Guidelines to identify visible signs of a concussion from World Rugby.

1. Video Interpretation for non-medical team
staff and match officials

2. MANAGING HEAD INJURIES
• The responsibility for identifying suspicious head injuries in rugby is not isolated to the
team doctors and match day medical staff.
• All officials, match and team, have a role in supporting identification of potential head
injuries
• If you have any suspicion of a head injury report this concern to your Team Doctor or
the Match Day Doctor so that they can review the player and the video
• Your responsibility is to identify and report.
2

3. IDENTIFY AND REPORT
The following signs may be seen from the side-line or on video.
1. Tonic posturing (a form of fit or convulsion)
2. Balance disturbance or unsteady (ataxia)
3. Suspected Loss of Consciousness (suspected knock out)
4. Dazed player (blank or vacant stare)
3

4. TONIC POSTURING
CLASSICAL SIGNS OF TONIC POSTURING
• This is a form of fit or convulsion
• After the player falls to the ground one or both upper limbs may be held
rigidly away from the body for 5-10 seconds.
• The arms are typically held in the air and the player looks to be unconscious
In the following video watch ‘Black 14’ and the extended right arm
4

5. TONIC POSTURING - EXAMPLE
5

6. BALANCE DISTURBANCE / UNSTEADY
ALSO KNOWN AS ATAXIA
• Typically the player is slow to rise from the ground after their head injury
• The player may be unsteady sitting or unsteady rising from the ground
• Once the player rises they may be unsteady for the first few steps or the player may
be unsteady when attempting to return to play.
• Often the player avoids immediate participation in the game.
In the following video watch ‘White 4’ and his unsteadiness after his injury
6

7. ATAXIA - EXAMPLE
7

8. SUSPECTED LOC
LOC = loss of consciousness (knocked out)
• Following the head injury the player may lay on the ground without moving for more
than 5 seconds
• The player is often seen to fall to the ground without protective action
• The player may also be noted to have no neck control on falling to the ground which
is often referred to as the ‘rag-doll’
In the following video watch ‘Gold 13’ and his lack of protection when falling to the ground
8

9. SUSPECTED LOC - EXAMPLE
9

10. CLEARLY DAZED
A dazed player has
• A blank a vacant stare following a head injury
• May not respond as expected to questions or instructions
• May want to stay on the ground
• This sign may be seen on video but is more easily seen with close-up observations
In the following video watch ‘Black 12’ and vacant stare with the close up video
10

11. CLEARLY DAZED - EXAMPLE
11

12. RESPONSIBILITY
IDENTIFY
AND
REPORT
12