IRB CONCUSSION GUIDELINES

The IRB Concussion Guidelines ensure that Players who suffer concussion are managed effectively to protect their long term Player health and welfare. These guidelines are designed for use by physicians and other health professionals, as well as, team management, teachers, parents and players.

CONCUSSION MANAGEMENT RESOURCES

IRB CONCUSSION GUIDELINES SUMMARY

Guideline Principles

• Concussion must be taken extremely seriously to safeguard long term Player welfare.
• Players suspected of having concussion must be removed from play and must not resume play in the match or training.
• Players suspected of having concussion must be medically assessed.
• Players suspected of having concussion or diagnosed with concussion must go through a graduated return to play protocol (GRTP).
• Players must receive medical clearance before returning to play.

Stage 1: Diagnosis and Management of Concussion

This includes protocols for diagnosis and management of concussion, when a Medical Practitioner and/or Healthcare Professional IS present, and is NOT present.

Medical Practitioner / Healthcare Professional IS present to diagnose and manage concussion.

Where an injury event with the potential to cause a head injury or concussion occurs and there is a Medical Practitioner or Healthcare Professional present -

• The Player will be examined and if any of the signs or symptoms of concussion (as per Pocket Scat 2), the Player MUST be removed from the field of play in a safe manner for a comprehensive medical evaluation.
• The Player MUST NOT resume play once removed from the field for suspected concussion.

Medical Practitioner/Healthcare Professional is NOT present to diagnose & manage concussion.

If there is NOT a Medical Practitioner or Healthcare Professional present -

• The Player who is injured may be disorientated and unable to make a judgement about their own condition.Fellow Players, coaches, Match Officials, team managers, administrators or parents who observe an injured Player displaying any of the signs or symptoms the head injury or concussion MUST do their best to ensure that the Player is removed from the field of play in a safe manner.
• The Player MUST be referred to a medical practitioner for diagnosis and comprehensive assessment, as soon as possible. Player must NOT be left on his or her own and must NOT be allowed to drive a vehicle.

Children and adolescents

• Whilst the guidelines apply to all age groups particular care needs to be taken with children and adolescents due to the potential dangers associated with concussion in the developing brain. Children under 10 years may display different concussion symptoms and should be assessed by a Medical Practitioner using diagnostic tools.
• As for adults, children (under 10 years) and adolescents (10 – 18 years) with suspected concussion MUST be referred to a Medical Practitioner immediately. Additionally, they may need specialist medical assessment.
• The Medical Practitioner responsible for the child’s or adolescent’s treatment will advise on the return to play process, however, a more conservative GRTP approach is recommended. It is appropriate to extend the amount of time of asymptomatic rest and/or the length of the graded exertion in children/adolescents.

Children and adolescents must NOT return to play without clearance from a Medical Practitioner.

Stage 2: Graduated Return to Play (GRTP)

The management of a GRTP following a concussion or suspected concussion of a Player should be undertaken on a case by case basis and with the full cooperation of the Player.

Where GRTP IS managed by a Medical Practitioner,

• A Player completing each stage successfully (without the reoccurrence of any symptoms) would take approximately (1) one week to proceed through the full GRTP rehabilitation protocol.

Where GRTP is NOT managed by a Medical Practitioner, 

• A Player MUST NOT play until at least the 21st day after the incident.
• The GRTP process may commence after a 14 day stand-down period from playing sport and/or training for sport and only if there are no symptoms of concussion.
• Where the Player completes each stage of GRTP successfully (without the reoccurrence of any symptoms), the Player would take approximately (1) one week to proceed through the full GRTP rehabilitation protocol.

If any symptoms occur while progressing through the GRTP protocol, the Player MUST return to the previous stage and attempt to progress again after a minimum 24-hour period of rest.

All players MUST complete the GRTP protocol, and MUST have clearance from a Medical Practitioner before they can return to play.

IRB REGULATION 10. MEDICAL

10.1 Concussion*

10.1.1 A Concussion must be taken extremely seriously. Players suspected of having concussion or diagnosed with concussion must be removed from the field of play and take no further part in the Match or training.

10.1.2 Players suspected of having concussion or diagnosed with concussion must go through a graduated return to play protocol described in the IRB Concussion Guidelines.

10.1.3 The IRB Concussion Guidelines denote the highest threshold for adolescents and children, which must be strictly adhered to.

10.1.4 The IRB Concussion Guidelines shall be updated from time to time in accordance with best medical practice and as approved by the Executive Committee. 

10.2 Local Anaesthetic

10.2.1   A player may not receive local anaesthetic on Match day unless it is for the suturing of bleeding wounds or for dental treatment administered by an appropriately qualified medical or dental practitioner.

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* Concussion is a complex process caused by trauma that transmits force to the brain either directly or indirectly and results in temporary impairment of brain function. Its development and resolution are rapid and spontaneous. A Player can sustain a concussion without losing consciousness. Concussion is associated with a graded set of clinical signs and symptoms that resolve sequentially. Concussion reflects a functional rather than structural injury and standard neuro-imaging is typically normal.

IRB Regulation 10. MEDICAL is available (in full) at www.irb.com/lawregulations/regulations/index.html