We would like to take this opportunity to remind you that while the effective use of the Head Injury Assessment (HIA) process is being seen at the elite adult level of the game, it should be noted that HIAs must not be carried out during games other than those in competitions and matches, as approved by World Rugby:

• Aviva Premiership
• England Senior team internationals (men and women)
• England U20 home internationals (men and women)
• A-League
• Greene King IPA Championship
• Anglo-Welsh Cup
• British and Irish Cup
• European Champions Cup
• European Challenge Cup

All other matches and training involving adult male and female players (including the new women’s Tyrrells Premier 15s League) and all age grade activities must adhere to regulation 9, which states “any individual who exhibits any of the signs or symptoms of concussion should be immediately and permanently removed safely from the field of play, should not return to play that day, and it is recommended that they are referred to a medical or healthcare professional for assessment and advice.”

To see Regulation 9 in full, see below.

This must be adhered to irrespective of the qualification/profession of the individual providing the pitch-side first aid and/or immediate care provision.

Following a suspected concussion players should follow the appropriate Return to Play protocols, whereby if they remain symptom free for 14 days, the player can gradually increase physical activity and can return to playing 19 days after the original incident if an adult, or after 23 days if in the U19 age group or younger.

More information regarding suspected concussion management and the return to play protocols can be found on the HEADCASE pages of the ER website.

http://www.englandrugby.com/my-rugby/players/player-health/concussion-headcase/resources/

http://www.englandrugby.com/mm/Document/Governance/Regulations/01/30/34/79/RFU_Regulation_9_Neutral.pdf