The co-author of a study into concussion in inter-county hurling has called on the GAA to enforce existing guidelines with regard to the assessment of players who may have suffered suspected concussive events.

Darek Sokol-Randell, from University College Cork's School of Medicine, outlined the study’s findings on RTÉ’s Today with Claire Byrne.

Research was collated for inter-county hurling league and championship matches in 2018 and 2019 and concluded that only 10 out of 43 players who showed at least one sign of concussion were removed from play.

The GAA introduced guidelines in 2018 for testing of those players who may have suffered suspected concussions, including a Sport Concussion Assessment Tool (SCAT5) assessment.

However, researchers were unable to find evidence of the 10-minute test being conducted as mandated in their video analysis of 183 potentially concussive events.

While 86.3% of players who sustained suspected concussive events were examined by medical personnel, 81% of those assessments lasted less than one minute.

"Our research analyses a wide variety of head hits," Sokol-Randell told listeners.

"We don't only analyse concussions. We analyse what we think could be potentially concussions.

"We look at direct head hits and if players are unable to resume playing for five seconds or more immediately after said head hit.

"What we found was that only a quarter of those players were positive for concussive signs.

"A quarter of these players had demonstrable signs for concussion. What's important about this subgroup of players is that we found that only 10 were removed from the field of play.

"There clearly need to be more adherence to the guidelines set out by the GAA with regard to concussion protocols.

"Furthermore, while we found that although players who were more severely injured – ie had more signs of concussion visible, were more likely to exhibit obvious dysfunction neurologically – were likely to be removed from the field of play, those who might have demonstrated a little less or a subtherapeutic level of concussive threshold – ie they only demonstrated one sign of concussion or potentially their signs of concussion may have gone by the time of assessment – were more likely to go out to the field of play.

"That's the real danger. Those players who may have resolved their concussive symptoms by the time the assessment happens and ultimately go back out on to the field of play and get reinjured or have a new neurological injury happen to them."

The potentially catastrophic nature of second impact syndrome has been linked to a number of neurological diseases, including chronic traumatic encephalopathy (CTE).

A definitive diagnosis for the neurodegenerative disease can only be made post-mortem, but has been linked to contact and semi-contact sports.

"I was trying to break out of the ambulance to try and carry on and play"

Former Waterford and De La Salle star John Mullane believes players are far too invested to play any part in deciding their own capacity to continue after suffering potential concussive episodes, and relayed a vignette on his own commitment to the cause which illustrated how clouded players' judgement can be on such matters.

Playing in a Waterford club championship match back in 2005, he was involved in a crashing collision, but attempted to continue playing against medical advice.

"I took a hit into the chest and went flying up into the air," Mullane explained.

"Whatever way I came down, I smacked my head off the ground. I swallowed my tongue and had an epileptic fit. It was such a harrowing experience.

"Luckily for me, Declan Spellman, he was full-forward on the opposing team and a male nurse, he got the referee’s pen and he flicked back my tongue. The epileptic fit stopped.

"The ambulance came and, lo and behold, I was in the ambulance and I was trying to break out of the ambulance to try and carry on and play.

"My now-wife, girlfriend at the time, had to restrain me, as did the medical person in the ambulance. They had to calm me down and put the oxygen mask on."