Initial management

There is no specific treatment that can be initiated for the management of head injury on the pitch except for the early provision of oxygen. Efforts are focused on the transfer of the player to the nearest appropriate emergency department as soon as possible.

The following principles should be adhered to:

All participants following a head injury who have an ACVPU of C or less, should be extricated with spinal immobilisation from the pitch as soon as it is safe to do so and transferred as soon as possible to the nearest emergency department if there are no signs of recovery.

Scrupulous attention should be given to the ABCs to ensure the delivery of adequate oxygenated blood to the brain. High flow oxygen should be applied in all cases. Meticulous cervical spine immobilisation should be applied, unless contraindicated.

If it is not possible to transfer the player immediately to the nearest appropriate emergency department, the player should be extricated to a temperature controlled, well-lit medical room, for further assessment and to await transfer wherever possible.