Concussion protocols, the blood rule, stretchers, and the health and safety guidelines that govern an AFL game.
The stretcher, the blood rule, the concussion protocol. Football has always been physical, but the league's regulations around player welfare have tightened significantly in the last decade — driven by research on long-term head injury, infection control, and the duty of care owed to players.
Regulation 34 sets out when stretchers can be used and how they must be handled. A stretcher is called for players who cannot leave the field under their own power, typically due to suspected spinal injury, leg fractures, or serious head trauma. Match officials have discretion to pause or stop play while the stretcher is on the field.
Players stretchered from the field cannot return under any circumstances. The replacement sub — if used — is triggered, and the team plays out the remainder of the match one player short if no sub remains.
Regulation 35 governs medically unfit players. A player who has sustained an injury severe enough to prevent continued participation — a suspected fracture, ongoing concussion symptoms, or a significant soft-tissue injury — must be removed and cannot return that match. The club medical officer has the final say; coaches cannot override a medical exclusion.
A player who is medically unfit must be cleared by a club doctor before the following match. For concussion specifically, the AFL mandates a minimum 12-day stand-down period, introduced in 2021 as part of the league's strengthened concussion protocols.
Regulation 36 — titled "Bleeding and Blood Borne Infections" — codifies the blood rule. A player who is bleeding from any source, or whose uniform has a visible amount of blood on it, must leave the field immediately until the bleeding is stopped and the uniform is clean or replaced.
The rule exists for infection-control reasons — to prevent the spread of blood-borne pathogens like hepatitis B and C or HIV through on-field contact. A player with a bleeding wound can return after treatment, provided the bleeding has stopped and the wound is covered or dressed.
The HIA protocol sits within Regulation 12 but operates as a cornerstone of player welfare. A player suspected of having concussion is removed from the field and evaluated by the club medical officer using the SCAT5 assessment — a standardised concussion evaluation tool. A player with signs of concussion cannot return to the field.
The AFL's 12-day stand-down — 13 days including the day of injury — effectively guarantees a player concussed in Round 1 will miss Round 2 at minimum, and typically Round 3 if symptoms persist. This is a significant departure from practice as recently as the mid-2010s, when players were routinely allowed to return the same match after head knocks.
Regulation 37 incorporates the AFL's broader Health and Safety Guidelines — covering environmental factors (heat, lightning), ground conditions, on-ground medical arrangements, and emergency protocols. These guidelines can trigger match delays, suspensions, or relocations when conditions are unsafe for players.
Heat policies, for example, require drink breaks at a certain wet-bulb globe temperature and can produce shortened quarters. Lightning policies pause play when strikes are detected within a defined radius of the ground. Both policies have been invoked in recent AFL seasons — particularly in Perth, Darwin, and Queensland during summer and early-autumn rounds.