BIBA To Permit Rehydration Drinks In Competition To Reduce Dehydration and also Risk of Potential Bleeds To Brain.
In March this year the British & Irish Boxing Authority (BIBA) became the first Professional Boxing Commission to introduce Infra-Scanners ringside at events sanctioned by themselves, in an effort to reduce the time between diagnosis of possible bleeds to the brain following contests and the receiving of effective treatment.
Since introducing the Infra-Scanners the BIBA Deputy Chief Medical Officer Professor Michael Graham, has been undertaking research into head injuries in sport as well as investigating procedures that may assist in reducing the actual risk of bleed to the brain injuries in competition.
The on-going research has highlighted a number of concerning issues, one such issue relates to volume changes of cerebrospinal fluids (CSF) which is directly related to dehydration, as such Professor Graham and the BIBA Medical Committee, headed by BIBA CMO Dr Louise Eccles, have made a number of recommendations that they believe should be introduced as they could assist in reducing the risks.
Besides the recent introduction of the ‘Rehydration Clause’ for all day before weigh-in contests, the first of these new initiatives to be introduced is that from January 2018 rehydration drinks will be permissible for consumption by competitors during the one minute break between rounds during all contests of eight rounds and over, in an attempt to reduce excess dehydration during longer duration contests, which potentially also reduces the risk of bleed to the brain injuries.
The Effect of Fluid Intake Following Dehydration on Subsequent Athletic, Cognitive Performance & Potential Traumatic Brain Injuries
A systematic review and meta-analysis (McCartney et al., 2017) of sixty-four (64) trials derived from 42 international publications indicates:
A beneficial effect for fluid intake on athletic and cognitive performance is strongest when a continuous exercise task is employed (i.e., high intensity sport e.g., boxing).
The magnitude of improvement is greater when the continuous exercise is performed at elevated environmental temperatures and over longer exercise durations (i.e., boxing multiple rounds, in closed environments, where temperatures are greater than standard room temperature and pressure).
The volume of fluid consumed, relative to body mass (BM) lost, does not appear to influence the size of the treatment effect. The fluid intake at levels that comply with current recommendations for restoring body water content (1.25–1.50 L per kg BM lost) are as yet inconclusive. Rehydration drinks must be allowed ad libitum.
Life Saving Infra-Scanners Introduced This Weekend at UK Boxing Events
In February the British & Irish Boxing Authority (BIBA) announced that they were set to introduce hand held Infra-Scanners, that can detect Brain bleeds, ringside at events sanctioned by themselves in the United Kingdom and Republic of Ireland, following a number of high profile head injuries incidents and the death of Scottish Boxer Mike Towell.
The Infra-Scanner is a hand held brain scanner that is designed to detect bleeding on the surface of the brain inside the skull, so epidural and subdural bleeds, which are the common bleeds associated with an impact to the head, ones that can commonly cause life changing injuries or in the worse case scenario, death, in a short space of time.
Within Boxing, the Infra-Scanner is not intended to replace an MRI scan, which is required annually for Professional Boxers, but allows Doctors at Ringside to undertake a two or three minute scan, to determine if as a result of the boxing match that a boxer may have sustained an epidural and subdural bleed to the head.
Should the scan produce a positive result this will enable the Ringside Doctors to ensure that the Boxer is admitted immediately to the nearest specialist unit, where the appropriate care can be undertaken.
Yesterday, InfraScan Inc. representative Jonah Roche, from SkillShop.Eu, travelled to the United Kingdom to deliver the first of the Infra-Scanners as well as undertake a training session for a number of the British & Irish Boxing Authority (BIBA) Ringside Doctors and affiliated Chief Paramedics, ahead of launching the use of the Infra-Scanners at an event in Paisley, Scotland this coming Saturday.
The British & Irish Boxing Authority had made the decision to introduce the potential life saving scanners following four major head injury incidents at events in the United Kingdom last year, even though these catastrophic injuries were sustained on events overseen by the British Boxing Board of Control (BBBofC) and not on events sanctioned by them.
In January 2016, Tommy Martin suffered a bleed to the brain following the Commonwealth and WBC International Championship bout against John Wayne Hibbert.
In March 2016, Nick Blackwell was put in an induced coma due to a bleed in the skull following his British Title fight with Chris Eubank Jr, and once again in November following a sparring session.
In September 2016, Mike Towell suffered a bleed to the brain during the British Welterweight Championship Eliminator contest against Dale Evans and passed away shortly after due to the injury.
In November 2016, German based Kazakh Eduard Gutknecht collapsed in the dressing room following the WBA International Championship bout against George Groves and was rushed to hospital, where he underwent surgery to relieve swelling on his brain and, whilst still in a coma, was transported to Germany in December.
In February this year BIBA Vice President Gianluca Di Caro wrote to BBBofC General Secretary Robert Smith, offering the use of the scanners for any boxer licensed by themselves, should they be suffering headaches or nausea following sparring or a contest, however this offer was refused and shortly after Mr Smith made the following statement to Boxing News Magazine.
“We’ve looked into it and we’re still looking into it,” Robert Smith tells Boxing News.
“We want to make sure they are accurate, and ensure the people using them are qualified to do so. We have asked many doctors, and received many opinions.
Ultimately, it seems it is too early to tell if this technology will be suitable for boxing. We will continue to look into the possibility of implementing them because safety has been paramount to us for many years, and will continue to be so.
“Nobody has said to me that this is definitely the way to go, because at this time, it’s just too early to say. In the future, after further research, they might be. It will be discussed in detail at our medical seminar in the summer.”
Following the introduction training course, Renowned Sports Forensic Scientist and BIBA Deputy Chief Medical Officer (D-CMO), Professor Michael Graham MBChB; JCPTGP; PhD; FRSM; MPhysoc; BASEM; MICR; MCSFS; PCCMH; APIL Expert; FSB, stated;
“The growing recognition of sports-related brain trauma creates an ideal application for the Infra-Scanner.
In contact sports like Boxing, Football, Karate, Mixed Martial Arts and Rugby, and others, the Infra-Scanner can provide field-based diagnosis and assist in the decision whether to evacuate an injured athlete to a hospital for immediate investigation and medical or surgical management.
The Infra-Scanner has been subject to a substantial number of Controlled Research Studies, around the World, and has already proven 80-100% selectivity and 90-100% specificity.
In addition there are over two hundred Infra-Scanners in use by the American Military, as this equipment was developed specifically for them for use in the field, as well is currently undergoing further trials at St Mary’s Hospital and The London Air Ambulance.
The Infra-Scanner is proven to accurately detect intracranial haematomas using the unique light-absorbing properties of haemoglobin, which is located within blood, and the non-invasive, non-ionizing nature of Near Infrared (NIR) technology.
Enormous advantages of the Infra-Scanner for speed of diagnosis are:
Portability, Infra-Scanners weighs just 400 grams.
Patient measurement is completed within 2-3 minutes.
The Infra-Scanner detects haematomas greater than 3.5 ml in volume, as well as detects haematomas up to 2.5 cm deep from the surface of the brain, or 3.5 cm from the skin.
I expect that such technologically advanced equipment will become mandatory at all public and private events, within a very short period of time.
Failure, by sporting organisations, to have the Infra-Scanner and personnel trained in its use will ultimately invalidate sporting licenses and insurances and result in enormous medical negligence claims.
Already it is clear in Boxing alone, that deaths from intracranial haemorrhages could have been prevented, if the Infra-Scanner had been present and used as a diagnostic tool.
As such we at the British & Irish Boxing Authority are extremely proud to introduce this technology at events sanctioned by ourselves, as we believe they will prevent future tragedies in the sport.”
The Infra-Scanners will be introduced Ringside at the British & Irish Boxing Authority (BIBA) sanctioned event promoted by Gerard Boyle-Welsh at the On-X Centre, in Paisley, Scotland this coming Saturday.
Hand Held Infra-Scanners, That Detect Brain Bleeds, Introduced By BIBA For Professional Boxing Events In The United Kingdom.
The British & Irish Boxing Authority (BIBA) are set to introduce hand held Infra-Scanners, that can detect Brain bleeds, at events sanctioned by themselves in the United Kingdom and Republic of Ireland.
Sky News’ Health & Science Correspondent, Thomas Moore, highlighted the benefits of the use of the Infra-Scanners, that can detect brain bleeds with an accuracy of 90%, often before any symptoms such as headaches or confusion become apparent, following the death of Mike Towell last year at an event sanctioned by the British Boxing Board of Control (BBBofC).
In the article Mr. Moore stated “Compulsory brain imaging using Infra-Scanners could be “massive” for boxers who risk death from professional competition.”
On announcing the introduction of Infra-Scanners, that will be available ringside at events sanctioned by them, BIBA Vice President Gianluca Di Caro said.
“We are extremely proud to be the first to introduce Infra-Scanners at events in the United Kingdom and Ireland, as we whole heartedly believe having them ringside will significantly prevent further tragedies within our sport.”
Before expanding further and explain what had led to the decision to introduce the use of Infra-Scanners at BIBA events;
“Following two major head injury incidents last year, one that resulted in the death of Mike Towell, even though neither were on events sanctioned by ourselves, the BIBA board had decided to actively seek solutions regarding improving the way that injuries such as these can be detected as quickly as possible. The first move we made was to appoint renowned forensic sports scientist Professor Michael Graham PhD to our Ringside Medical Officer & Medical Advisory Board.
Professor Graham led the esteemed team that produced the internationally published papers “Direct Hits to the Head During Amateur Boxing is Associated With a Rise in Serum Biomarkers For Brain Injury” & “Should an Increase in Cerebral Neurochemicals Following Head Kicks in Karate Influence Return to Play?”
Professor Graham and his esteemed team are currently researching the short-term and long-term effects of head injuries in Rugby as well as preparing, in conjunction with ourselves and a prestigious UK University, a long term research project to assess cognitive function following brain trauma.
Around the time of the appointment of Professor Graham, our CMO, Dr. Louise Eccles, proposed that we should investigate obtaining Infra-Scanners, as the use of these would massively assist in detecting problems such as a bleed on the brain quickly, especially as there is only a limited amount of time to assess the location of such an injury.
Following Louise’s advice, I contacted the manufacturers and am extremely proud to say that the initial trial unit will arrive later this month, hopefully in time for the 26th February event in Bradford, that features two ten round International contests.
We have initially ordered two Infra-Scanners which will be operated by Professor Graham and Dr Eccles at our events, and are aiming to order a further eight units over the coming twelve months, so that every BIBA Ringside Doctor will have an Infra-Scanner available by 2018.
Both the appointment of Professor Graham and the introduction of Infra-Scanners, are just two pro-active decisions made by ourselves with regard to Boxer Health & Safety, there are more to come, as Professor Graham and another of our Ringside Medical Officer & Medical Advisory Board, Dr Mark Xuereb have also proposed the introduction of further safety measures, one of which is the introduction of Cognitive Testing, which will come into force very soon.
We believe that Boxer Health & Safety is paramount, as such we will continue researching procedures that can assist us provide the very best medical evaluations possible.”