IRB welcomes Zurich Concussion recommendation

(IRB.COM) Friday 3 May 2013
IRB welcomes Zurich Concussion recommendation

  • Leading forum endorses Rugby’s approach
  • IRB and Unions committed to driving best-practice
  • Player welfare central to the growth of the Game
The International Rugby Board welcomes the recommendations of the Zurich Conference on concussion management in sport.

The world’s leading forum on the subject, of which the IRB is a co-sponsor, endorsed Rugby’s proactive and innovative approach to educating and protecting its athletes when it comes to head knocks.

The Consensus Statement on Concussion in Sport; the 4th International Conference on Concussion in Sport held in Zurich, November 2012, outlines the best practices to evaluate and treat concussion during sporting events and in a clinical setting. The statement also outlines the consensus agreement on the best way to evaluate, diagnose and manage a possible concussion.

The statement confirms that athletes should not be allowed to return to play after a diagnosed concussion and should not return to play or train on the same day and goes on to outline an approach to help physicians determine when an athlete might be safe to return to sport.

This is entirely consistent with the IRB’s approach under the guidance of the IRB Medical Commission, featuring top sports physicians and independent experts. The commission has driven key revisions to IRB Regulation 10 including concussion management and return to play protocol guidelines and importantly education best-practice for elite and community Rugby.

Regulation 10 features a two-pronged approach to protect players at both the elite and community levels. Where concussion is diagnosed, a player must be removed from the field of play and not return to play or train on the same day and must be guided through a dedicated return to play protocol.

All players with suspected concussion where there is no appropriately qualified person is present to diagnose concussion must be removed from the field of play and not return to play or train on the same day and should be reviewed by an appropriately qualified person and then should complete the graduated return to play protocol described in the IRB Concussion Guidelines.

An additional layer of protection for elite athletes is currently being trialed in competitions around the world. The Pitchside Suspected Concussion Assessment (PSCA) is designed to standardise the assessment of players in an elite match environment in line with the Zurich recommendations.

IRB Chairman Bernard Lapasset said: “As custodians of the sport we have a responsibility to ensure the highest-possible standards of welfare and medical support for our athletes at all levels and for contact sports the diagnosis and management of concussion is a top priority.”

“We have made strong advances in core concussion policies, including Game-wide education and the PSCA are positive advances that put players first and ensure that Rugby is at the forefront of this critical area, but we continue to strive to do more.”

IRB Chief Medical Officer Martin Raftery added: “The Zurich Conference is the leader in sports concussion discussion, evaluation and best-practice and the IRB is delighted to play a prominent role in the process. It is positive to see the statement endorse Rugby’s approach.”

“Progressive changes implemented by the IRB and its Unions include a review of the concussion regulation, development of concussion guidelines, production of an online concussion education tool, the introduction of a trial of the new PSCA process in elite competitions and the commissioning of research into long-term health outcomes in Rugby players. All of which have player welfare at their core.”

The IRB's proactive work on concussion management is part of a holistic approach to player welfare driven by the IRB's annual Medical Commission Conference. Current priority areas include the development of an expert group to establish Game-wide injury prevention strategies, standardising the role and training of the match day doctor and delivering comprehensive education and training materials.

Pitchside Suspected Concussion Assessment (PSCA) trial

The recommendation to remove the player can be made by either the referee, the independent match day doctor or the team doctor from the player's team. Once that command is made, the referee will indicate that the player is leaving the field of play with a hand signal where he touches his head three times.

Once the player has been removed from the field of play and temporarily replaced, the team and independent match doctors will proceed through an IRB pitch side concussion assessment procedure incorporating standardised questions and observations.

If the player fails any aspect of the assessment and has relevant symptoms he will not be able to return to the field of play and the substitution becomes permanent.

The IRB Executive Committee permitted dispensation for Unions to trial the PSCA during the November 2012 international window and the trial currently operates at elite selected competitions worldwide.