AUSTRALIAN CRICKET Community Cricket Concussion and Head Impact Policy
1.
Overview:
..................................................................................................................2
2.
Background:...............................................................................................................3
3. Protective Equipment Requirements:....................................................................... 3
4. Management of Head Impacts and Concussion: ..................................................... 4
5. Key steps in the early management of concussion:................................................. 4
6. Recognising and Removing:.................................................................................... 4
7. Recording and Referring.......................................................................................... 5
8.
Return to Cricket
......................................................................................................6
9. Junior Considerations: ............................................................................................. 6
10. Multiple Concussions:............................................................................................ 7
1. Overview:
1.1
Australian Cricket (AC) considers it critical to pursue best practice
in prevention and the management of concussion and head trauma in
organised community cricket competitions, matches and training sessions.
A conservative approach that prioritises the safety and wellbeing of
everyone involved in cricket is recommended. 1.2 Repeated head trauma
(RHT) and concussion is a growing concern in sporting communities.
While most concussions recover quickly, some can lead to complications
including prolonged symptoms, increased susceptibility of further injury
and chronic traumatic encephalopathy (CTE). 1.3 Clear and consistent
information on concussion recognition and management is crucial for
everyone involved in cricket, from administrators, officials, coaches,
parents/guardians and athletes themselves to keep everyone safe. 1.4 Australian Cricket endorses the following key resources which guide our approach to concussion management.
a) 2023 Amsterdam Consensus Statement on Concussion in Sport (Consensus Statement)
b) 2024 AIS Concussion and Brain Health Position Statement
c) 2024 International Cricket Council Concussion Guidelines 1.5
The aim is for the AC Community Cricket Concussion Guidelines to be
consistent with these resources where appropriate, ensuring a
comprehensive and up-to-date approach to concussion management. 1.6
It is recommended that Affiliated Clubs and Associations should enforce
these Guidelines for Cricket Participants taking part in Community
Cricket training, matches and competitions. 1.7 These guidelines are
intended to assist in the management of concussion and do not replace
the need to seek medical assessment.
2. Background:
2.1 What is concussion?
2.1.1
A concussion is a brain injury resulting in a disturbance in brain
function following an impact to the head, neck or the body with force
transmitting to the head meaning this can be from a direct or indirect
blow. 2.1.2 Concussion can affect individuals in varying ways:
a) Physical: nausea or vomiting, sensitivity to noise, balance problems, dizziness, blurred vision,
b) Cognitive: “don’t feel right”, difficulty remembering, drowsiness, difficulty concentrating
c) Emotional: irritable, more emotional, sadness, change in personality d) Fatigue: low energy
e) Sleep: Not being able to sleep or sleeping more than normal
A person does not need to have lost consciousness to have suffered a concussion.
2.2
Concussion is often an evolving injury, with symptoms changing over
hours or days following the injury. There are often adverse effects on
balance and cognitive function. Recovery times following concussion vary
between individuals.
3. Protective Equipment Requirements:
3.1 CA strongly recommends the use of neck protectors and British Standard BS7928:2013 helmets in community cricket. 3.2 Players should wear:
(a) properly fitted British Standard (BS7928:2013) compliant helmets; and
(b)
products/attachments properly fitted to helmets that provide additional
protection for the vulnerable upper neck (occipital) area of the
batsman or close in fielder (Neck Protectors), when batting, fielding
within seven meters of the bat (except for off-side slips and gully
fielders) and when wicket-keeping up to the stumps (regardless of age). 3.3 Umpires should wear:
a)
properly fitted BS7928:2013 compliant helmets in higher risk situations
(umpiring for T20 formats or when there is a match situation where
attacking batting is being played). 3.4 Helmets should be replaced
immediately following a significant impact (a blow to the helmet) in
accordance with the manufacturer’s recommendations.
4. Management of Head Impacts and Concussion:
4.1 It is recommended to take a conservative approach to removal of players.
Continuing to play following a concussion can increase risks and lead to a longer recovery period.
5. Key steps in the early management of concussion:
5.1 Recognising the injury may be a concussion or suspected concussion,
5.2 Removing the player from play or training,
5.3 Recording instances of head impacts and concussion, and
5.4 Referring the player to a medical professional.
6. Recognising and Removing:
6.1
During organised community cricket competitions, matches and training
sessions, Cricket Participants should be proactive in reporting the
presence of any concussion symptoms to a coach, other club official,
medical professional and/or family member. 6.2 AC encourages club members and teammates to look out for one another and promote a culture of reporting concussion symptoms. 6.3
If a Cricket Participant receives a blow to the head or upper neck
(whether wearing protective equipment or not) or collides with another
person or fixture (e.g. boundary fence) a concussion should be
suspected. 6.4 A simple process to ascertain the extent that
the individual is adversely affected by the head impact is to ask some
or all of the below questions. This can be done by anyone who is
checking on the individual.
a) What happened?
b) What day is it? What month is it?
c) What venue are we at today?
d) What is the current innings score (if on match day)?
e) Who was the opposition at the last match you played (if during the cricket season)?
f) Who bowled the ball to you (if blow was from batting at a team training)? 6.5
If the Cricket Participant cannot answer the questions satisfactorily,
they should be immediately removed from the field of play (or training
environment) and a concussion should be considered likely. The
participant must undertake an assessment from a qualified medical
practitioner as soon as possible. 6.6 If any of the signs or
symptoms listed below are present, they are considered as having
concussion and should not return to play and be referred to a medical
doctor for assessment. 6.6.1 Table of Symptoms:
Headache
Sensitivity to light
Sadness
'Pressure in head'
Sensitivity to noise
Nervous or anxious
Balance problems
Fatigue or low energy
Difficulty concentrating
Nausea or vomiting
'Don't feel right'
Difficulty remembering
Drowsiness
Neck pain
Feeling slowed down
Dizziness
More emotional
Feeling 'like in a fog'
Blurred vision
More irritable
6.7 Additional information to support on the on-field management of suspected concussion can be found in:
a) Cricket Australia’s On-field Management of Suspected Concussion
b) Concussion Recognition Tool 6 (CRT6)
6.8
If there is a doctor or other medically trained person available, they
should be informed about the impact immediately if they did not witness
it and should attend to the Cricket Participant and use the process
outlined in the AIS Healthcare Practitioner On Field Concussion
Management Decision Tree
12+ Years: Sport Concussion Assessment Tool 6 (SCAT6)
8-12 Years: Child SCAT6
6.9
Concussion is an evolving condition. Therefore, signs and symptoms can
change or be delayed. It may take up to 48 hours following a head
contact to confirm or exclude a diagnosis of concussion.
Parents/caregivers, household members, coaches and attending healthcare
practitioners need to be alert to behaviour that is unusual or out of
character.
7. Recording and Referring
7.1 The
Concussion Officer is responsible for recording instances of head impact
and concussion, ensuring the concussion protocol is enacted and manages
the coordination of matters related to concussion. 7.2 A concussion
officer is not a concussion expert and is not expected to diagnose or
treat concussion or determine when a participant can return to play
after a head impact or concussion. 7.3 It is recommended that all
cases of concussion or suspected concussion (and all other head traumas)
should be documented on an injury report form.
7.3.1 The QSDCA injury report form is downloadable at https://tinyurl.com/58xzfnu4.
7.3.2 It is further recommended that Injury Report Forms be completed for all concussion or suspected concussions including matches where no official umpire is in attendance. 7.4 Individuals with suspected or confirmed concussion should NOT:
a) Be left alone initially (for first 3 hours). If worsening of symptoms occurs immediate medical attention should be sought
b) Be sent home by themselves. They need to be with a responsible adult.
c) Drink alcohol
d) Drive a vehicle until cleared to do so by a healthcare professional
8. Return to Cricket
8.1 An individual should not return to cricket on the same day if concussion is suspected, likely or confirmed. 8.2
If the individual has been diagnosed with a concussion, the final
determination on when they return to cricket (including training),
should be made by an independent qualified medical doctor. It is
recommended that a Medical Clearance Form is completed and retained by
the Club or Association. 8.3 For clarity, whenever possible, avoid
medical clearance being provided by anyone that has a close personal
relationship with the participant (e.g. spouse/partner, family members,
teammates or close friends) in line with the S 4.15 of the Medical Board
of Australia’s Good medical practice: a code of conduct for doctors in
Australia 8.4 The Australian Cricket Graded Return to Play after
Concussion Framework (GRTP) should be used as a guide for whoever is
overseeing the return to play process after a concussion. Key
considerations are:
a) At least 14 days symptom free (at rest) before return to full training.
b) A minimum period of 21 days from incident until return to play.
9. Junior Considerations:
9.1 Managing concussion in juniors requires a more conservative approach.
Individuals are identified as being junior players if they are 18 years or younger. 9.2
Recovery from concussion for adolescents is slower than in adults, so
return to school and studying should be guided by medical advice. 9.3
Junior participants should not return to play for a minimum of 21 days
from the time of injury including remaining asymptomatic for a minimum
of 14 days prior to return to play. 9.4 Some concussions require
longer than 21 days to fully recover after symptoms depart. As with
adult Participants, progression from lower to higher intensity (or risk)
activities requires a minimum 24–48-hour period to monitor for the
return or exacerbation of symptoms.
10. Multiple Concussions:
10.1
Individuals who experience multiple concussions in cricket or have a
history of multiple concussions are at risk of prolonged symptoms and
recovery timeframes. Recovery timeframes will be influenced by factors
such as the severity of the most recent injury, number of previous
concussions and general medical history. 10.2 The AIS Concussion and
Brain Health Position Statement (2024) describes multiple concussions as
a minimum of two concussions within a 3-month period, or a minimum of
three concussions in a 12-month period. 10.3 It is recommended that those who suffer from multiple concussions are:
a) Assessed by a medical practitioner with specific training and expertise in concussion before returning to cricket,
b) 28 days symptom-free before return to full training,
c) Managed more conservatively in their return to cricket and not return to full training or play while symptomatic.
Key Definitions:
Cricket Participant means:
a) Players that are registered with or participate in the activities of an Affiliated Association, Club or Indoor Centre.
b) Umpires, and other officials, who are involved in the cricket matches for Affiliated Associations, Clubs and Indoor Centres.
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