Brukner foreshadows concussion protocol changes
Australia's team doctor Peter Brukner believes cricket will eventually follow Australia's football codes and introduce a system in which players leave the field for concussion assessment after blows to the head. The assessment process was the subject of attention on day two in Christchurch, when Steven Smith was struck on the helmet by a bouncer from New Zealand fast bowler Neil Wagner.
Smith fell to the ground before getting to his feet again, and Brukner and Australia's physio David Beakley ran onto the field to assess whether he needed any treatment. After spending roughly five minutes on the field, Brukner saw no signs of concussion and decided that Smith could continue his innings, but he said further testing had been undertaken later that day and the next morning.
"There are things we look for, how well orientated they are, how alert they are, and there's standard questions that you always ask automatically," Brukner said after day four at Hagley Oval. "We took him through those. He answered all those questions perfectly. He seemed quite alert. We kept talking to him in that five minutes and by the end of that five minutes I was comfortable that there was nothing too serious going on."
The incident occurred in the last over before tea and Brukner also spent time with Smith during the tea break, as well as using a computerised concussion test called Cogstate after stumps that day. A test of cognitive function that assesses a wide range of areas including reaction times, Cogstate was again used to assess Smith before play on the third morning.
"We have baseline measures for all the players in the Australian squad. We did that again on that night, and we were able to compare that with his baseline. And there was no difference between what he did on Sunday night and the baseline. And he was feeling okay. I repeated that test on Monday morning, just because sometimes they have a delayed response and deteriorate overnight. Once again he felt okay and the test was okay."
Smith was also assessed at other breaks in play, and showed no signs of concussion. Brukner said that while there were "grey areas" in determining concussion, if he had any doubts he would not hesitate to rule a player out, as he did when Chris Rogers missed two Tests in the West Indies last year following a blow to the helmet at training, and he also took Rogers from the field following a blow during the Lord's Test.
"There are some very clear-cut concussions, they're knocked out and talking gibberish and so on, there are others who are absolutely fine. And there's a grey area," Brukner said. "I accept it's a difficult ... we would love a test to say yes that's a concussion, that's not a concussion. But we've got our symptoms, we've got our questions, we've got our computer tests, that's our package at the moment. That's what we go on."
Unlike cricketers, AFL and NRL footballers who suffer blows to the head are taken from the field for a 20-minute period to be assessed and reduce the risk of further blows in case of a delayed concussion reaction. Brukner said he expected that cricket would eventually follow the football codes and introduce such a system.
"There's a lot of things on the table at the moment about concussion subs and all that sort of stuff," he said. "It's complicated. I think the football codes feel that 20 minutes is about right. It would be nice to take someone off for 20 minutes. I think ultimately something will come in on those lines. I think it's got to, these days.
"The climate is out there and cricket will do it ... After that five minutes out there, if I'd had doubts, I'd have said come off - you can have a replacement, it's not as if you can't bat again - come off and we'll do a more thorough assessment. There was no indication to me out there that that was required. The next stage is to take them off and fully assess them. But he seemed fine to me, so I felt comfortable to keep him out there."
Brydon Coverdale is an assistant editor at ESPNcricinfo. @brydoncoverdale