Hawaii's official youth lacrosse league, AYLA is a member of US Lacrosse with teams in age groups from kindergarten through high school. This is a volunteer run organization.





U.S. Lacrosse recommends that each team, club, and league develop a Concussion Action Plan.  A Concussion Action Plan (CAP) is a plan that coaches, parents, league stakeholders will follow when an athlete is suspected of having a concussion.  The CAP ensures a uniform care of athletes with a suspected concussion across the Aloha Youth Lacrosse Association (AYLA).  It is imperative that coaches review and understand the CAP to ensure the health and safety of their athletes



A concussion is a traumatic brain injury induced by biomechanical forces such as a direct hit to the head or to the body. Some features of a concussion:1


  • Concussion typically results in impairments that may vary in length.The impairments usually resolve spontaneously.

  • Concussion signs and symptoms affect brain function rather than structural injury therefore no abnormalities are seen on neuroimaging (CT Scan, Radiographs, MRI)

  • Concussion result in a range of signs and symptoms that may or may not involve loss of consciousness.



As defined in ACT 262 Hawaii Concussion Law, a “coach is an individual who is paid or a volunteer in working for, assisting, or managing a sports team for school athletics or youth athletic activity.”




For AYLA Board/Commissioner/Area Presidents

  • Board shall organize distribution of CAP to prospective coaches and teams

  • Area Presidents shall ensure designated coaches’ CPR/AED certifications are current

  • Commissioner shall organize preseason coaches meeting

  • Area Presidents shall develop emergency transportation plan for game/competition and practices sites.

  • Board shall organize and distribute packet of CMP documents to all coaches

    • CMP

    • CRT5

    • Concussion injury documentation form

    • Notice to parents if athlete is suspected of having a concussion

    • Gradual return to play protocol

  • Board shall ensure parents have received concussion education and awareness information. Information can be provided through:

    • HCAMP BrainSpace course for Parents (online)

    • U.S. Lacrosse CDC HEADS UP handout


For coaches

  • Prior to the first practice coaches need to complete a concussion education and awareness session.

    • HCAMP BrainSpace course for Coaches (online)

  • Coaches must check protective equipment for appropriate fit at the start of the first practice.It will be at the discretion of the coach how often appropriate fit of equipment will be checked.

  • Prior to the first game, coaches shall discuss with athletes:

    • Importance of reporting concussions

    • Importance of reporting a teammates’ concussion

    • Training on lacrosse contact rules, sportsmanship and avoiding dangerous and risky behaviors on the field of play


For parents

  • Prior to first practice, parents are highly encouraged to complete a concussion education and awareness session

  • Parents are responsible for equipment maintenance and inspection.

  • Parents are encouraged to be an “extra set of eyes” on the field and report any player who may have a suspected concussion




When a concussion is suspected

  • Athlete must be removed from participation and shall not be allowed to return to play that same day.

  • A coach familiar with signs and symptoms of a concussion should monitor athlete suspected of having a concussion.Coaches should monitor athlete using the Concussion Recognition Tool 5 (CRT5).

  • Athlete with a suspected concussion should not be left alone or allowed to drive home on their own.

  • Parents should be notified of the concussion event as soon as possible.Parent notification form must be filled out and given to parent with copy of form/photo given to AYLA Presiden.

  • Athlete may not return to participation until a written medical clearance is obtained.


911 MUST be called when in the event of any of the following

Loss of consciousness

Pupils are unequal in size

Slurred speech

Eyes sensitive to light

No breathing or pulse noted

Repeated vomiting

Worsening headaches

Fluid coming out of ears and/or nose

Numbness in arms or legs


Suspected neck injury

Increasing confusion


Coaches should not be hesitant to call 911 if they feel unsure


When calling 911 from practice and game site

  • Be sure to provide name, age, nature of injury.

  • Be familiar with game site and nearby streets.

  • Have a coach wait and meet ambulance on roadside and direct to injured athlete.

  • Anytime 911 is called/activated Head coach must contact league organizer via phone within 24 hours.

  • Head coach will also need to document event and submit to AYLA Board President via email within 24 hours.


Documentation of concussion event

  • Within 24 hours of an injury event form should be filled out and submitted to AYLA Board President via email.

  • When a written medical clearance is obtained, the written clearance must be emailed to AYLA Board President prior to returning to practice or participation in first game.




Prior to returning to participate or engage in any organized team activity

  • A written medical clearance must be obtained from a licensed health care provider.Parent notes are not accepted under any circumstances.

  • The written clearance must be emailed to AYLA Board President prior to returning to unrestricted practice or participation in first game.

  • Athlete must be in school full time without any academic adjustment or accommodations.


Gradual Return to Play Protocol

  • A gradual return to play program MUST be implemented prior to full-unrestricted participation.

  • Coaches should monitor the Gradual Return to Play process.

  • If athlete presents any signs or symptoms during the gradual return to play program, athlete should be removed from activity and parents should be notified.

  • Each Step is separated by a 24-hour period.It may take an athlete 4 practices or more before unrestricted activity is allowed.


Written Medical Clearance obtained

NO symptoms reported for at least 24 hours


Step 1

Light aerobic activity: 10 minute slow to moderate run

Increase heart rate

Step 2

Sports Specific exercises: Strenuous running, basic drills, no contact

Increase activity and movement

Step 3

Non Contact Training drills:  Harder drills and activities

Exercise, coordination, and increase thinking.

Step 4

Full contact practice:  Normal training activities

Restore confidence and assessment of skills by coach

Step 5

Unrestricted activity



1.             McCrory P, Meeuwisse W, Dvorak J, et al. Consensus statement on concussion in sport-the 5(th) international conference on concussion in sport held in Berlin, October 2016. British journal of sports medicine. 2017;51(11):838-847.