Medics to get new video view

The treatment of head injuries in rugby is an evolving science, and one which rugby officials are getting right more often than not.

Concussion is one of the biggest issues, not just in world rugby at the moment, but in world sport.

That is why pressure is on rugby officials to make the right decisions around head injuries in games, and on protecting the players. In an attempt to improve the process of protecting players who have suffered head knocks during games, New Zealand Rugby will roll out a video review system for Super Rugby matches from next week.

The system will allow independent match day doctors and team doctors to review the footage of a player in an on-field incident.

NZ Rugby’s medical director, Dr Ian Murphy, said the system had been in development for some time and could have been helpful for incidents in the current Super Rugby season.

The obvious incident is when Highlanders prop Josh Hohneck returned to play after appearing to lose consciousness in a collision during a match against the Crusaders. Doctors working at the game did not see the video evidence of Hohneck losing consciousness, busy dealing with what they initially believed to be a neck injury. If they had the video review technology at that game, Hohneck would not have returned to the field.

As it stands, players who have lost consciousness, or who doctors suspect of losing consciousness, are immediately pulled from the game.

World Rugby’s head injury assessment protocol states that a player suffering a confirmed loss of consciousness or suspected loss of consciousness must be removed from the field immediately.

Sometimes it is hard to determine, however.

‘‘There are reasons for permanent removal from a game, and those can be enacted by either of the team doctor, the match day doctor – who is an independent arbiter on these matters – and/or the referee,’’ Murphy said.

‘‘Those people that have been mentioned, the match doctor, the team doctor and the referee, we would like to think work to achieve the right outcome as often as possible.’’

When Hohneck came off the field, the match day doctor and team doctor had no suspicion that Hohneck had been knocked out.

He flew through the other section 1 guidelines in the head injury assessment form, with no lack of balance; he was not clearly dazed, and had no other symptoms suggesting a head injury.

The doctors then put Hohneck through section 2 of the head injury assessment form, which is the pitch-side head injury assessment. Hohneck flew through the test, reaching his base standards in all areas, and was allowed back on the field.

The pitch-side head injury test includes questions which find out a player’s orientation, for example: ‘‘Who scored last in this match?’’

An immediate memory test has players repeat a list of words read out by the doctor, and then a more difficult test asks players to repeat a string of numbers but in the reverse order they were read out.

After that a player must perform a tandem gait test, walking in a straight line, and then their delayed recall is tested, having to repeat as many of the words from the first test as possible.

Should the player fail to repeat their baseline scores, set when 100 per cent fit before the match, they are pulled from the match.