In rugby, HIA stands for Head Injury Assessment. It is a three-stage process introduced by World Rugby for elite adult teams to assist with the identification, diagnosis, and management of head injuries and concussions. The three stages of the HIA protocol are:
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Off-field HIA1 Assessment: This is the first stage of the HIA protocol, which is done on the game day. It involves an off-field assessment using the HIA1 Form to identify potential head injuries and confirm Criteria 1 signs indicating immediate and permanent removal. The off-field screening tool, pitch-side video review, and clinical evaluation by the attending doctor are also included in this stage.
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Post-game, same-day assessment using HIA2 Form: This is the second stage of the HIA protocol, which is done within three hours of completing the match. It involves a medical evaluation using the HIA2 clinical assessment to assess clinical progress and determine an early diagnosis of concussion.
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36-48 hour post-injury assessment using HIA3 Form: This is the third stage of the HIA protocol, which is done after two nights rest (36-48 hours post-head impact event). It involves further medical testing using the HIA3 to further assess clinical progress and determine a late diagnosis of concussion.
The HIA protocol has been developed to support Law 3.11 and Regulation 10, both of which are relevant to the temporary replacement for head injury and the management of concussion. Temporary substitution for head injury was introduced permanently into Law for elite adult rugby in August 2015.