Rory Lamont in action during the 2011 World Cup © Getty Images

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Pitchside Suspected Concussion Assessment (PSCA)

• A PSCA can be requested by the player's team doctor and the match referee if they suspect that a player may have suspected concussion.
• Match referee will signal, via comms device and hand signal of three taps to the head, that a PSCA has been called. PSCA carried out at pre-agreed place, medical room or alternative if not easily accessible, with a temporary replacement taking the field.
• The substitution will become permanent should a player fail the test, while temporary replacements are not allowed to take kicks at goal.
• PSCA must be completed inside five minutes - commencing with the player leaving the field at the half-way line and ending with presentation to the reserve official after being cleared to play.
• PSCA incorporates the Maddocks Questions (cognition), a balance assessment and a 'symptoms and signs' assessment.
• Maddocks Questions: At what venue are we today? Which half is it now? Who scored last in this match? What team did you play last game? Did your team win the last game?
• One failed Maddocks question, four balance errors and the presence of one or more signs will see the player removed from the game. A 15-minute period is allowed for players suffering suspected concussion and a blood injury.

Ex-Scotland international Rory Lamont has hit out at the International Rugby Board's concussion protocols labelling them "flawed" and added players know how to cheat the tests to determine whether they are fit to play or not.

The IRB is currently under-fire for its Pitchside Suspected Concussion Assessment (PSCA) which was brought in throughout the game last year. The test sees players who have suffered a suspected concussion leave the field for five minutes while the doctors determine whether they are fit enough to return to the pitch by asking the player a series of questions.

But former IRB medical advisor Dr Barry O'Driscoll hit out at the governing body and called for it to review its protocols after an incident in the third British & Irish Lions Test. Australia flanker George Smith suffered an early clash of heads with Richard Hibbard and despite looking dazed and confused, Smith passed the PSCA and was back on the field minutes later.

Lamont, who won 29 caps for Scotland, retired from the game last month after a series of injuries and he has slammed the IRB's protocols. "I don't know what research the IRB used for this trial but it is seriously flawed," Lamont told the Scotsman. "Everyone saw George wobbling his way off the field, clearly concussed, and then come back on.

"I have suffered clean knockouts, real sleeping-on-the-floor episodes in a game, so I know the protocols inside out, the symptoms and recovery periods, and there is no way a player should be allowed to stay on the pitch after a head knock. It's insanity. People might get annoyed with me saying this, but we are seeing reckless disregard for players' welfare right now."

The newspaper reports when Lamont first started running out in professional rugby, the guidelines saw a player ruled out for a mandatory three weeks if they had suffered a concussion. Coaches and players alike deemed this to be over-reacting in some cases so the process was changed. Players are now tested every day after suffering a concussion but according to Lamont, the players can beat the test.

"In many cases that is because they cheat," Lamont added. "Players all talk about it. A test is done at the start of the season as a baseline test, and players who suffer from concussion have to return to that level to be passed fit to play.

"But some players will deliberately do stuff in the baseline test so that their results are low, making it easier to pass after concussion. And I've seen players carrying concussion into games. They'd come off a fairly straightforward tackle, but be sitting on the ground, starting into space for a few seconds.

"It's a bit like your body shutting down and re-booting. I've experienced that. I didn't hide it, but you are often ostracised by coaches who assume you are being dishonest or shirking by saying you can't train or play, so with that pressure boys do play when they have head trauma.

"I'd like a return to a minimum three weeks out after concussion, because that would take away the pressure from coaches and medics to try to get a player back too early."

I did the concussion article because I think it is a serious problem in rugby. The current IRB concussion protocol is simply dangerous.

— Rory Lamont (@Rorylamont) July 27, 2013

Rugby culture is all about bravado and mental toughness. Complaining about injury and pain is often seen as weakness of the mind.

— Rory Lamont (@Rorylamont) July 27, 2013

Players think a bruised brain is the same as a bruised leg, in which it is something that you can train and play through. #Theyneededucation

— Rory Lamont (@Rorylamont) July 27, 2013