Concussion tests

[Browner]

George Smith returned to the field having passed a "concussion test" http://www.rugbydump.com/2013/07/3294/george-smith-knocked-out-by-richard-hibbard-on-wallaby-return , does anyone knows what this test consists of ....... & would it be appropriate if a suitably qualified person was present below Elite Level?

 

[crossref]

IMO The actions of the IRB are sending a consistent message that concussion isn't really much to worry about.
That worries me . Last season I witnessed a 16 yr old prop who had been clearly knocked out returned to the pitch after (imo) a completely cursory examination.

5 minutes later his team mates were so worried about him they asked for him to be taken off.

 

[Browner]

IMO The actions of the IRB are sending a consistent message that concussion isn't really much to worry about.
That worries me . .

Yep, similar to blood.

 

[crossref]

IMO The actions of the IRB are sending a consistent message that concussion isn't really much to worry about.
That worries me . .

Yep, similar to blood.

Indeed

 

[The Fat]

I'm not sure about our 2nd tier competitions in Australia but there is no concussion bin at community level rugby regardless of what brain surgeon may be attending the game.
If a player leaves the field having been knocked out or is showing signs of a possible concussion, his/her afternoon is over.

I had one a month or so ago in an under 15s game where I told the assistant coach that his player's night, following a head knock, was over and that someone needed to monitor him over the next few hours.
15 minutes later the kid was back on the field. When I told him to leave the field, the AR said that he had let him come back on because he thought I had only put him in the concussion/head bin to be assessed. My answer was "There is no head bin and even if there was, who was qualified to make the assessment?"

- - - Updated - - -

IMO The actions of the IRB are sending a consistent message that concussion isn't really much to worry about.
That worries me . Last season I witnessed a 16 yr old prop who had been clearly knocked out returned to the pitch after (imo) a completely cursory examination.

5 minutes later his team mates were so worried about him they asked for him to be taken off.

I'm hoping you were not the referee???

 

[Simon Thomas]

IRB - NO NO NO and NO.

This incident and allowing Smith to return after a 5 minute test, as specificed by the IRB for Elite Rugby, is wrong for Elite levels and any other level too.

A concussion can be very serious (and has been fatal) and needs careful treatment - having been there twice myself many years ago, I am forever thankful to the two blazers who stopped me from going back on (neither was a medical doctor). I dread to think of the one time I did return v Wasps in a very physical match and what might have happened - to this day I have no recollection of the match, or a few hours later being taken to Addenbrookes having thrown up in the Hawks Club afterwards drinking just water. I was kept in hospital for 48 hours observation.

Good article by Peter Fitz here including reference to Barry O'Driscoll, who resigned after 15 years as an IRB medical adviser recently directly related to the 5 minute test. "''We're going from being stood down for three weeks to one week to five minutes with players who are showing exactly the same symptoms. The five-minute rule came out of the blue. I couldn't be a part of it so I resigned from the IRB. It saddened me, but I couldn't have my name attached to that decision.''

 

[Phil E]

All Warwickshire Referees have one of these handy guides produced by the RFU.
Not sure how good it will come out?

View attachment 2591

anyone got the original pdf ?

 

[crossref]

I'm hoping you were not the referee???

Indeed not, or it would have been very different - this was - in IMO - about as bad as it gets. Apparent unconsiusness, staggering, confusion, personality change, the lot. He was flanker and the most effective player on the pitch, and then suddenly a passenger 10m behind the play. I couldn't beleive he played on. When his team conceded a try he sat down for a rest leaning against the posts and that's when his team mates insisted he left the pitch.

I was merely there to watch my son. injury was to a player in opposing team.

 

[TheBFG]

As a ref for a "mens" game, i'm pleased to say i operate at a level where there is always a "qaualified" medical staff member for each team and i would let them make the call (but would still over rule if i didn't think it was safe)

If no medical staff, anyone who was knocoked out/badly dazed would not come back on.

In a youth game, as a ref, i would never let a player back on and if a coach didn't like it, tough, take it up with the CB :wink:

 

[Jacko]

Possibly stupid question from a non-medic:- Is it possible to be knocked unconscious and not suffer from a concussion?? If it is, and this test can reliably identify someone who has been knocked out but it has not resulted in a concussion, then fair enough.

No test at my games, so anyone knocked out goes off. In fairness to the medics, I cannot remember the last time it was me who had to insist against their wishes. The player involved wishes are a different kettle of fish...

 

[Simon Thomas]

No test at my games, so anyone knocked out goes off. In fairness to the medics, I cannot remember the last time it was me who had to insist against their wishes. The player involved wishes are a different kettle of fish...

good to hear Jacko , same at Group Level 5 in my experience - any serious head injury with even possible concussion, the coaching staff get them off, however much they may wish to stay on.

 

[crossref]

Normally I don't think this is an issue: in last several seasons I can only remember once having to force a player off the pitch against the wishes of the coach/medic.

 

[barker14610]

Possibly stupid question from a non-medic:- Is it possible to be knocked unconscious and not suffer from a concussion??QUOTE]

No. It looked like Smith got hit on the jaw. Right where a boxer aims. No direct blow to the head but the brain still suffers trauma as it rebounds in the skull.

 

[crossref]

IRB - NO NO NO and NO.

This incident and allowing Smith to return after a 5 minute test, as specificed by the IRB for Elite Rugby, is wrong for Elite levels and any other level too.

A concussion can be very serious (and has been fatal) and needs careful treatment - having been there twice myself many years ago, I am forever thankful to the two blazers who stopped me from going back on (neither was a medical doctor). I dread to think of the one time I did return v Wasps in a very physical match and what might have happened - to this day I have no recollection of the match, or a few hours later being taken to Addenbrookes having thrown up in the Hawks Club afterwards drinking just water. I was kept in hospital for 48 hours observation.

Good article by Peter Fitz here including reference to Barry O'Driscoll, who resigned after 15 years as an IRB medical adviser recently directly related to the 5 minute test. "''We're going from being stood down for three weeks to one week to five minutes with players who are showing exactly the same symptoms. The five-minute rule came out of the blue. I couldn't be a part of it so I resigned from the IRB. It saddened me, but I couldn't have my name attached to that decision.''

great article, but I completely disagree with

I repeat: I accept the medical professional involved, who gave Smith the PSCA test, acted with integrity. He or she is not the problem. This newly instituted test is. And I am not the only one horrified

a medical professional needs to the integrity to make their own judgement whether a player is fit to play. 'because the IRB told me to' is simply not an excuse. IMO

 

[Taff]

George Smith returned to the field having passed a "concussion test" .... does anyone knows what this test consists of?

I thought the IRB produced quite a handy document regarding concussion a couple of years ago. I have printed it off but don't have it to hand.

TBH I thought it was put on the RR.com Wiki, but can't find it right now. Have a quick scroll through the "Wiki" pages (link at the top of this page) and if you've got a few minutes have a look through. Even if it's not there, I can virtually guarantee that you will stumble across something else you'll find useful anyway. :biggrin:

 

[Dixie]

This was Davet a year ago:

In the community game, if the refereee feels that such an assessment would be justified then I would expect him simply to remove the player from the field permanently, for safety reasons.

I would NOT want this to mean that a player with a bang to the head goes off for 5 mins rest and then comes back on.

Pity that the iRB does not match his wisdom . That thread also contains this:

IRB Chief Medical Officer Martin Raftery said: "The safety and welfare of our players is of paramount importance for the IRB and its 118 Member Unions. As a sport, we have been driving forward concussion management development and best-practice policy over the past decade but we can always do more to protect our athletes.”

"The advantage of this new procedure is that it enables an extra layer of protection for our athletes while delivering for the first time a standardised process of examination and assessment that doctors will follow. The five minute window is ample time and will deter tactical manipulation and will not impact on the shape and character of the Game."

"It is important to remember that these trials are not a fait accompli and we will undertake a thorough analysis of the results at the end of the IRB Junior World Championship and IRB Junior World Rugby Trophy. I would like to thank all the participating Unions and their doctors for their commitment and enthusiasm for this trial."

The IRB has been at the forefront of driving forward sport concussion research, policies and guidelines in recent years. In 2011 the IRB introduced revised protocols governing concussion evaluation and Graduated Return to Play guidelines. It also launched a fully interactive concussion management education website for players, coaches and doctors, www.irbplayerwelfare.com.

Perhaps the Oxford English Dictionary might care to adopt this as an example of Hollow Words.

Oh - and Heeeeerrrrrreeeees Bryan:

I'll also be honest in saying players arent stupid; they want to play and know the standardized questions by now for a concussion assessment, so some will be smart (or stupid?) enough to dodge their way out of it in order to keep playing.

 

[Rushforth]

http://www.irbrugbyready.com/index.php?section=69&tab=tab-6 ?

 

[Blindpugh]

Some of you may have followed the recent IRB Junior under 20 World Cup and seen the Wales scrum half being "knocked out" by knee to head from his own LH prop when trying to tackle the Argentinian full back?

That was my son Josh and as I sat watching with my wife my first thoughts were I hope he is alright and then shit he is going to be out for 3 weeks. I was pleased when medic gave thumbs up to coaches and he walked back (gingerly) to posts.

I watched him closely for final 10 minutes and there were no after effects and Wales went on to beat Argentina.:biggrin: He had a headache after game and next day but was monitored closely (unable to go go karting etc) and then had series of tests before being declared fit to play against South Africa.

Carwyn Jones second row also suffered concussion and was ruled out of semi final because he failed the balance test.

Until recently I refereed at grassroots level (6) and in my pre match check I would establish the level of cover provided. If it was a qualified Doctor I was happy for them to make assessment but if I saw any Bambi like actions then I had no hesitation to have player replaced.

I was surprised George Smith was allowed back on field and wonder how much pressure these medics are under to confirm they are ok to continue?

 

[Browner]

There must be some research that justified the 5 min test ? http://www.canada.com/news/School+b...yer+dies+after+head+injury/8376953/story.html

 

[damo]

NZRU Domestic Safety Law Variations

Applicable to all levels of New Zealand domestic rugby.
Does not apply to International and Investec Super Rugby.
9. THE REFEREE'S POWER TO STOP AN INJURED PLAYER FROM
CONTINUING
(a) If the referee believes a player has been concussed or suspects a player
has been concussed, the referee must order that player to leave the
playing area. That player must not return and play in that match.

None of this 5 minute business here either. No discretion for the referee. If he suspects a player has been concussed then forget it, no amount of medical intervention can get him back onto the field.

I'll let the internationals deal with their laws in their own way, but frankly I was less than impressed when Smith came back onto the field.