On-pitch concussion management: a view of healthcare professionals in elite football.

Collecting an account of practitioners' lived experiences of on-pitch concussion management in football provides real-world insight into areas for improvement, and future research direction. Previous research suggests that healthcare professionals (HCPs) in football are confident with on-pitch concussion recognition; however, some players are still returned to the field to later be removed with a concussion. Objectives: The aim of this study is to understand the on-pitch assessment procedure of HCPs and factors that may influence whether or not a player is removed following a suspected head injury in football based on semistructured interviews. Methods: 10 elite-level pitch-side HCPs participated in a semistructured interview. Recorded interview transcripts were analysed via reflexive thematic analysis. This process generated four key themes: time, formalised procedure for identifying concussion, interpretation of behaviour and stakeholder actions. Results: This study provides evidence that HCPs in football feel that they do not have enough time to conduct a thorough concussion assessment. Assessments are currently subjective and rely on the sideline healthcare staff's relationship with the player to determine if they are acting normally. The HCPs value seeing the mechanism of injury and advocate the use of video replays. Temporary concussion substitutes would allow more time for assessment and for the use of assessment tools such as the Sport Concussion Assessment Tool. Conclusions: Based on the current findings, research should focus on developing multimodal testing batteries to detect concussion on-pitch, while football should consider implementing video analysis at all levels and temporary concussion substitutes.