On-field identification and management of concussion in amateur rugby union

Background: Rugby is a popular team sport and due to its contactnature carries a relatively high potential for injury, includingconcussion. Moreover, it is estimated that as much as 50% ofconcussions are not reported due to a variety of reasons, includingnot considering the injury to be sufficiently serious or not wantingto miss game time.Objectives: The aim of this brief review was to investigate andsummarise current best practice for on-field identification andon-field management of concussion in amateur rugby.Methods: PubMed and ClinicalKey were searched betweenSeptember and December 2014 for articles in the five yearspreceding the search dates. The latest versions of the ConsensusStatement for Concussion in Sports and World Rugby’s concussionguidelines were also consulted.Results: Based on this search strategy, eight systematic reviews,one physician information article and four patient guidelineswere investigated. Four reviews specifically described an “actionplan” for on-field evaluation and management. Education of keystakeholders could reduce the number of unreported concussions.Once identified or suspected, concussions should be managedaccording to best practice procedures, which include removingthe player from play immediately and consulting a medical doctor.If a medical doctor is not immediately available on the field toolssuch as the BokSmart on-field pocket “Concussion Guide”, andWorld Rugby’s “Pocket Concussion Recognition Tool”, are freelyavailable online.Conclusion: Stakeholder education (including players, parents,teachers, coaches, referees, spouses) on both the on-fieldidentification and management of concussions could reduceunder-reporting and improve the overall management ofconcussed rugby players.Keywords: injury prevention, injury management, head injury,football