considerations and challenges of a british & irish lions … · living with the lions...
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LIVING WITH THE LIONS CONSIDERATIONS AND CHALLENGES OF A BRITISH & IRISH LIONS TOUR
MR PRAV MATHEMA
DISCLOSURES
WRU NATIONAL MEDICAL MANAGER
WRU NATIONAL SQUAD PHYSIOTHERAPIST
WORLD RUGBY CONCUSSION WORKING GROUP MEMBER
BRITISH AND IRISH LIONS REPRESENTATIVE 09,13 & 17
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“WINNING ISN’T EVERYTHING IT’S THE ONLY THING”
RED SAUNDERS/VINCE LOMBARDI
188813022
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188813022
20174744
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188813022
642 (13)
249 46
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BEFORE DURING AFTER
BEFORE
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4 3 4 2 33
SCHEDULE/PLANNINGGOVERNANCE
NZRU SUPPORT CLINICAL INFORMATION (PRE-TOUR FACE TO FACE)
CONCUSSION (HIA, VIDEO AND REVIEW PROCESS)EQUIPMENT/CONSUMABLES
TRAVEL/RECOVERY PROTOCOLS
PRE-TOUR
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SCHEDULE/PLANNING
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GOVERNANCE
INSURANCE SIGN-IN AND OUT PROCESS ALL CLINICAL AND MANAGERIAL CONSENT
SECURE ELECTRONIC NOTE KEEPINGMEDICINES MANAGEMENT POLICY AND PROCEDURES
EMERGENCY ACTION PLANNING
GOVERNANCE
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NZRU SUPPORT
MATCHDAY• PERSONNEL AT EACH GAME• EXTRICATION TEAM • DEDICATED AMBULANCE • LIVE VIDEO REPLAY • MDD • EMERGENCY MEDICINE TEAM
NZRU SUPPORT
NON MATCHDAY• ACCESS TO IMAGING• CONSULTANTS • PHARMACEUTICALS• CONSUMABLES
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CONCUSSION
ALL BASELINES (SCAT AND COMPUTERISED)INJURY STRATIFICATION
APPLICATION FOR USE OF HIACONFIRMATION OF LIVE VIDEO REPLAY
CONCUSSION
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EQUIPMENT/CONSUMABLES
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53 ITEMS
FLYINGON ARRIVAL (MINDFUL OF FIRST GAME IN 72 HRS!) SOFT TISSUE THERAPISTS (ADDITIONAL SUPPPORT)ORGANISATION OF FACILITIES (ON AND OFF SITE)
TRAVEL/RECOVERY PROTOCOLS
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ACTIVE COMPONENTS – POOL/BIKE/WALK
PASSIVE COMPONENTS –SOFT TISSUE/SEQUENTIAL COMPRESSION/WEARABLE COMPRESSION/CONTRAST
BATHING/SLEEP/ NUTRITION
48 HRS PROGRAMME – MOBILITY/SOFT TISSUE
RECOVERY PROTOCOLS
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DURING
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STANDARD TRAINING DAY• 0730 meeting • 0800 screening/treatment• Morning session varied• Afternoon treatment/prep for Rugby • Rugby • Treatments post training • 2100 shop closed (but phone is on!)• Social time!
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STANDARD MATCH DAY• 0730 meeting • 0800 screening/treatment/rehab for non Match squad• Morning Rugby for non Match squad• Afternoon treatment/prep for Match squad • Treatments post training for non Match squad• Match• Post match triage• 0030-0100 shop closed/social time
OWNERSHIP & EMPOWERMENT
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MRI REPORTDigits 3,4 and 5 – Full thickness tear (partial at 5) of RCL at PIPJ
Digit 3Full thickness tear accessory radial collateral ligament at PIPJ, Volar plate
irregularity
Digit 4 Partial tear accessory radial collateral ligament at PIPJ, radial Volar plate tear
Digit 5 Partial tear accessory radial collateral ligament at PIPJ, bone marrow oedema head
of prox phalanx
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67 mins
67 mins
80 mins
69 mins
Crusaders
• ? Last Lions tour
• Best player
• Functional
• Psychologically strong
• Protect with strapping
• Off season pending
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86% for 891% in NZ21 @ 95%
80
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AFTER
MEDICAL AND TEAM DEBRIEFEXIT SCREENING
COMMUNICATION AND NOTES MANAGMENT TO CLUBSSTOCK CONTROL AND DISTRIBUTION
H.O.D DEBRIEF WITH BOARDCOMMENCE PLANNING FOR NEXT TOUR TO SA 2021
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LESSONS LEARNT
STAFFINGEXTRA SOFT TISSUE THERAPIST WAS POSITIVE
BUT AT THE EXPENSE OF DOCTOR CONSISTENCY IS KEY
PRE-TOUR PITCHSIDE MODULE VERY BENEFICIAL
GOVERNANCEONEROUS ? FULLY ELECTRONIC
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CONSUMABLESVERY ONEROUS ESPECIALLY FOR LOGISTICS
STREAM LINE/CENTRAL STOCK
SCHEDULINGGAME 1, 72 HRS POST ARRIVAL?
LACK OF PREPARATION TIME IS ALWAYS CHALLENGING COMMERICIAL VS PERFORMANCE DEMANDS
26 in 2 weeks
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“WINNING ISN’T EVERYTHING IT’S THE ONLY THING”
RED SAUNDERS/VINCE LOMBARDI
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Dr Eanna FalveyBob Stewart
Phil PaskAngela Rickard David Revins
Dr Ian Murphy (NZRU)
Dr James RobsonDr Gary O’DriscollRichard Wegrzyk
Clint Redhead (SARU) Dr Warren McDonald (ARU)
ACKNOWLEDGEMENTS