HIA tools
HIA1 - Pitch side assessment tool
All players who undergo a HIA MUST have this completed on the SCRM or the the HIA1 form completed in full and returned to the Competition Co-ordinator.
HIA2 (SCAT6) - Post-match, same-day assessment tool
All players who have had a HIA administered, irrespective of the result, MUST have a HIA2 completed before leaving the ground.
HIA3 - Diagnostic summary tool
All players who have had a HIA administered, irrespective of the result, MUST have a HIA3 diagnostic summary assessment undertaken within 36 to 48 hours of the injury. This HIA3 assessment will include completion of the symptom assessment form and completion of the team's preferred supportive concussion assessment tool, e.g. SCAT6, CogStatet, ImPACT, etc.
What is the role of the HIA2 and HIA3 in diagnosis of concussion?
The HIA2 and HIA3 are tools used to SUPPORT the clinical diagnosis of a doctor. It is recommended by the Berlin 2016 consensus statement that assessment of a suspected concussion should include a symptom checklist, cognitive assessment and balance assessment. HIA2 and HIA3 incorporate this multi modal approach.
Clinical suspicion of concussion should ALWAYS overrule a negative HIA1, 2 or 3 assessment.
How do I interpret the HIA2 tool?
Results from this post-match assessment should be compared with the baseline HIA2 results. Each mode - symptom check, cognitive assessment (SAC) and balance - should be compared with the respective baseline. Any variation in one or more mode(s) is strongly in favour of concussion.
It should be noted that any symptom declared in the symptom list which is not usually experienced by the player following a Rugby match or training is strongly in favour of concussion.
How do I interpret the HIA3 tool?
The HIA3 tool is a combination of the Symptom Assessment Form (SAF) and each team's follow-up concussion assessment tool, e.g. CogState, ImPact, , etc.
The Symptom Assessment Form (SAF) is the symptom checklist used in the HIA2 (SCAT6) that will identify symptoms present at the 36-48 hour review and also the presence of symptoms since the injury, their duration and also their severity.
The Diagnostic Summary in the HIA3 will allow the differentiation between:
- A concussion diagnosed with support of the HIA2 on game day with no residual signs or symptoms at time of completion of HIA3.
- A concussion diagnosed with support of the HIA2 and/or HIA3 with residual signs or symptoms still present at time of completion of HIA3.
- An excluded concussion, no signs or symptoms of concussion noted since the injury.
What HIA assessments need to be done and when?
| During match | Post-match | 36-48 post-match | |
| Player removed permanently from field of play | HIA1 completed (for research purposes) | HIA2 completed | HIA3 completed |
| Head injury - HIA positive (player removed permanently from game) | HIA1 completed | HIA2 completed | HIA3 completed |
| Head injury - HIA negative (player returns to play and monitored) | HIA1 completed | HIA2 completed | HIA3 completed |
| Concussive symptoms post-game at ground | HIA2 completed | HIA3 completed | |
| Concussive symptoms after leaving ground | HIA3 completed | ||
| Team Doctor (TD) video review confirms HIA should have been undertaken, or on questioning player post video review, TD confirms the player had or has suspicious signs or symptoms | HIA3 completed |
HIA 4
- This assessment is currently a simple confirmation that the player has been cleared to return to full play.
- Failure to complete this assessment will mean the concussion 'case' remains open, prolonging recorded recovery and possibly creating a 'concussion history' in the player's file.
We will now look at each of the HIA tools in turn.
HIA1 - Pitch side assessment tool
Download the HIA1 tool as a printable Adobe PDF file
HIA2 - Post-match, same-day assessment tool
You'll be able to download the HIA2 tool when you have completed the Concussion Management for Match Day Medical staff using the HIA Protocol module by answering all questions correctly.
HIA3 - Diagnostic summary tool
You'll be able to download the HIA3 tool when you have completed the Concussion Management for Match Day Medical staff using the HIA protocol module by answering all questions correctly.