The Blue Card Concussion Initiative (BCCI) was first introduced in the Bay of Plenty in 2017 and is now in its second year of implementation. This initiative is designed to improve player welfare in relation to brain injuries like head knocks and concussion. It is an extension of the existing Graduated Return To Play (GRTP) Stages, that has been in place for a number of years.
Prior to the commencement of each season, all referees that are going to be officiating in any senior rugby match (Representative, Premier Mens, Premier Womens, Division 1, Premier Development, Sub Union Senior or Senior Reserve fixture) will be required to attend specific Medical Training by a NZ Rugby approved medical person on recognising the Symptoms of Concussion. Only referees that attend this training are authorised to issue Blue Cards.
If, during a match where a “BCCI Trained referee” is in control and the referee identifies a player suspected of suffering from a head knock or concussion, the referee will issue “A BLUE CARD” and the suspected injured player must leave the field immediately and will not be permitted to play for a minimum of 21 days (any player 19 or over) or 23 days (any player under 19 years).
The power of a referee to remove an injured person is NOT new and has existed in law for some time. The 2018 World Rugby Laws of the Game Law 3.22 states:
“The referee may also order an injured player to leave the playing area to be medically examined.”
NZ Rugby Domestic Safety Law Variation Law 3.10 states:
“Without limiting Law 3.10 above, in Provincial Unions that have been approved by New Zealand Rugby to take part in the Blue Card Concussion Initiative, if the referee believes a player has been concussed, or suspects a player has been concussed, the referee must show a Blue Card to that player, and that player will be required to leave the playing area, and not return and play in that match. Further the player shown a Blue Card may not return to play in any future match without first meeting the requirements of the return to play protocol, as set out in this Blue Card Concussion Initiative booklet.”
Once a player is sent from the field under a Blue Card, the new BCCI process kicks in and the referee, the injured player, their parents or next of kin, the player’s coach, the player’s manager and the BOPRU ALL have a role to play in ensuring the player’s welfare remain paramount when undertaking the GRTP protocol.
At the conclusion of the match, the referee ensures that the player that has been blue carded is CLEARLY IDENTIFIED on the team sheet, just like any player issued a yellow card or a red card.
It is highly recommended the injured player NOT drink alcohol for at least 24 hours after the match and if they drove to the game, make arrangements for someone to drive them home. They should also seek medical attention within 24 hours.
The player now has the responsibility to follow the Graduated Return To Play Stages, ensuring that they are symptom free throughout all of the stages.
The player also has a mandatory duty to obtain a medical clearance to return to play ONLY AFTER the expiration of the mandatory 21 or 23 day recovery period.
An injured player’s coach and/or manager is responsible for ensuring that the injured player is not left alone after the match and has a safe way of getting home from the venue.
They are also responsible for ensuring their injured player is aware of the GRTP Stages, including when they can return to re-join team trainings for:
Coaches and Managers are not permitted to play a player AT ANY TIME:
The Bay of Plenty Rugby Union Blue Card Concussion Initiative Administrator will write a separate letter to both the injured player and the player’s coach or manager:
The BCCI Administrator will also monitor the player’s recovery to ensure that they are following the GRTP stages.
The BCCI Administrator will keep a register of all Blue Cards issued and ensure that any costs incurred by the injured player in obtaining the medical clearance to return to play are reimbursed to the injured player.
A. No. The Blue Card Initiative has been introduced to enhance player safety and welfare. Player safety and welfare is the joint responsibility of many, the referee is not held solely responsible or liable.
A. A Blue Card can only be issued on the field, by a referee. Refer to Process (above).
A. The Community concussion guidelines are applicable to concussion and suspected concussion. These guidelines do not provide an avenue for reducing the stand-down period. A player who has been blue carded is deemed to have reached the threshold of at least having a suspected concussion.
As there is no gold-standard test that a doctor can do post-match to reliably diagnose or exclude concussion in their rooms, we err on the side of caution. A person with concussion can appear normal at rest (in the doctor’s rooms) but become symptomatic with activity including contact after being ‘cleared’. Therefore, a doctor can only exclude a concussion over time, hence maintaining the value of a stand-down period. We are hopeful that in the future we will be able to reduce this stand-down period to a shorter time but the mechanisms for providing safe care across the country do not allow this at present. Player safety and welfare is paramount.
A. The formal Return to Play protocols applicable to Professional Players applies.
A. A professional player who has been issued with a Blue Card follows the formal Return to Play protocols applicable to Professional Players. This player has been benchmark tested at the commencement of the season and is monitored daily by a doctor. The player has also followed the Graduated Return To Play protocol under direct medical supervision at each stage. This includes computerised testing to demonstrate he/she has recovered.
A. This is desirable, but not essential. Only a referee can issue a Blue Card. The referee may issue a blue card after consulting with the Assistant Referee. In receiving a report from an Assistant Referee, the referee must take into consideration whether or not the Assistant Referee has participated in the training programme.
A. In the Bay of Plenty, the Blue Card Concussion Initiative will apply to all senior matches including Representative, Premier, Division 1, Premier Development, Sub Union Senior & Senior Reserve, Colts and Women's. It will also be applied to any secondary school or Junior rugby fixture where a “Blue Card Trained” Referee is officiating.
A. Only Registered (affiliated) Referees who have participated in the required training course, can issue a blue card.
A. A blue card can only be issued on the field, by a referee. Refer to Process (above).
A. The Concussion Recognition Tool can be very helpful with this. Click here to view
A. A blue Card can only be issued on the field, by a referee. Refer to Process (above).
A. It is strongly recommended this practice be adopted. The player should visit a doctor within 24 hours of sustaining the knock to the head and then again to obtain a clearance to return to play. The minimum requirement is for the player to visit a doctor to obtain a medical clearance/certificate to return to play.
A. Most costs should be covered by ACC. However, any surcharge costs incurred by the injured player in obtaining the Return to Play medical clearance certificate will be reimbursed by BOPRU upon presentation of both the Medical Clearance to Play certificate and a receipt for the surcharge costs incurred.
A. The player will need to pay the surcharge at the time of their visit, retain the receipt and provide it to their Provincial Union for reimbursement.
There is a formal process for the rescinding of a Blue Card. Click here for further information
For further information please feel free to download the following documents:
1. Blue Card Concussion Initiative - Booklet
2. Blue Card Concussion Initiative - Introduction Presentation
3. Blue Card Concussion Initiative - FAQ
4. Pocket Concussion Recognition Tool
5. Graduated Return To Play Stages
6. SCAT3 Sport Concussion Assessment Tool – 3rd Edition
7. Process for Rescinding a Blue Card
If after pouring through all the material, you still have a question, please feel free to contact: