Should Players who loose consciousness from Head Injuries be immediately Subbed?

Stev_o

This is becoming a scary epidemic that really has gone unmentioned by the IRB or anyone else for that matter.

Today BOD was knocked out after a tackle on Rougiere after making contact with his hip. He obviously lost conciousness for a split second and of course the medics rushed on. There therapy for this was smelling salts. BOD played the rest of the match.


In a number of years time what will the end result be of this reckless practice of leaving players who are clearly concuss on the field? Bernard Jackman addressed this issue in his book saying that coaches put pressure on players to play on.

Should the IRB implement a rule that IF a player is knocked out the REFEREE should force a substitution for that player not the coaches.

In 10 years time or even less we will be hearing about a lot of players complaining of serious side effects of this practice, hell i doubt BOD will be able to remember him lifting the 6N Trophy in Cardiff.

ScrubsfanChris

Mabey a Head-injury sub like a blood sub should come in.
Take player off, do all the necessary checks, wait a few minutes then bring him back on.

Eoin

I think that's more a question for medical professionals rather than rugby fans.

Stev_o

ScrubsfanChris wrote: »

Mabey a Head-injury sub like a blood sub should come in.
Take player off, do all the necessary checks, wait a few minutes then bring him back on.

But who's checking the player? IRFU paid doctors or a independent Neurologist.

I very much think we need to be looking at what the NFL currently has implemented and start trialling that system out.

Chucky the tree

It's a huge issues in the NFL at the mount. The problem is it takes a few years for the effects to be noticed. Anyone who is knocked out should be subbed and there should be a independent doctor on the side of the pitch to check someone over, if he says no then he can't come back on. This year Alain Rolland told a team he wasn't happy with a player condition and wanted him subbed, it's a few other times before but refs should be far tougher on it.

Stev_o

Chucky the tree wrote: »

It's a huge issues in the NFL at the mount. The problem is it takes a few years for the effects to be noticed. Anyone who is knocked out should be subbed and there should be a independent doctor on the side of the pitch to check someone over, if he says no then he can't come back on. This year Alain Rolland told a team he wasn't happy with a player condition and wanted him subbed, it's a few other times before but refs should be far tougher on it.

Happened with Simon Webster in 2008 where he knocked himself out and stayed on and he started throwing up 5 minutes later on.

Dr.Evil

Personally I think they should. Look at the amount of trouble with players like Fogarty and Jackman now. Players will say they're fine, but you won't know for sure. Better to be safe, especially in today's game.

theboss80

The referees first and foremost responsibility, regardless of the game , is the safety of the players. If it is compromised then a substitution must be made.

theoneeyedman

i think there is a rule where a player knocked out not only is replaced but must sit out for 3 weeks as a precaution. this is not enforced prob cause of some creative doctoring from teams. somone can prob confirm if this rule is still in force or not

CatFromHue

theoneeyedman wrote: »

i think there is a rule where a player knocked out not only is replaced but must sit out for 3 weeks as a precaution. this is not enforced prob cause of some creative doctoring from teams. somone can prob confirm if this rule is still in force or not

thats the old rule.

now players do some reaction/psyco-metric tests at the start of the season. if they get a hit to the head during the season they have to do the test again. if there score is 5% or so lower they have to take time off.

if you ask me neither rule is perfect. honestly until we understand more about concussion we're pissing in the wind.

clsmooth

CatFromHue wrote: »

thats the old rule.

now players do some reaction/psyco-metric tests at the start of the season. if they get a hit to the head during the season they have to do the test again. if there score is 5% or so lower they have to take time off.

if you ask me neither rule is perfect. honestly until we understand more about concussion we're pissing in the wind.

Jackman was saying players purposely do poorly on these tests in pre-season so its easier to pass and if they fail it on a Monday they can repeat it on a Tuesday etc

thomond2006

The International Rugby Board are in the final stages of drafting a "robust" set of guidelines to tackle the on-field treatment of suspected concussion.

The initiative will go before the IRB council in March and is designed to ensure there will be no repeat of the situation that occurred with Chris Ashton last November.

The England wing took a heavy blow to the head against South Africa but played on after passing some on-field tests, despite referee George Clancy wanting him to be replaced.

Diagnosing the severity of a head injury in the heat of a rugby match is difficult, particularly when a player is anxious to remain on the field.
Ashton has since admitted to "putting a very good act on" because he did not want to be replaced but he has very little recollection of the match.

The IRB's new procedure will state a player must be removed from the field and not return if there is any doubt about his condition.

The guidelines will cover all levels of the game and referees have been reminded of their responsibility to demand players be replaced if required.

Injury audit

An injury audit conducted jointly by the Rugby Football Union, Premiership Rugby and the Rugby Players' Association shows concussion to be in the top five most common injuries in the game.

"If there is any doubt you should not take risks with a player's life," said an IRB source.

The idea of so-called concussion bins to allow medics more time to examine an injured player will not be introduced.

It is understood the IRB fear concussion bins would be open to abuse, just as the temporary blood replacement system was in the infamous Harlequins Bloodgate saga.

The RFU's Image of the Game task-force, set up in the wake of Bloodgate, proposed the introduction of rolling substitutes to assist medics in diagnosing concussion.

But Simon Kemp, the RFU's head of sports medicine who has been part of the IRB's working group, believes the new guidelines will make the protocols clear.

"The IRB are at the final draft stage on a new set of concussion guidelines that I expect would flag up the importance of players with symptoms of suspected concussion being removed from the field of play," Kemp said.

Best practice

"Our management of players once they have come off the field of play is according to best practice.

"There are particular challenges around assessment in a game in which the potential for concussion is so high and players get dings the whole time.

"There are some challenges around making decisions in a short period of time on a pitch with a player who is often engaged in the next play.

"It will be the focus of a very robust initiative. I am very confident the position we will get to will be entirely adequate."

The injury audit, published on Monday, showed a 20 percent reduction in the likelihood of a player being injured in a match last season compared with 2008-09.

The total number of injuries reported fell to 636 from 769, or an average of 1.6 per team per match.

http://www.skysports.com/story/0,19528,12333_6753140,00.html

Stev_o

Stev_o wrote: »

Happened with Simon Webster in 2008 where he knocked himself out and stayed on and he started throwing up 5 minutes later on.

The aforementioned incident

https://www.youtube.com/watch?v=OwEZLKA1Suc

I'm no doctor, but there's no way anyone should be allowed stay on the pitch in that state. He was on for 10 minutes after the incident.

I think that a "head bin" a la "blood bin" would be a good idea alright.

Risteard

I think if there's any doubt about a head injury then the player should be taken off.

I remember at the Toulon game in January I saw Paul Warwick getting up after receiving attention and he was holding onto the medic trying to get his balance and was subsequently subbed at half time.

I'm not a doctor but certainly if a player is in such a bad state that he can't regain his balance without the help of someone, then he must be taken off.

We all take our rugby fairly seriously I suppose but at the end of the day the safety of players is the primary concern.

Stev_o

Im a bit worried about these rules the IRB are about to announce.

I still think that a player should be IMMEDIATELY taken off the pitch for assement if they do sustain such a injury. They say they are afraid for a repeat of BloodGate but surely then they should relealise that the medical staff are under pressure to keep players on the field and not off it and i bet they ll be pressurised to keep a suspected player on the field if it means bending the laws.

Independant Neurologists need to be employed for this sort of stuff.

yimrsg

That video shows just how good a referee Alain Rolland is. An almost carbon copy tackle in the air happened to Lee Byrne happened on the weekend by Southwell and yet he was bloodsubbed for Lamont who came on.

Also he has the confidence/experience/whatever/knowledge to tell say he wants Webster off the pitch, clearly looking out for the players health.

An independant doctor should be perhaps included as a method of halting false or convenient injuries from occuring and also for the players health without any potential bias from a team doctor.

Gracelessly Tom

yimrsg wrote: »

That video shows just how good a referee Alain Rolland is. An almost carbon copy tackle in the air happened to Lee Byrne happened on the weekend by Southwell and yet he was bloodsubbed for Lamont who came on.

This is not the same at all, Southwell was not concussed, he simply had his face cut by the boot/studs of Byrne and therefore had to head to the bloodbin for stitches.

But he should have been binned...

yimrsg

Gracelessly Tom wrote: »

This is not the same at all, Southwell was not concussed, he simply had his face cut by the boot/studs of Byrne and therefore had to head to the bloodbin for stitches.

As Emmet said a player taken out in the air and the perp leaving the field with medical attention in both instances. One got a yellow, one didn't. Rolland had the decency not to yellow card the player on the stretcher.

I just think he did the right thing and managed the whole situation much better than Clancy.

jdivision

The long-term effects of concussions can take ages to set in but their effects are scary. I retired after my sixth, I played through four of them. In one case I don't just not remember the game after about the third play, I don't remember the two days afterwards either. Players who are concussed need to be taken off immediately and need proper treatment afterwards.
Nobody wants to end up like Mike Webster
http://espn.go.com/classic/obit/s/2002/0924/1435977.html

RuggieBear

yeah i'm the same. more or less retired due to too many concussions and other bangs to the head. After my last game during which my head hit the hard august ground, I had a headache for 2 days and vomited every other hour or when bright light hit me...that was the final straw for me.

Hazys

Concussions haven’t always been an issue in the NFL, the worst thing is that it wasn’t seen as a real injury and if you were a real player it wouldn’t stop you from playing on. It’s only in the past season the NFL has taken concussions seriously. Players with suspected concussions were taken out of the game and evaluated all week to see if it was safe to go the next Sunday.

This season is the only time I can recall any players to miss a game due to concussion. For my team the NE Patriots this season, we had 3 players suffer concussions. Danny Woodhead suffered a suspected concussion in a game and was taken out for the game but we cleared to be back the next week. Dan Connelly suffered a concussion in a game, missed 4 weeks and was able to come back for the playoffs. Mike Wright suffered a concussion in a game was out for weeks and the team hoped he could come back near the end of the season but 6 weeks after the concussion he couldn’t sit in a room with bright lights or watch TV, so they called his season over. Hopefully Mike Wright has no long term effects and he'll be back next season. What’s scary is 3 players suffered concussions this season for my team; I can’t remember any who missed games in previous seasons...so how many players played with concussions in past seasons? my guess is a lot.

The NFL only started taking concussions seriously after a GQ article released shocking facts of past NFL cover-ups and generally ignorance to the seriousness of concussions. Mike Webster (who jdivison highlights) is featured heavily in the article, suffered multiple concussions tru his career and suffered massively from depression and mental issues.

I highly recommend reading the GQ article, its scary stuff: http://www.gq.com/sports/profiles/200909/nfl-players-brain-dementia-study-memory-concussions

Luckily somewhat for rugby is that it’s a different game to the NFL, where there is no use of helmets and tackling and hits are different so from what we know concussions would be less frequent (tbh I’m only guessing, there doesn’t appear to be any studies of concussions in rugby). But the IRB should play it safe rather than sorry because the long term effects of professional rugby are unknown. The average life expectancy of an NFL player who plays 10 seasons is between 53-59 (depending on position); the average life expectancy of a professional rugby player who plays 10 seasons is unknown.

Although saying that, other sports that look less violent than rugby and NFL are suffering from concussion like NHL and the MLS (soccer). Marc Savard of the Boston Bruins for the 2nd season in a row has finished early due concussions. Even more surprisingly soccer player Taylor Twellman of the NE Revolution has retired from playing soccer after suffering multiple concussions and they say only because his doctors (who treat NFL players also) had extensive knowledge on concussions was it ever considered for a soccer player retire from the sport because of concussions.

The worst thing about BOD playing on with a suspected concussion is, if he gets a second concussion while being concussed, he could suffer serious brain damage. There was an ESPN documentary on a College Football player who got concussed one week in practice, never told the doctors, used pain killers all week because he couldn’t look at bright lights, went out the next game suffered a massive blow to the head and is knocked out cold...unfortunately he suffered major brain damage and now lives with severe neurological deficits.
http://www.whatsgoodblog.com/2010/05/danger-football-concussion-traumatic-brain-injury/

toomevara

Eoin wrote: »

I think that's more a question for medical professionals rather than rugby fans.

As one of the above, the answer is incontrovertibly and emphatically yes. Any LOC and a player has no business on a field of play.

Gracelessly Tom

yimrsg wrote: »

As Emmet said a player taken out in the air and the perp leaving the field with medical attention in both instances. One got a yellow, one didn't. Rolland had the decency not to yellow card the player on the stretcher.

I just think he did the right thing and managed the whole situation much better than Clancy.

Sorry, slightly misunderstood your original post, I thought you were saying the Southwell was concussed. My bad.

Fully agree with yourself and Emmet, should definitely have been a yellow for Southwell, how one wasn't issued is beyond me!