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The HIA process 
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Post The HIA process
So, the RFU have felt the need to defend the HIA process, no doubt in light of recent events, and also the comments from ex IRB medical chief Barry O'Driscol. There has been a lot of finger pointing around the recent high profile rugby concussions, North, Murray, Sexton etc. But I agree with O'Driscol, it's not so much the clubs or the doctors, or the tv video, or whoever else that is to blame. It's the very process itself and World rugby are at the heart of it.

If a player sustains a concussion, the guidlines are quite clear. "any clear or suspected symptom of concussion results in immediate and permanent removal of the player from the match or training session". That's straightforward enough, until he is off field and then subjected to a HIA ? But why would you subject him to a HIA, if he is already suspected of concussion ? Because if he has been suspected of concussion, its game over. It seems a clear contradiction of itself. Which begs another question, who does the HIA process actually benefit here ? I think this is going to get very messy on the legal front, which is possibly why Northampton recently were not sanctioned. It was the process at fault, and not them. We have red cards issued to players for all manner of things, who are sent from the field not to return. Yet, when a player is sent from the field suspected of concussion, he can have a quick HIA and he's back on ? Here's a suggestion. Any player suspected of concussion is issued with a green card, removed from play, permanently substituted, and is not allowed to return to play.



Rugby concussions: RFU head of medicine defends HIA process
http://www.bbc.co.uk/sport/rugby-union/38669294


Thu Jan 19, 2017 11:33 am
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Post Re: The HIA process
Okay. Every time a player takes a little dig to the head, gets up and clears his head with a rub at the spot and shake of the nogging, that's a sign of concussion, off you go, get your shower you're done for the day.

We'll need teams with around 20-25 subs each to finish a game.

That's why the HIA exists

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Thu Jan 19, 2017 12:06 pm
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Post Re: The HIA process
CymraegJanner wrote:
Okay. Every time a player takes a little dig to the head, gets up and clears his head with a rub at the spot and shake of the nogging, that's a sign of concussion, off you go, get your shower you're done for the day.

We'll need teams with around 20-25 subs each to finish a game.

That's why the HIA exists


Staying with England. In the 2015/16 season, there were 135 games played in the Aviva premiership. During which there were 92 reported concussions, which equates to less than 1 per game.


Thu Jan 19, 2017 5:46 pm
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Post Re: The HIA process
plus presumably a raft that didn't get picked up.

We've seen a couple of cases recently whereby the need for a HIA was completely negated, the players were out, and should have played no further part they did, and in that sort of instance your green card system would work, IF the laws were implemented properly.

However, concussion like symptoms can be as simple as a rub and a shake of the head when you've caught it on something, you can't just remove those players for the rest of the game, and there will be considerably more than a handful a game. No problem giving them a HIA, but the outcomes of this have to be adhered to, the medical staff aren't truly independant, and as a result players are allowed to go back on when they shouldn't

The problem with the HIA and the whole setup isn't really the process, it's the players (yes the players) the clubs the administrators and the medical staff not adhering to their own preset standards.

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Thu Jan 19, 2017 6:24 pm
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Post Re: The HIA process
CymraegJanner wrote:
plus presumably a raft that didn't get picked up.

We've seen a couple of cases recently whereby the need for a HIA was completely negated, the players were out, and should have played no further part they did, and in that sort of instance your green card system would work, IF the laws were implemented properly.

However, concussion like symptoms can be as simple as a rub and a shake of the head when you've caught it on something, you can't just remove those players for the rest of the game, and there will be considerably more than a handful a game. No problem giving them a HIA, but the outcomes of this have to be adhered to, the medical staff aren't truly independant, and as a result players are allowed to go back on when they shouldn't

The problem with the HIA and the whole setup isn't really the process, it's the players (yes the players) the clubs the administrators and the medical staff not adhering to their own preset standards.


I agree with you there, the process is full of holes on different levels. I don't think the HIA will be dropped either, it's a horse that World Rugby have backed, and backed heavily. What I think will probably happen, is it it'll get tighter and tighter in how it's applied, as you say independent medics. Whether the HIA is scientifically robust though is a matter of differing views. Interesting interview here with two eminent figures in questioning it ;

"Two leading medical experts discuss the issues surrounding brain injury in sport, particularly in rugby"
http://www.irishtimes.com/sport/rugby/i ... -1.2516781


Thu Jan 19, 2017 7:20 pm
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Post Re: The HIA process
The HIa isn't robust enough IMHO, it contains too much lip service to player welfare and not enough actual action, and that's in both how it's composed and how it's implemented by the staff conducting it.

I would like to see it evolve over the next 18months, though I suspect in 18 months we'll still be exactly where we are with a lot of lip service, and nowhere enough substance.

The trouble for rugby is that even if we did go down the road for a HIA for every knock to the swede that a player had enough to feel and grimace at, players would be going off every 5 minutes, not great for the spectacle, and why it will mostly be just about looking like it's dealing with the problem rather than actually dealing with it

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Thu Jan 19, 2017 7:50 pm
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