Injuries are a fact of life in sport, but how they are handled by match officials can greatly affect how participants feel about the referee’s performance. Even when no foul is involved, managing injuries appropriately is an important part of officiating.
Stop play — Although players will often stop play as a courtesy, referees have full authority to stop a match immediately for any injury they consider serious. In youth games, impacts to the head, face, or legs that leave a player down should be treated seriously.
Assess the injury — Head and neck injuries require immediate attention and team staff should be called on without delay. Other injuries may only require assistance leaving the field. If play was stopped, that assistance must be allowed.
Stay attentive to the field — Once staff begin treatment, referees must still manage the game environment. Emotions may be high. The referee should stay within five to ten yards of the injury to supervise the situation while maintaining awareness of the rest of the players.
Choose your words carefully — Injury moments can be tense. Officials may need to reassure, calm, or instruct. Communication should be calm, professional, and thoughtful.
If there is blood — Safe sport practices must be followed. The player must leave the field. Wounds must be cleaned and covered, and any blood on clothing must be replaced. Blood on the playing surface must be removed before restarting the match.
After a head injury, it must be assumed that:
A concussion is a brain injury that can affect memory, vision, concentration, and overall well-being. Loss of consciousness is not required. Symptoms may include dizziness, confusion, nausea, headache, or unsteadiness.
Even mild impacts can cause concussions. If a player feels unwell but believes they can continue, this may still be unsafe. The safest rule is: when in doubt, keep them out.
A quick sideline assessment may help. The “Pocket Concussion Recognition Tool” can be downloaded here. If any listed symptoms appear, the athlete must be removed from play.
Most concussions resolve naturally over several days. Complete rest is required. Players must not return if symptoms remain.
A minimum of one day is required for each stage. If symptoms return, step back to the previous stage.
Children’s Hospital Emergency Department sees athletes up to and including age sixteen. Athletes age seventeen or older are evaluated at an Emergency Department or the Sport Medicine Centre.
In the event that an athlete experiences a suspected concussion, the following procedures should be followed:
1.) If the athlete has a suspected serious head or spine injury during a soccer game or practice - an ambulance should be called immediately to transfer the patient, if a youth, to Children’s Hospital Emergency Department, if 17 years old or adult to the nearest Emergency Department, (or an appropriate Emergency Department for those outside Winnipeg) for evaluation. After the initial evaluation, youth with a concussion may be referred to the Pan Am Concussion Program, and if 17 years old or an adult to the Sport Medicine Centre (145 Pacific Avenue, Winnipeg, MB, R3B 2Z6, 204.925.5944), for further follow-up.
2.) If the athlete develops symptoms of a concussion during a soccer game or practice but they are deemed to be non-life threatening, they should be evaluated immediately at the Children’s Hospital Emergency Department or nearest emergency room, if a youth, and 17 years old or adult at the nearest Emergency Department. If they are diagnosed with a concussion and further follow-up is required, youth will be referred to the Pan Am Concussion Program and 17 years old or adults can be sent to Dr. Kashefi at the Sport Medicine Centre, as they don’t require a referral.
3.) If the player develops delayed (days later) symptoms of a concussion, the athlete should be evaluated by a medical doctor (Emergency room physician, pediatrician, family physician). If necessary the medical doctor can refer the youth to the Pan Am Concussion Program and Dr. Kashefi at the Sport Medicine Centre can accommodate the 17 years old or adult patients, as they don’t require a referral.
In the event that an athlete experiences a suspected concussion and a trained athletic therapist or physician is present, the initial sideline concussion evaluation should be carried out using the Sport Concussion Assessment Tool 3 (SCAT3) to document initial neurological status. Regardless of SCAT3 testing results, all athletes with a suspected concussion must be evaluated by a physician and receive written medical clearance prior to returning to practice or gameplay.
Further contact information and instructions about how pediatricians, family doctors, and emergency room doctors can refer children to the Pan Am Concussion Program is available at www.panamclinic.org and for adults at the Sport Medicine Centre at www.sportmedicinecentre.ca Note: This information is based on scientific evidence produced by the FIFA Medical Assessment and Research Centre F-MARC. All recommendations are to be considered in tandem with your medical practitioner.
Remember - at an injury, many eyes will be on the referee, watching how you handle the stoppage.