Six Nations Championship and Celtic Rugby adopt IRB’s concussion protocols

Decision allows for the five-minute PSCA to be introduced for a trial period to be used in the treatment of head injuries to players

Both the Six Nations Championship and the Celtic Rugby Board, who govern the Pro12 League, have adopted the International Rugby Board's (IRB) concussion protocols for the first time.

Following a meeting in the Hilton Hotel in Heathrow this week the Six Nations Council voted to introduce the five minute Pitchside Suspected Concussion Assessment (PSCA) into this year's championship. The Pro12 decided last week, while the European Rugby Cup have not adopted the measures.

The decision allows for the PSCA to be introduced for a trial period to be used in the treatment of head injuries to players. It has been used as a type of triage tool in other jurisdictions around the world since the IRB first introduced it as a trial during the 2012 under-20 World Cup in South Africa.

Yesterday, the IRFU welcomed the decision by the Six Nations Council to approve the measures.


“The IRFU support the IRB PSCA protocols and welcome its introduction into the 2014 RBS Six Nations Championships,” said a spokesman.

The decision, however, will also be seen to be controversial by various world authorities on concussion, who have criticised the protocols for being inadequate in dealing with what is a complex injury.

Prime critics
One of the prime critics, Dr Barry O'Driscoll, an uncle of Irish centre Brian, has pointed out on numerous occasions that no medical authority is capable of telling whether a player does not have concussion within a five-minute period of assessment in the changing room of a stadium.

In addition Dr O’Driscoll has argued that as it is impossible to rule out concussion in five minutes, “brain-damaged players” will and are being returned into a professional match environment of full body contact, which he has called a “brutal arena”.

The main hurdle for the Six Nation Council was Scotland's stance on the issue and it is believed that their medical staff, headed by Dr James Robson, were not entirely convinced about the efficacy of the PSCAs. Had Scotland held firm in their resistance, the protocols would have been difficult or impossible to have been used in this year's championship.

Officials could not have had one match adhering to the concussion protocols and in another, involving Scotland, only one team signed up. Clearly Scottish concerns have now been allayed.

What the change means on the ground is that any player taking part in the Six Nations, which begins next weekend, will be subject to medical scrutiny for a five-minute period if the medical team or referee suspects they have taken a blow to the head and may have symptoms of concussion.

Being examined
While the player is being examined, the team may put on a replacement for that time.

The issue of extending the examination period to 15 minutes has been mooted and would satisfy many of the grievances that doctors such as O’Driscoll hold. However, the IRB see an extended period as a possible route to teams cheating.

As in the 'Bloodgate' affair in 2009, Harlequins player, Tom Williams, faked injury to allow outhalf Nick Evans to return to the field in a Heineken Cup tie against Leinster.

The primary motive for Harlequins was to get a dedicated kicker back on the pitch.

In IRB thinking a 15-minute window to assess players for concussion may damage the integrity of the game as teams would see it as an opportunity to bring on impact players for tactical reasons.

At the end of last year former Scottish international Rory Lamont spoke of his experiences at a Brain Acquired Injury symposium in Aviva Stadium. Lamont admitted to have been knocked out cold on 10 occasions. He added that players routinely cheated on their COG tests.

Johnny Watterson

Johnny Watterson

Johnny Watterson is a sports writer with The Irish Times