Very little is known about the Head Injury Assessment Process, a process commonly referred to as the HIA Process or simply the “Concussion Test“.
As players get bigger, fitter, stronger, so the collision area becomes more intense. The force being transferred from one, two or three players to another is larger than it ever has been in the history of the game. In addition, we are now far more aware of the long-term detrimental effects that repeated blows to the head can cause.
But what happens in the HIA process? Have you ever pondered this question? Have you ever wondered why a player can be knocked almost into the next realm and in the next moment is cleared to return to the field? And a player who is seemingly fit enough to juggle and skip at the same time is left off the field?
Here at The 1014 we have pondered these questions and thought it was about time someone asked them. And when we mean ask, we don’t mean ask someone close to the game or who used to play 25 years ago. That isn’t how it works. If you want to know what is happening you need to go to the source and ask the experts.
Thankfully for us the Head Doctor of the Blues Super Rugby team, Dr Stephen Kara, kindly agreed to give up his time to answer a few questions for us.
The first thing I learnt when speaking to Dr Kara about the HIA process was that I had been looking at it all wrong. I had been looking at it from the perspective of a fan; the same perspective that commentators across the globe look at it and commentate on it. “The test is not a test to get people back on the field.“, I was told. Take a moment to consider that statement.
The test is not a test to get people back on the field.
The test, conducted by medical professionals, is a “tool to determine if a person has signs or symptoms of concussion“, a test they want the patient to fail. Fail you say? If we take a moment to consider this it makes sense. From a medical point of view, it is imperative that the player only passes the test if they are showing no signs at all of concussion at that point in time. This is why the test is so thorough, so detailed, and to be honest, it is a little hard, as I found out.
Even before commencing the HIA tests the doctor can make a call as to whether or not a player is concussed. And therefore whether or not they are allowed back on the field. These pre-test tests are as follows:
- 11 criteria that doctors look for. These include ataxia (in simple terms the player is walking like a drunk person), a player walking to the wrong end of the field, convulsions or seizures. Or simply the player has been knocked out, or is suspected of being knocked out, and so on
- 5 MADICS questions. Who scored last? What half are we in? Who did we play last week? Who are you marking? Did we win last week?
- Reviewing the video box, the so-called “head box“, a screen the doctors can view on entering the tunnel with the player. This gives them the ability to review the incident that caused the player to be considered for an HIA.
If the player fails any of these initial checks there is no need for the HIA tests to take place. The player is immediately ruled out of the contest and the correct procedures are followed.
It should be mentioned that this is all presided over by a match day doctor. This sort of four-eye analysis is used to ensure there is no hoodwinking going on. As we know in sport, questions would always be raised if this were not the case.
All of this before the HIA even takes place. Who would have thought?
From The Shed
Author: The 1014 Rugby
The 1014 is servicing the needs of a passionate and respectful global rugby community by producing world-class content based on three important values – Passion, Integrity and Respect.
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