HIA stands for Head Injury Assessment, which is a protocol introduced by World Rugby for elite adult teams to assist with the identification, diagnosis, and management of head injuries. The HIA protocol is a three-stage process that consists of:
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Stage 1 - Off-field HIA1 Assessment: This is the initial assessment of a player who has suffered a head injury. The player is removed from the field of play and assessed by a medical professional using a standardized assessment tool.
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Stage 2 - On-field HIA2 Assessment: If the player passes the HIA1 assessment, they may return to the field of play temporarily. However, they will be monitored by a medical professional and may be subjected to an on-field HIA2 assessment if they show any signs of concussion.
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Stage 3 - Post-match HIA2 Assessment: After the match, every player who has undergone an HIA1 off-field assessment must undergo another evaluation within three hours. This is done using a check of symptoms, memory assessment, and balance evaluation compared with previous player baselines. At 36-48 hours post-head impact event, the player(s) will be assessed again, going through a symptoms check-list, studying a player’s balance, and using a cognitive assessment tool like CogSport or Impact.
In rugby league, clubs are given a free interchange if a player leaves the field for an HIA. The use of the free interchange to allow for an HIA is in place to allow clubs to take the time to deliver the medical attention required for possible concussive injuries, without having to use an interchange. Although clubs may find ways to use this to their advantage, they are encouraged to use this for the intention it was introduced for. Compliance action can be taken where clubs abuse and undervalue the process.
