Head injuries may be missed - doctor

It does not matter how strict rugby’s on-field concussion protocols are, there will always be cases of players being missed, according to one of New Zealand’s most experienced team doctors.

Dr Steve Smith has spent close to two decades involved with rugby sides and was adamant the on-field protocols would identify a majority of cases.

Those protocols have been questioned since last Saturday’s opening Bledisloe Cup test in Sydney when All Blacks midfielder Sonny Bill Williams appeared to take a serious head knock in the early stages of the match but was not assessed by anyone.

That led to Sanzaar to question why medical officials did not conducted concussion tests on Williams who appeared disorientated.

‘‘I think everyone missed it to be fair, otherwise the HIA doc would have taken him off,’’ All Blacks coach Steve Hansen told reporters, referring to the Head Injury Assessment personnel. ‘‘Our doc certainly would have taken him off.’’

Smith said the on-field protocols were clear that any player identified as suffering concussion must leave the field.

There was a range of ways a player could be reported to the referee, including by teammates, those running fluids onto the field, the team doctor, the match day doctors or the team’s

management. However, Smith said there would always be cases, as with Williams, when a player who appeared to be in trouble was simply not seen.

‘‘We have an onus on the players themselves to own up, for them to put their hands up and take some time out, but the problem is sometimes the players suffer from amnesia like symptoms and simply don’t know they have a problem,’’ he said.

Improvements to the protocols were being made all the time, Smith said.

That included match day doctors having access to replays while the test was in progress so they could make an assessment as to whether a player should leave the field.

‘‘But it’s difficult. There are always going to be misses along the way.’’