Concussion Management for Match Day Medical Staff using the HIA Protocol

MDD rights and responsibilities

  1. Co-ordinate medical services delivered during a game.
  2. Support the Team Doctor with an injured player (if requested).
  3. Adjudicate on blood injuries suitable to access temporary substitution (up to 15 minutes) - Regulation 15.2.1 (c).
  4. Request an off-field HIA1 screen on a player if criteria defined in HIA procedures are identified.
  5. Enforce permanent removal from field of play if a player has signs as defined in the HIA procedures for permanent removal.
  6. Observe the HIA with the Team Doctor delivering the off-field HIA1 screen unless assigned this responsibility by the Team Doctor.
  7. Undertake HIA if the MDD is assigned the responsibility for undertaking a HIA by the Team Doctor. The MDD will complete the HIA and be responsible for deciding return to play unless there are simultaneous HIA s being completed.
  8. If the MDD is concerned regarding a return to play following an off-field HIA1 screen, this should be discussed with the Team Doctor. If an ongoing dispute persists, the MDD can request a repeat of the HIA1 before or after the player returns to play. The MDD does have the right to unilaterally remove a head injured player from further game participation BUT this should only occur following exhaustive discussions and potential re-assessment between the MDD and Team Doctor has been undertaken.
  9. Remove a player from further match participation in a game if indicated as per Regulation 15.2.1 (d) - If the nominated Match Day Doctor gives his opinion that a player should not continue playing on account of his injury (whether such injury is a blood injury, head injury or otherwise) that player shall not be allowed to resume playing. Before making a final decision the MDD must discuss this decision with the Team Doctor so that every effort is made to reach a consensus decision on removal of the player from further game participation or allow a return to play. The opinion of the nominated Match Day Doctor shall be conveyed to the player’s Team Manager or representative and it is then for that Team to decide whether or not a replacement shall be introduced.
  10. Confirm that Team Doctors have completed a post-match, same-day HIA2 on all players removed permanently or temporarily with a head injury during a game.
  11. Confirm that Team Doctors are aware that all HIA paperwork is to be forwarded to the World Rugby Competition Co-ordinators each week including the post-match, same-day HIA2.
  12. Confirm World Rugby Heat Guidelines require implementation on days of extreme temperatures
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