Hughes blow leads to first concussion sub

Cricket Australia's new rules regarding concussion substitutes have been implemented for the very first time after NSW Blues opener Daniel Hughes was replaced midway through Friday's Matador BBQs One-Day Cup Elimination Final.

Hughes was struck on the helmet while batting against Victoria and was later diagnosed with concussion. Under Cricket Australia's new Concussion and Head Trauma Policy, this immediately ruled him out of the rest of the match.

The new policy allows the Blues to name a "like-for-like" replacement player, and they have brought in Nick Larkin for the rest of the match, who can bat if required.

Under new playing conditions introduced this year, the concussion substitute must be a like-for-like player, but once activated can bat, bowl and field as if they were part of the starting XI.

Concussion substitutes were introduced this year in the wake of recommendations made by the Curtain Report - the independent investigation commissioned by Cricket Australia following the tragic death of Phillip Hughes, who had been struck during a Sheffield Shield match in November 2014.

The ability to use a concussion substitute is available in men's and women's domestic one-day matches, the BBL and WBBL, and other CA-sanctioned matches. They are not in use for Sheffield Shield matches after the International Cricket Council rejected the idea for use in first-class cricket.

Hughes had moved to 23 in the NSW run chase at Drummoyne Oval when he attempted to pull a delivery from Victoria fast bowler Peter Siddle and was struck on the left side of his helmet.

After taking a few moments to compose himself out in the middle, Hughes left the ground accompanied by NSW medical staff, including respected sports doctor, Dr John Orchard.

Hughes then followed Dr Orchard – the NSW Blues team doctor and Cricket Australia's Chief Medical Officer – into the stands where he underwent a concussion test. He emerged a few minutes later and chatted and smiled with some friends in the stands before returning to the players' pavilion.

Cricket NSW then confirmed that Hughes had concussion and had therefore been ruled out of the rest of the game.

Siddle understandably appeared to be shaken by the incident but continued his over after some comforting words from teammates. He was later seen chatting to Bushrangers coach Andrew McDonald and injured teammate John Hastings on the boundary line.

Under CA's new concussion policy, Hughes was required to undergo two separate tests, the medically recognised SCAT3 and CogSport tests with the team doctor.

Replays of the incident showed Hughes played under the ball and appeared to be struck on the peak of his helmet and the top of the grille simultaneously

Hughes was wearing the latest Masuri helmet, which meets the mandated stringent British Safety standards. The helmets have a second metal bar at the top of the grille in addition to the one featured on the old design.

The 27-year-old dropped his bat and crouched down on the side of the pitch as several Victorian players, including Siddle, as well as batting partner Ed Cowan and both umpires rushed in to check on his welfare.

Hughes then moved his body around to sit on the playing surface as Cowan helped him remove his helmet, revealing a mark under the batsman's left eye.

Hughes, by now in the hands of the NSW medical staff, regained his feet after about a minute and slowly made his way off the field.

Close-up footage captured by Wide World of Sports showed damage to the peak of Hughes's helmet, where the ball had impacted.

The incident comes just a week after the coronial inquest into the death of Phillip Hughes, who suffered a fatal blow during a Sheffield Shield match almost two years ago. On that occasion, Dr Orchard was the first medical professional to attend to the batsman after he was struck.

Just two months after the death of Phillip Hughes, his namesake Daniel was taken to hospital after he was struck on the neck during a Sydney grade match.

Just this week, Daniel Hughes said he felt confident at the crease wearing the new StemGuard neck protectors that were introduced after Phillip's passing in 2014.

"I was OK thankfully but it was quite a scary moment," he told News Ltd of the grade cricket incident two years ago.

"Luckily for me it just hit me in the jaw and it more concussed me than anything. A few people around the ground were a bit scared for me but the guys there took the precaution and took me to the hospital to get checked out.

"I do wear the StemGuards now. Most of the guys wear them. I feel a bit more at ease with the StemGuards on the back of the helmet."