The NRL is considering a major change around warm-up surveillance in the wake of three seperate head knocks for Eli Katoa that saw the Tonga star rushed to hospital on Sunday. Katoa continues to recover from surgery in an Auckland hospital after suffering a brain bleed and seizures following his side’s Pacific Cup loss to the Kiwis at Eden Park.

The Storm star is expected to spend the rest of the week in New Zealand, as the NRL continues to investigate the circumstances around the worrying scenes. It comes after Tonga officials admitted they did not see footage of the first heavy blow Katoa suffered in the warm-up after clashing heads with Tonga teammate, Lehi Hopoate.

Seen here, NRL star Eli Katoa being attended to during Tonga's Test against the Kiwis.

The NRL is considering changes to warm-up surveillance as it continues to investigate the events around Tonga star Eli Katoa’s three separate head knocks. Pic: Getty

Tonga officials conducted an on-field check of Katoa after the initial blow, but deemed he did not require a full head injury assessment. The 25-year-old was later taken for a HIA after a clash in the first half, before copping another head knock in the second stanza.

It was after the blow in the second half that the Melbourne second-rower began to fall ill and he eventually required an oxygen mask before being taken to hospital. However, had the Tongans been privy to footage of Katoa’s first heavy blow with Hopoate in the warm-up, there’s a chance he may not have been passed fit to play in the first place. In fact, The Sydney Morning Herald reported that Tongan officials would not have allowed him to play if they saw it.

Tonga officials say their medical staff did not see the replay until after full-time and had not viewed the footage when they assessed Katoa the first time. The collision with Hopoate at Eden Park was only captured on camera by chance from the host broadcaster, before it was replayed on the television coverage.

NRL could make changes in wake of Eli Katoa fallout

Katoa’s incident is the first known serious head knock in a warm up since the NRL’s concussion protocols were introduced, but there are no suggestions it could have been foreshadowed. NRL rules state players must not return to the field after going off for two HIAs, given concerns over multiple head knocks.

While it’s unclear if Katoa would have been ruled out of the Test after the first head knock in the warm-up, it’s doubtful he would have returned to the field after the second one during the first half. Currently, NRL clubs are required to have a spotter at all contact training sessions, monitoring head knocks as well as a camera fixed on players for review.

There are also spotters on the sideline at matches as well as an independent doctor in the Bunker, with officials able to review replays of head knocks. But there are no such requirements for video recordings of a warm-up, which usually involve light running drills and work with tackling bags. And that’s when Katoa copped the first blow.

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The independent doctor is also not responsible for picking up head knocks in the lead-up to the match, with no feedback to the Bunker monitoring warm-ups. But all those measures are set to be looked at as part of a sweeping NRL review into the shocking incidents.

Seen here, Tonga's Eli Katoa is attended to by a trainer after a nasty head knock in the Test match against New Zealand at Eden Park.

Tonga’s Eli Katoa is attended to by a trainer after a nasty head knock in the Test match against New Zealand at Eden Park. Pic: Getty

One change that would make a lot of sense is establishing a line of communication between teams and host broadcasters, in case incidents like this are missed in future. The Fox League panel discussed the pre-game head clash at length and having the ability to relay that information to teams would certainly be beneficial.

The NRL hope to conclude its findings on the matter next week, but is yet to consider whether changes to the protocols need to be made. The Rugby League Players Association are also looking into the matter and are backing the NRL to conduct a thorough review before making recommendations.

with AAP