There is hope that the light at the end of the tunnel is not an oncoming train. At last the IRB are introducing independent medics to improve their concussion protocol, and it will start on a trial basis in next week’s Junior World Championship in South Africa, as well as an age grade tournament in the USA. Surely once it is introduced we can leave behind the current format where team medics are expected to make calls that jeopardise both their players and their jobs.
The mechanics of this will involve the introduction of a head bin. It won’t be called that, but effectively that’s what it will be. So if a player is suspected of having his bell rung then he is removed immediately and assessed over a five minute period. That gives time for a standardised test to be carried out to assess if the player is concussed.
The key to this is that an independent doctor will make the call. In the first place, any of the following: the referee, team doctor, or the independent doctor, can ask for a player to be removed to the bin. Without an independent element this would be wide open to abuse: those who have had their brains scrambled would get a chance to unscramble them, and then rejoin the fray. Or others who are looking fatigued could opt out for a few minutes’ rest and then hop back on board when they’ve got their breath back. And they wouldn’t even have to fake a blood injury to get the break!
So while head bins on their own would be bad for business, factor in an independent voice and we’re on the right road. It will be interesting to see how it operates on the ground, for some concussions are missed completely if they coincide with another injury. In which case the victim staggers back to his feet and continues.
You’d imagine there will be teething problems. Where to position the independent medic to give him best sight of what’s going on may take trial and error. And he will need to have a direct line in to the referee, or the fourth official, so that he or she can stop play when an incident occurs.
It would be an idea too to earwig on the conversation pitch-side when the examination is being carried out. Off the record doctors have admitted to me that the pressure is acute to get injured players back on the field. The introduction of an independent medic should factor out the coach barking into his mouthpiece demanding that his star player get back on the park.
Clearly this won’t make the game itself any safer to play, rather it has the potential to protect players from themselves and their team doctors who are compromised. If we want to make the game safer then we will need to study carefully the incidents that most give rise to concussion, and then make law changes around them. I suspect front-on chest high tackles, while popular with the punters, is something we could do without.
What this trial should affect positively is the reduction of repeated trauma, the second impact syndrome. If we can close the window on a player getting a second concussive shunt minutes after picking up the first, then it’s a step in the right direction.
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