That’s a Red Card!

by Tony Doran, Psy.D.
HeadFirst Concussion Care Program Director

Most of the globe is currently watching the World Cup and although football gets the lion’s share of the headlines about concussions, the June 19 soccer game between Uruguay and England is sure to land FIFA in some hot water. During the second half of the match, Álvaro Pereira, one of the stars of Uruguay’s national team, laid unconscious (below) on the field after taking a knee to the head. He fell to the turf and took at least 15 seconds before he showed any signs of consciousness.

Image

Richard Heathcote / Getty Images

It was clear to everyone—the players, the referee, the TV commentators—that Pereira was unconscious. At this stage, there’s no further diagnosis necessary. You will often read that doctors disagree about when to diagnosis a concussion or mild traumatic brain injury but once there is a loss of consciousness all doctors agree that a concussion or mTBI has occurred.

Pereira should not have been let back onto the field. His coach, his team physician and the FIFA physician all should have stopped him. But Pereira insisted on returning to play for the remainder of the game over the objections of his team’s doctor, while FIFA doctors didn’t even examine him until after the game was over.

Sure, any player would be upset but irritability and mild aggression are normal responses following a head trauma. Pereira should have been lead off the field and if the team didn’t get him off the field, they should have been issued a yellow card.

FIFA needs to do more in terms of educating international coaches, players, fans, and their medical staff. Mr. Pereira was cleared an hour after the game by FIFA physicians as being apparently concussion free; no return to normal cognitive activity and no return-to-play protocols needed. That’s a red card!

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