Tottenham criticised for allowing Hugo Lloris to play on with head injury
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Tottenham Hotspur have been slammed as "irresponsible" for letting goalkeeper Hugo Lloris to stay on the field despite being knocked out during Sunday's goalless draw at Everton.
The Frenchman was caught in the head when he collided with Romelu Lukaku in the second half at Goodison Park, with the Everton striker needing an ice-pack on his knee afterwards.
The doctors were keen to take Lloris off and Brad Friedel prepared to come on, but Lloris' desire to continue convinced his manager André Villas-Boas.
Villas-Boas told Sky Sports: "The medical department was giving me signs that the player couldn't carry on, because he couldn't remember where he was.
"But he was quite focused and determined to continue, so when you see this kind of assertiveness it means he is able to carry on, and that is why it was my call to delay the substitution.
"You have to make a decision in situations like this but from my knowledge of Hugo he seemed okay to continue."
The 26-year-old did have a CT scan after the match in Liverpool and was given the all-clear, but Villas-Boas' decision has been criticised by brain injury charity Headway.
Headway CEO Peter McCabe told Sky Sports News: "If someone has been knocked out on the pitch then they should be removed and properly assessed. Asking the player if he is ok is ludicrous, it seems to us.
"You risk so much - no-one can see inside somebody's skull. It is dangerous and irresponsible to leave someone in that situation.
"We think the FA needs to give clearer guidance to clubs. If somebody is knocked out we believe the FA should have a protocol that requires the player to leave the pitch and be properly assessed."
The FA has detailed regulations on head injuries and the rules state that anyone suffering unconsciousness should not play again that day.
The FA regulations state: "Any player remaining immobile and unresponsive to verbal commands following a head injury will be regarded as being unconscious and treated in accordance with established principles for extrication and management of the unconscious player. There will be no return to play during that day."
The rules do however allow for "a transient alteration of conscious level" following a head injury, which says a player can return to play following assessment by medical staff.
"The player will only be allowed to resume play if asymptomatic and with normal co-ordination. The medical attendant should alert the coaching staff, and the player closely observed for any deterioration in playing ability," the regulations say.
However, FIFA chief medical officer Professor Jiří Dvořák said that if there is any doubt about concussion then the player should be removed from the field of play.
Dvořák said: "The player should have been substituted. The fact the other player needed ice on his knee means it's obvious the blow was extensive.
"It's a 99 per cent probability that losing consciousness in such an event will result in concussion.
"When he has been knocked unconscious, the player himself may not see the reality.
"I do not know the details but I know that the Premier League doctors are extremely good and I can imagine that the doctor may have recommended he be replaced.
"We have a slogan: if there is any doubt, keep the player out."
Further criticism came from the world players' union, FIFPro, with its medical advisor Vincent Gouttebarge saying: "This decision is unacceptable. FIFPro condemns that the health and safety of players are let to coaches/trainers or even to players themselves."
The treatment of head injuries and concussion has been a major issue for rugby union and American Football, where the long-term effects of repeated blows to the head are of growing concern.
The Rugby Football Union is currently running a concussion-awareness campaign following warnings that it was allowing players with brain damage to continue because of inadequate controls.
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| Tottenham goalkeeper Hugo Lloris lies injured after a collision with Everton's Romelu Lukaku Photo: Getty Images |
The Frenchman was caught in the head when he collided with Romelu Lukaku in the second half at Goodison Park, with the Everton striker needing an ice-pack on his knee afterwards.
The doctors were keen to take Lloris off and Brad Friedel prepared to come on, but Lloris' desire to continue convinced his manager André Villas-Boas.
Villas-Boas told Sky Sports: "The medical department was giving me signs that the player couldn't carry on, because he couldn't remember where he was.
"But he was quite focused and determined to continue, so when you see this kind of assertiveness it means he is able to carry on, and that is why it was my call to delay the substitution.
"You have to make a decision in situations like this but from my knowledge of Hugo he seemed okay to continue."
The 26-year-old did have a CT scan after the match in Liverpool and was given the all-clear, but Villas-Boas' decision has been criticised by brain injury charity Headway.
Headway CEO Peter McCabe told Sky Sports News: "If someone has been knocked out on the pitch then they should be removed and properly assessed. Asking the player if he is ok is ludicrous, it seems to us.
"You risk so much - no-one can see inside somebody's skull. It is dangerous and irresponsible to leave someone in that situation.
"We think the FA needs to give clearer guidance to clubs. If somebody is knocked out we believe the FA should have a protocol that requires the player to leave the pitch and be properly assessed."
The FA has detailed regulations on head injuries and the rules state that anyone suffering unconsciousness should not play again that day.
The FA regulations state: "Any player remaining immobile and unresponsive to verbal commands following a head injury will be regarded as being unconscious and treated in accordance with established principles for extrication and management of the unconscious player. There will be no return to play during that day."
The rules do however allow for "a transient alteration of conscious level" following a head injury, which says a player can return to play following assessment by medical staff.
"The player will only be allowed to resume play if asymptomatic and with normal co-ordination. The medical attendant should alert the coaching staff, and the player closely observed for any deterioration in playing ability," the regulations say.
 | |
| Tottenham goalkeeper Hugo Lloris is attended to by medical staff after being involved in a collision Photo: Reuters |
However, FIFA chief medical officer Professor Jiří Dvořák said that if there is any doubt about concussion then the player should be removed from the field of play.
Dvořák said: "The player should have been substituted. The fact the other player needed ice on his knee means it's obvious the blow was extensive.
"It's a 99 per cent probability that losing consciousness in such an event will result in concussion.
"When he has been knocked unconscious, the player himself may not see the reality.
"I do not know the details but I know that the Premier League doctors are extremely good and I can imagine that the doctor may have recommended he be replaced.
"We have a slogan: if there is any doubt, keep the player out."
Further criticism came from the world players' union, FIFPro, with its medical advisor Vincent Gouttebarge saying: "This decision is unacceptable. FIFPro condemns that the health and safety of players are let to coaches/trainers or even to players themselves."
The treatment of head injuries and concussion has been a major issue for rugby union and American Football, where the long-term effects of repeated blows to the head are of growing concern.
The Rugby Football Union is currently running a concussion-awareness campaign following warnings that it was allowing players with brain damage to continue because of inadequate controls.
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