Saints wing North ‘symptom-free’ and could face Scotland, says Wales medical manager

The 22-year-old took took an accidental boot to the head from England lock Dave Attwood in the first half of the game in Cardiff and underwent a mandatory concussion assessment that kept him out of the action for eight minutes.

North subsequently returned to the field, but he then clashed heads with team-mate Richard Hibbard during the second half in what appeared to be a worse incident, and which attracted attention from rugby union’s global governing body World Rugby.

North did not go off a second time, playing on as England started their Six Nations season with a 21-16 victory.

World Rugby subsequently requested “a full report” from Welsh rugby chiefs.

That prompted the Welsh Rugby Union (WRU) to release a video on Monday night, in which medical manager Prav Mathema discussed the handling of North’s situation.

Mathema revealed that North has started his return-to-play protocol and remains free of concussion symptoms.

The Saints man will continue to be assessed this week, but could be fit in time travel to Murrayfield for Wales’ clash with Scotland this weekend.

“George, since the incident actually on Friday, has been symptom-free the whole time,” said Mathema.

“Post-match he was symptom-free, today he has also been evaluated and he has shown no signs and symptoms of any concussion.

“And because of that he has actually started his return-to-play protocol already, and there has been no issue with the first stages of that.

“He has to go through that process for the rest of the week, having a step-by-step increase in his activity, and we will evaluate whether or not he will be fit for selection this weekend.”

Mathema confirmed that the WRU had provided World Rugby with a report on Saturday - the day it was requested.

“In the first incident, George took a blow to the head from an accidental boot. Following that, we attended to him on the field of play, and we weren’t quite sure as a medical team at that point about his diagnosis,” Mathema added.

“Because of that, we decided to use the head injury assessment protocol, and he went off for 10 minutes for a review. That was deemed negative, so he returned to the field of play.

“In the second incident, regrettably I was unsighted at that moment. The other pitchside medic on the far side of the pitch was also unsighted.

“All I saw was George North getting up off his knees. When I arrived at the scene, as it were, he was completely lucid and was conversing spontaneously with me. I undertook some on-pitch evaluations, and that point I deemed him fit to continue.

“Regrettably, we didn’t get a chance to see the incident, and had I been given that opportunity, there is no doubt that he would have been removed from the field of play.

“There is no pitchside replays available currently, and the independent match-day doctor was unable also to aid us in that process.

“We unfortunately didn’t see it, but having seen it since, obviously, there is no doubt that he looks like he has a momentary loss of consciousness, and in that case he should definitely be removed from the field of play.”

Reflecting on events post-match, Mathema said: “Part of the head injury assessment process is that he (North) has a secondary more in-depth evaluation, and this was done again by the independent match-day doctor.

“Again, he was deemed to be negative for any signs and symptoms of concussion.

“However, as a medical team we always get together afterwards and evaluate. The first time as a group we were able to evaluate the video footage, at that moment it was clear to see he had a momentary loss of consciousness.

“Because of that, irrespective of him having no signs and symptoms, we will be dealing with George as a concussion.

“George will go through a step-by-step process of increasing his cognitive and his physical activity through the week. He will be assessed every single day by a doctor, and he will also get a neurological opinion before we make a decision whether or not he is fit to return to play.

“Since the incident, certainly we’ve seen where our protocols need to improve.

“For the next four games of the Six Nations, we are certainly going to have instant video replay for both our home and away matches.

“We’ve also had this discussion with World Rugby, and we are hopeful that our discussions will spark some form of global intervention as well with regards to this.

“Pitchside practitioners sometimes will need help.

“There are the rare occasions, like the one on Friday night, when sometimes things are unsighted. Where possible, we need to enhance these protocols, which is certainly something we are looking to do in the immediate term.”