The Aviva Premiership Rugby season kicks off this weekend with a new Head Injury Assessment protocol.
The 2014-15 season will see the IRB Head Injury Assessment (HIA) supersede the Pitch Side Concussion Assessment (PSCA) that was trialled in 2012-13 and 2013-14 in order to further enhance the pitch-side head injury assessment process.
A recent independent peer reviewed study published in the British Journal of Sports Medicine (BJSM) showed that the number of players left on the field of play that were later diagnosed as having concussion reduced from 56% to 12%. This reduction can be largely attributed to the combined strategy of education and implementation of the research driven assessment. The findings of this study have enabled further enhancements to be made to the global process.
The HIA will see two components of the PSCA expanded, with the memory tests being strengthened and the balance test altered to increase the level of information that doctors have available to them in order to make return to play decisions.
In order to accommodate these components and following a successful trial, the time permitted in order to undertake the assessment has increased from five to ten minutes.To support these advances, other league-wide enhancements have been made;
Substitution cards for every match have now been changed to make the identification of head impacts clearer for review. Substitution cards will now have separate columns for "Injury”, "Blood Replacement”, "Head Injury Assessment” and "Confirmed Concussion” making it easier for concussive incidents to be classified and reviewed post match.
All stadia will be fitted with video equipment that will enable team doctors - during the 10 minutes - allowed to review the incident as part of the head injury assessment, to further enhance the decision making process.
The HIA will also be used in the LV= Cup, European games and Test matchesPremiership Rugby Director Phil Winstanley said: "We put player welfare right at the top of the agenda within Aviva Premiership Rugby. The success of the PSCA over the past two seasons is significant, the new HIA proves that with extended time and amended processes our medics can be even more accurate in their clinical decision making.
"The HIA does not allow a player demonstrating concussive symptoms to be examined. Any player demonstrating these symptoms must be removed from the field of play immediately.
"The HIA is a tool derived to aid doctors in reaching an informed decision about the player. It does not make the clinical diagnosis but forms part of the information to allow the doctor to do so.”
Information on Substitutions
1. Injured (Including Concussion)
Can be replaced only with players on the bench not previously used, (except front row players used for a tactical replacement may go back onto the field of play in the event of an injury to a front row player). The player cannot return to the field.
2. Tactical
Can only be replaced by players on the bench not previously used. Can the player be used again? Yes to replace a player leaving the field for Blood, HIA or Front Row substitution.
3. Blood (15 Minutes)
Can be replaced by any player who has not been removed due to injury (i.e. including those already removed for tactical reasons). Can he be used again? No but he can return in 15 minutes. If the player does not return the temporary replacement becomes permanent.
4. HIA (10 Minutes)
Can be replaced by any player who has not been removed due to injury (including those removed for tactical reasons). However,
A. The temporary replacement may NOT take a penalty kick for goal or conversion until such time as the replacement is confirmed as permanent.
B. If the temporary substitute is given a red or yellow card, the penalty associated with the infringement will apply to the player undergoing the HIA. Can he be used again? No but he can return in 10 minutes. If the player does not return the temporary replacement becomes permanent.
The 2014-15 season will see the IRB Head Injury Assessment (HIA) supersede the Pitch Side Concussion Assessment (PSCA) that was trialled in 2012-13 and 2013-14 in order to further enhance the pitch-side head injury assessment process.
A recent independent peer reviewed study published in the British Journal of Sports Medicine (BJSM) showed that the number of players left on the field of play that were later diagnosed as having concussion reduced from 56% to 12%. This reduction can be largely attributed to the combined strategy of education and implementation of the research driven assessment. The findings of this study have enabled further enhancements to be made to the global process.
The HIA will see two components of the PSCA expanded, with the memory tests being strengthened and the balance test altered to increase the level of information that doctors have available to them in order to make return to play decisions.
In order to accommodate these components and following a successful trial, the time permitted in order to undertake the assessment has increased from five to ten minutes.To support these advances, other league-wide enhancements have been made;
Substitution cards for every match have now been changed to make the identification of head impacts clearer for review. Substitution cards will now have separate columns for "Injury”, "Blood Replacement”, "Head Injury Assessment” and "Confirmed Concussion” making it easier for concussive incidents to be classified and reviewed post match.
All stadia will be fitted with video equipment that will enable team doctors - during the 10 minutes - allowed to review the incident as part of the head injury assessment, to further enhance the decision making process.
The HIA will also be used in the LV= Cup, European games and Test matchesPremiership Rugby Director Phil Winstanley said: "We put player welfare right at the top of the agenda within Aviva Premiership Rugby. The success of the PSCA over the past two seasons is significant, the new HIA proves that with extended time and amended processes our medics can be even more accurate in their clinical decision making.
"The HIA does not allow a player demonstrating concussive symptoms to be examined. Any player demonstrating these symptoms must be removed from the field of play immediately.
"The HIA is a tool derived to aid doctors in reaching an informed decision about the player. It does not make the clinical diagnosis but forms part of the information to allow the doctor to do so.”
Information on Substitutions
1. Injured (Including Concussion)
Can be replaced only with players on the bench not previously used, (except front row players used for a tactical replacement may go back onto the field of play in the event of an injury to a front row player). The player cannot return to the field.
2. Tactical
Can only be replaced by players on the bench not previously used. Can the player be used again? Yes to replace a player leaving the field for Blood, HIA or Front Row substitution.
3. Blood (15 Minutes)
Can be replaced by any player who has not been removed due to injury (i.e. including those already removed for tactical reasons). Can he be used again? No but he can return in 15 minutes. If the player does not return the temporary replacement becomes permanent.
4. HIA (10 Minutes)
Can be replaced by any player who has not been removed due to injury (including those removed for tactical reasons). However,
A. The temporary replacement may NOT take a penalty kick for goal or conversion until such time as the replacement is confirmed as permanent.
B. If the temporary substitute is given a red or yellow card, the penalty associated with the infringement will apply to the player undergoing the HIA. Can he be used again? No but he can return in 10 minutes. If the player does not return the temporary replacement becomes permanent.
