Quick questions on Sports injury management - RICER, no HARM, concussion: HSC PDHPE Sports Medicine

Suspected fractures should not be managed with RICER. The bone needs imaging and professional management, not ice and a bandage.

Some sports (e.g., professional rugby league) have team doctors trained to reduce common dislocations (shoulder, finger) on-field if the dislocation is recognised quickly. School and community sport should not attempt this.

The standard tool used by sport governing bodies is the SCAT (Sport Concussion Assessment Tool), most recently SCAT6 (released 2023).

Remove from play immediately. Any suspected concussion ends the athlete's participation in that game and that day's training. The previous "play on if you feel okay" approach is now considered unsafe.

The Australian Institute of Sport Concussion in Sport position statement (most recent 2023 revision) sets out a graded return-to-play protocol. The minimum graduated return-to-sport approach is 21 days from injury for children and adolescents - longer than the previous protocols of 7-10 days.

The AFL and NRL have both faced class action litigation from former players with chronic traumatic encephalopathy (CTE) linked to repeated concussions. Both codes have implemented harder concussion protocols including mandatory stand-down periods and independent concussion assessment.

Stop the activity. Protect the injured area from further damage.

Apply ice (wrapped in a barrier, not direct skin contact) for 15-20 minutes every 2 hours. Reduces swelling through vasoconstriction. Reduces pain through nerve effect.

Firm bandage extending above and below the injury. Limits fluid leakage into tissue. Must not be so tight that it impairs circulation - check for numbness, blue colouration, or distal pulse weakening.

Raise the injured part above heart level. Uses gravity to support fluid drainage.

Refer to a medical professional within 24-48 hours for diagnosis and rehabilitation planning.

Any suspected concussion ends the athlete's participation in that game and that day's training. The previous "play on if you feel okay" approach is now considered unsafe.

Any suspected concussion should be assessed by a GP or emergency department.