed to allow you to self-check your comprehension of the module content, but only focuses on key concepts and ideas.

Read each question carefully. Select the best answer, even if more than one answer seems possible. When done, click on the "Get Quiz Answers" button. If you do not answer all the questions, you will receive an error message.

Good luck!

1. _____ and _____ are normal with most concussions.

2. What could happen if a second concussion happens before completely recovery?

3. According to one study, a young athlete dies from cardiac incident once every _____ days in the United States.

4. Which of the following is a common sign of heat stroke?

5. When should you visit an emergency room with a concussion?

Have a great day!

Important! You will receive an "error" message unless all questions are answered.