RUGBY AUTHORITIES have been urged to adopt stricter guidelines to safeguard players from the risks of concussion.
Prof Jack Phillips, an esteemed neurosurgeon who has worked as a medical adviser to both the Boxing Union of Ireland and the Turf Club for the last 20 years, in particular recommends that rugby extends temporary replacements – which are permitted for blood injuries – to include head injuries.
Concussion, particularly in American football, has become the subject of deep concern, much study and even congressional hearings in the United States.
The rate of concussions appears to have increased recently in rugby union due to the higher velocity of the game, with grave concerns among some in the medical profession that players are resuming play while suffering concussion and that the game is kicking to touch on the issue. The accounts of two recently retired Leinster and Irish hookers, John Fogarty and Bernard Jackman, have focused further attention on the subject, with Fogarty revealing he is suffering the consequences of repeated concussions, blinding headaches, days on end in darkened rooms, fatigue and mood swings, and is resigned to having these symptoms for years.
Prof Phillips is co-author of the Phillips Report, which investigated 2,000 head injuries in the Republic that were admitted to Beaumont Hospital in Dublin and Cork University Hospital.
In an interview with The Irish Times, Prof Phillips says rugby does not have to apply an unwieldy protocol, merely precautions “that will recognise whether a player is concussed” and who 10 minutes later is still on the field and is still concussed. “That’s where a ‘second impact syndrome’ is now a reality.”
An improved protocol, without ruining the flow of the game, would also help doctors to make decisions when under the most intense pressure. To that end, doctors have to be empowered by an objective way of assessing whether a patient is concussed or not, and Prof Phillips agrees that were the player removed from the pitch for up to 10 minutes, that would facilitate this process.
This could simply be done with what is described as a Pocket Scat 2 Protocol.
“That is the simplest new psychometric test,” stresses Prof Phillips.
“You recognise the symptoms, you ask the important questions and you test his balance.
“It might take a minute and if the player passes it, he continues. If he doesn’t pass, remove him from play and repeat the test.
“Here is where the doctor can be granted some flexibility, but if after 10 minutes the player cannot answer the basic questions, is unsure where he is or is unsteady, he does not return to play and is substituted.”
