Concussion Management in Schools Rugby A Coaches Perspective Shane Mooney IRFU First Aid & Injury Prevention Coordinator
B.L.U.F. Your players are the highest risk group. Recognise and Remove It s the Law Respect and support the referee. Remove the player safely from the pitch and provide a handover of care. Follow IRFU return to play guidelines.
Why is it important? A schoolboy has died due to the effects of concussion. Second Impact Syndrome kills - this is the highest risk age group - it can be avoided. Schoolboys more at risk of concussion and take longer to recover. Concussion is treatable
It is Law Law 3.12 If, at any point during a match, a player is concussed or has suspected concussion, that player must be immediately and permanently removed from the field of play. This is known as Recognise and Remove.
What is concussion? Concussion is a traumatic brain injury. It is a complex process in which forces are transmitted to the brain and results in temporary impairment of brain function. Concussion is treatable
Children s brains are more susceptible to concussions than adults and catastrophic effects of repeated head trauma May have a longer development of symptoms and therefore require longer period away from sport
What causes Concussion Direct blow to the head or body. Indirect force to the head e.g. Whiplash type movement of the head
On Pitch Suspicion Most occur in the tackle >75%. Risk types of Tackle Both or Tackler upright. Speed differential Front on tackle High tackle, Spear tackle, Taken out in mid-air
On Field Signs Lying motionless on the ground /?LOC Fit or seizure Slow to get up / Unsteady on feet or falling over. Grabbing/clutching head. Dazed, blank or vacant look. Confused, not aware of calls or plays. Not being themselves (e.g. loud/aggressive) REMOVE THE PLAYER
Removal from Pitch Recognise and Remove Referee has ultimate authority to remove any player for safety concerns Law 3.10
Off field Signs and Symptoms Physical: Headache Nausea / Vomiting Balance problems Dizziness Cognitive: Memory problems Confused / forgetful. Slowed down Emotional: Irritable / aggressive More emotional More nervous / anxious. Sleep: Drowsy Sleeping more / less. Broken patterns
Performance Impact Continuing to play on or returning to play with of symptoms/signs of concussion: Decreased on-field performance. Higher risk of any injury.
What to do Recognise & Remove. Follow instruction of referee and medics Safety takes precedence over any other aspect of the game If safe to do so, the player MUST be removed from field and MUST NOT return
How to manage a player pitch-side Assign player to a person of responsibility on the sideline. (e.g. assistant coach, medic, parent/ guardian, colleague, teacher, team mate) Do NOT leave player alone Player must be accompanied at all times.
Handover of care Always handover player to a responsible person e.g. to teacher, parent/guardian. Information: - Suspected concussion. How it happened? Player should be monitored and assessed medically. Rest and return to play protocol
GRADUATED RETURN TO PLAY Age Rest Period Graduated Return to Play Period Total U20-U6 14 days 8 days 23 days NO EXCEPTIONS CHILD FIRST, PLAYER SECOND
RETURN TO PLAY
No Head injury assessment/psca/head bin/concussion bin in the amateur game Maddocks questions are not to be used on the pitch. They can be used after the player has been removed IF YOU SUSPECT CONCUSSION REMOVE THE PLAYER AND NO RETURN TO PLAY/TRAINING ON THE SAME DAY.
IRFU NEW LAW INTERPRETATION & SANCTIONING
Prevention Coaches ensure you: Follow the laws of the game Coach proper technique especially the tackle Ensure players optimal fitness to play With optimal technical development, progress physical demands to game intensity. Do not let players return early post injury
Schools Injury Report Form
Take Home Messages Your players are the highest risk group. Recognise and Remove It s the Law Respect and support the referee. Remove the player safely from the pitch and provide a handover of care. Follow IRFU return to play guidelines.
www.irishrugby.ie/concussion @IRFUSaferugby shane.mooney@irfu.ie