On-field identification and management of concussion in amateur rugby union

Abstract

Background: Rugby is a popular team sport and due to its contact
nature carries a relatively high potential for injury, including
concussion. Moreover, it is estimated that as much as 50% of
concussions are not reported due to a variety of reasons, including
not considering the injury to be sufficiently serious or not wanting
to miss game time.
Objectives: The aim of this brief review was to investigate and
summarise current best practice for on-field identification and
on-field management of concussion in amateur rugby.
Methods: PubMed and ClinicalKey were searched between
September and December 2014 for articles in the five years
preceding the search dates. The latest versions of the Consensus
Statement for Concussion in Sports and World Rugby’s concussion
guidelines were also consulted.
Results: Based on this search strategy, eight systematic reviews,
one physician information article and four patient guidelines
were investigated. Four reviews specifically described an “action
plan” for on-field evaluation and management. Education of key
stakeholders could reduce the number of unreported concussions.
Once identified or suspected, concussions should be managed
according to best practice procedures, which include removing
the player from play immediately and consulting a medical doctor.
If a medical doctor is not immediately available on the field tools
such as the BokSmart on-field pocket “Concussion Guide”, and
World Rugby’s “Pocket Concussion Recognition Tool”, are freely
available online.
Conclusion: Stakeholder education (including players, parents,
teachers, coaches, referees, spouses) on both the on-field
identification and management of concussions could reduce
under-reporting and improve the overall management of
concussed rugby players.
Keywords: injury prevention, injury management, head injury,
football