How do head injury (HIA) and blood replacements work in a Test?
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Both are temporary replacements under World Rugby Law 3.
Head Injury Assessment (HIA) (in matches World Rugby has approved in advance for the HIA process)
- The player leaves the field and is temporarily replaced, even if all the replacements have been used. Play can't restart until the replacement is on.
- If the player isn't back within 12 minutes (actual time), the replacement becomes permanent.
- If the player also has a blood injury, up to 5 minutes can be taken to stop the bleeding before the 12 minutes start.
Blood injury
- The player goes off and may be temporarily replaced until the bleeding is controlled or covered.
- If not back within 15 minutes (actual time), the replacement becomes permanent.
- In international matches, the match-day doctor decides whether it is a blood injury.
Concussion
- A player who is concussed or has suspected concussion must be immediately and permanently removed ("Recognise and Remove") and cannot return to that match.
Updated 22 Oct 2026