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Thread: physio v doctor

      
  1. #1

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    Default physio v doctor

    A player receives a bang to the head and is seen pitch side by a "physio", the physio says he has concussion and isn't allowed to play for 23 days, is he competent to make that statement. After the match the boy is taken to A&E where he is seen by doctors, they give him the all clear and state there is no sign of concussion and that he is fit to play.

    So as his club coach who do you go with? If I tell the parents I'm not picking their son as the physio has said he has concussion, they're likely to come back, but a highly qualified doctor in a hospital has said he's fine!

    As much as I can choose not to pick him, I have no control over school matches or other sides he might choose to play for, but if he does play will he be "insured"?
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    Default Re: physio v doctor

    doctor, every time.

    (assuming of course you're happy as to the accuracy of the stories, but i guess that's another question.
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    Default Re: physio v doctor

    I coach school rugby, so I have to deal with players coming back from concussion (or not coming back) every season. I would go with the doctor's opinion, but in the interest of legal self-preservation, I always require written permission from the doctor, and the player must be specifically cleared for rugby, not just sports or physical activity. On top of that we always follow the gradual return to activity protocol and I will be in touch with his teachers to see how he is doing in class.

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    Default Re: physio v doctor

    have you considered the possibility that they are both right as regards the concussion? Which is to say: the lad suffered a concussive head injury evidenced perfectly clearly, even to the untrained, by (for example) grogginess , unsteadiness, slurred speech, impaired memory of the event. But by the time a qualified medical practitioner got to see him, those signs of concussive injury had passed, and there were no residual signs for the doctor to hang his hat on.

    That seems to me to be entirely possible - even likely. If it is the case, then someone needs to weigh up the risks and rewards of playing the lad for the next three weeks. As those risks include death, I would suggest that only the boy's parents are qualified to make that judgement. But as they lack the detailed medical information needed to evaluate those risk properly in the absence of a privately paid-for brain scan and neurologist's specialist opinion, it may be advisable for all concerned to go with the RFU's "prudent" strategy - give him a break from the game in the interests of safety.

    If you had recently buried your own child an the autopsy indicated that cause of death was a repeat concussive incident on top of a recent previous one, would you (or possibly your wife) feel inclined to sue the responsible adults who had overruled the precautionary principle in the interests of the Somerset Youth Vase? If the answer to that is that it might cross your mind, then multiply that by a factor of about 10 for a parent who is not so heavily steeped in the rugby mould as we all are.

    I think in your shoes I'd be looking to persuade the parents not to allow Johnny to play for ANYONE, and I'd be digging out some of the relevant material from the likes of BOD's uncle(?) to support my case. If they overruled, I think I'd overrule them unless they themselves have detailed medical knowledge - in which case I may want a signed waiver.
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    Default Re: physio v doctor

    Wot Buff said .

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    Default Re: physio v doctor

    Some useful stuff here to suppport a decision not to play him:- http://www.rfu.com/headcase

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    Default Re: physio v doctor

    Physio. The kid could of seen a very junior FY2 in a busy ED. The physio saw him at the point of impact. And if ever you get someone say, "don't worry I'm a GP" ejaculate them from the incident.

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    Physio. The kid could of seen a very junior FY2 in a busy ED. The physio saw him at the point of impact. And if ever you get someone say, "don't worry I'm a GP" ejaculate them from the incident.

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    Default Re: physio v doctor

    I'd get the parents to read this and if they're still adamant he plays then so be it.
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    Default Re: physio v doctor

    Quote Originally Posted by Daftmedic View Post
    Physio. The kid could of seen a very junior FY2 in a busy ED. The physio saw him at the point of impact. And if ever you get someone say, "don't worry I'm a GP" ejaculate them from the incident.
    and what would be the physio's qualification for assessing a concussion?
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  10. #10

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    Default Re: physio v doctor

    Quote Originally Posted by TheBFG View Post
    and what would be the physio's qualification for assessing a concussion?
    doctors come in all shapes and sizes - it may well be that the physio for a large well reseourced club has more experience and knowledge regarding concussion than many doctors. If you are an ENT specialist, or gynocologist, or oncolcogist you wouldn't encouter any concussions in the course of your work.


    I must say if I had an injured 14 yr old and two professional disagreeinig over whether he is concused, I'd err on the side of safety.
    But I appreciate this question is about recovery plan rather than whether or not he stays on the field, so more difficult.

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