Iran goalkeeper Alireza Beiranvand collided with teammate Majid Hosseini inside the opening stages of Monday's Group B encounter in Qatar and was left in a bloodied heap.
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It caused a lengthy delay to the match as both players received treatment.
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Beiranvand looked noticeably shaken by the incident and had blood running from his noise and on his shirt.
Remarkably, after ten minutes of treatment he carried on.
But just a few minutes later Beiranvand went down to the ground again and had to be stretchered off.
Seyed Hosseini came on in his place on 19 minutes with the score goalless at the time.
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talkSPORT's Adrian Durham was among those watching who were stunned Beiranvand wasn't substituted sooner.
As per FIFA rules, if there is any suspicion of a player having sustained a concussion, they must be removed from the field of play and not allowed to return if they are deemed to be concussed.
"They put the goalkeeper in the recovery position and then allowed him to play on," said Durham.
"If we are going to have a concussion protocol it has to be implemented correctly for the good and the safety of the players."
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Beiranvand's replacement, Hosseini, must have wished he could have stayed on the bench as England ran riot after his introduction.
Gareth Southgate's men produced a blistering attacking display to take control of the opening Group B game.
Jude Bellingham, Bukayo Saka and Raheem Sterling all scored to put the Three Lions 3-0 up in a first half that eventually lasted 59 minutes.
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Harry Maguire had earlier controversially been denied a penalty after appearing to be grappled to the floor in the Iran box.