FIFA World Cup 2022: Concussion rules for Qatar tournament - after Alireza Beiranvand substitution vs England

Iran goalkeeper Alireza Beiranvand became the first ever concussion substitute in World Cup history when he was forced off against England on Monday (November 21).
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As England kicked off their World Cup campaign with a Group B fixture against Iran on Monday (November 21), fans filling the Khalifa International Stadium in Qatar were braced for an entertaining afternoon of football. However, within minutes of kick off, they surely did not expect to witness a worrying head injury.

The Iranian goalkeeper Alireza Beiranvand suffered a serious knock to the face just past the 10-minute mark and collapsed straight to the floor. Iran’s medical team rushed to his side to provide treatment to the 30-year-old.

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Beiranvand had tissue shoved up his nose and, due to FIFA protocol of blood not being allowed on player jerseys, his shirt was replaced.

BBC’s play-by-play commentator, Jermaine Jenas, showed concern regarding the condition of Beiranvand, as the goalkeeper remained on the pitch. After a matter of minutes, the Iranian lay on the ground and requested to be substituted, with deputy Hossein Hosseini waiting in the wing. There were 14-minutes of added time applied at the end of the first-half due to the incident.

“I don’t see how him carrying on is right. This is ridiculous, it is almost as if he’s been forced to carry on here. It’s 2022 and we are having so many discussions about concussion protocols and how it can lead to dementia. This is not ok,” said Jenas on live television.

During the half-time analysis of the game, BBC pundit and Newcastle United legend Alan Shearer accused FIFA of “failing their players” for their concussion policy. The ex-England international also called for the introduction of temporary substitutions, which would give teams appropriate times and circumstances to monitor the player to decide whether or not they had suffered a head injury.

Official FIFA rules and protocol for concussions

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According to the official FIFA rules, the protocol for dealing with concussions begins with ‘observation and recognition’. A pitch-side doctor should monitor the player who they perceive to have suffered a head injury for certain signs or symptoms. This can vary from balance problems and dizziness, to grogginess and confusion.

If a medical profession adjudges that the athlete is indeed showing one or more of these symptoms, they should immediately remove the player off the pitch for a more detailed examination. Due to the severity of head injuries, timing is inexplicably important so FIFA advises medics that if they adjudge the player to be suitable to continue, that they closely monitor them during the match but should immediately advise their substitution if any ‘red’ or ‘orange flags’ are spotted.

Following appropriate supervision and observation, especially if the professional needs to be admitted to hospital, they will need to take a period of rest and treatment to ensure their safety. As a result, a head injury or concussion will mean that a player will be out from on average seven to 10 days.

FIFA had only recently announced a fresh new addition to its concussion protocol ahead of the World Cup in Qatar. International teams are now permitted one additional permanent concussion substitution (APCS) that can only be used once a player suffers a head injury. This does not impact on the five allowed substitutions that teams can make during the field of play.