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Grade 1: "Ding" or "Having Your Bell Rung"
The athlete is conscious at all times, but dazed, foggy, or fuzzy. The player may miss one or two items in the concentration test, but shows no confusion or memory loss. Ask the concentration questions again in 10 minutes, and again in another 10 minutes. If the athlete answers all questions correctly, passes all neurologic tests, and has no recurrence of any symptoms with the exercise test, you can consider allowing the athlete to return to play.
A second "ding" in the same game or practice requires a trip to the emergency room. If someone from the side-lines or stands offers to evaluate a player to see if he/she can go back into a game, remember that only a physician (MD/DO) or licensed certified athlete trainer has the education and experience to make that evaluation.
If a player suffers a second "ding" in the same season, he/she should not return to activity until seen and cleared by a physician.
No matter how minor the head injury, notify the family about it and about potential symptoms, do not rely on the athlete. A responsible person needs to watch for delayed problems.
Regardless of others' recommendations, if your gut feeling tells you to bench a player, do not let anyone - not players, parents, coaches, fans, or circumstances - change your mind. You are never wrong to keep a player out of a practice or game. It is the safest option.
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