The International Rugby Board (IRB) have released a statement detailing their commitment to ensuring that the concussion management procedure, that has been on trial, is being applied properly and will continue to improve and maintain player safety.
There was a fair amount of critism levelled at the IRB following the Wallabies-Lions third Test when Wallaby flanker George Smith was clearly knocked out, but allowed to return back to the field and play on. The IRB took note, and have released a statement, which you can see in full below.
The International Rugby Board and its Member Unions have reaffirmed their commitment to ensure best-practice concussion management procedure delivery by undertaking a full review of the first year of the application of the Pitchside Suspected Concussion Assessment (PSCA) protocols to further enhance the delivery of the important player welfare tool.
The PSCA is designed to give teams and match doctors time to assess cases in which concussion is not immediately apparent and since its introduction as a global trial in 2012 has proven highly successful, leading to 25 per cent more players being removed from the field of play permanently following a head impact.
The review, which will be overseen by the PSCA Working Group, is designed to assess the PSCA functionality and compliance, obtain feedback from Team Doctors and collectively ensure that the correct procedures are followed to ensure clear and consistent management of suspected concussion cases and further enhance best-practice delivery.
The IRB is a signatory to the 2012 Zurich Consensus statement on concussion, widely recognised as the world's leading sports concussion forum, and the PSCA protocols were adopted following expert independent neurological input and operate entirely in line with the recommendations of the 2012 statement regarding the on-field management of suspected concussion arising from a head impact.
The PSCA allows the team doctors to make their assessment in a quiet situation within a five minute interval. This calm environment away from the field of play and the pressures that come with operating in the middle of an incredibly noisy and often pressurised on-field situation hopefully will contribute to more accurate assessments.
The George Smith knock, which sparked some of the criticsm
IRB Chief Medical Officer Martin Raftery said: "The PSCA is intended to be a supportive tool for physicians in the elite Game. If a player is clearly displaying the signs of concussion, that player must be removed from the field of play and should not return to play."
"Concussion management is at the very heart of the IRB's player welfare strategies and the message to players, coaches and parents is clear - if in doubt, sit it out."
"Our Member Unions have supported the PSCA process and recognise the enormous benefits that the PSCA process delivers in this important area of player welfare."
"All head injury incidents occurring within the PSCA trial are logged by the IRB Game Analysis unit for assessment. This review one year on from implementation will enable us to work with the physicians to review all the cases, identify practice learnings and reinforce the importance of following the correct procedures."
"The area of concussion is highly emotive and diagnosis is complex, especially in the heat of the battle, and the PSCA was developed in line with international best practice to assist doctors and give them the best possible platform to assess their players when it is unclear whether concussion is apparent."
"All the evidence suggests that the PSCA is proving to be a very effective tool to protect our players and team physicians are twice as likely to remove players from the field of play than independent medics, but we can and will continue to review and improve our practices to ensure that we are collectively doing all we can."
Meanwhile, the International Rugby Players’ Association (IRPA) has again backed the IRB's committment to managing head injuries, and driving forward player welfare, highlighting the PSCA as a key tool that puts players first.
"It is our view that the PSCA trial has been good for the health and wellbeing of our elite players," said IRPA Executive Director Rob Nichol.
"It must be remembered that the Pitchside Suspected Concussion Assessment is only a tool to assist the medical practioners make a clinical assessment, and that it is not definitive. From the moment a player takes a knock on the field, the medics should observe and assess that player."
"They are responsible for applying their expertise and making the clinical judgement. If a medic is suspicious that a player has concussion at any stage, regardless of the outcome of a PSCA test, then he must be removed from the field of play and not return. This would include displaying symptoms of concussion as the player is treated on field, or as the player is escorted from the field."
"It is about collective responsibility and we will continue to work in full collaboration with all stakeholders to ensure that players are fully educated as this is an area that all in Game take very seriously."
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