Health Council of the Netherlands Reports 2003 - Gezondheidsraad

Dutch Boxing Association therefore prohibit a contest from taking place without
a ringside physician. The Netherlands Association of Sports Medicine (ASM)
has issued a guideline regarding boxing and other fighting sports: physicians
should endeavour to establish preventive measures and by no means promote
these sports activities. The Royal Dutch Medical Association has ruled that all
physicians in the Netherlands are to observe the ASM guidelines.
The prevention of brain injury in soccer
Whenever brain injury is suspected, the Committee would like to see the
guidelines developed by the American Academy of Neurology applied. The
additional and more specific advice given by the International Conference on
Concussion in Sports ought to be followed in the Dutch sports setting because of
the detailed step-by-step plan for a sportsperson’s return to play following a brain
injury. Appropriate care following brain injury can prevent aggravation of the
damage.
On-site provision should be made for the medical treatment of acute brain
injury. Such provision is already made for all professional matches in the
Netherlands. The medical personnel in attendance are all given instructions by
the Royal Netherlands Football Association on how to respond in the event of a
(suspected) brain injury. The Committee believes that compliance with these
instructions should be mandatory. Amateur matches are too numerous to make
the universal attendance of trained medical personnel practical. In the United
States, an easy-to-use reference card has been developed, which lists signs and
symptoms of concussion and sets out a number of simple but validated on-thespot
tests that can be used to assess the condition of someone who has received a
blow to the head. The Committee recommends the development of a Dutch
version of this reference card for on-field use in both professional and amateur
sport. All referees and coaches should then be instructed, at least at the beginning
of each season, in the use of the card. Wherever doubt exists regarding a player’s
fitness to continue following an incident, he or she should be withdrawn from the
match and referred for medical examination. The Committee also recommends
that professional players should undergo both an immediate on-field test, plus
more thorough subsequent testing.
In the interests of brain injury prevention, strict enforcement of the rules of
the game is also important. As well as advocating such enforcement, the
Committee would like to see the rules modified in two respects. The FIFA is
already seeking to outlaw use of the elbow when jumping to head the ball. The
Committee’s view is that use of an elbow should be outlawed in all phases of
14 Health Council of the Netherlands; Reports 2003