Concussion Management in Schools Rugby
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 [email protected]
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 [email protected]
