League announces enhanced concussions protocols

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The NFL has issued a statement regarding an enhancement to its existing in-game concussion protocols.  The changes become effective immediately.

As expected, the league has announced that a “certified athletic trainer” will attend each game, with the goal of assisting the teams and the medical staffs regarding concussion evaluation and treatment.  The certified trainer will come from a “major college program in the area,” selected jointly by the league and the NFLPA.  The trainer will have no affiliated with any NFL club.

The overriding purpose of the certified, independent trainer will be to provide information to team medical staffs, given that personnel at field level may miss things like, for example, a quarterback nearly getting his head taken off by James Harrison.  The certified, independent trainer will have no authority to remove a player from a game.

Also, medical staffs will be allowed to use their cell phones in order to obtain information regarding the care of an injured player, whether the player has a concussion or any other injury.  Though we’re not quite sure how that will help a doctor diagnose a concussion or any other injury, it can’t hurt.

All that said, the league still needs to have independent neurologists present on the sidelines to handle the diagnosis of a possible concussion.  As suggested during today’s PFT Live, the league and its teams possibly prefer not to have an independent neurologist present because the independent neurologist would possibly want to take the player to the locker room for a proper evaluation, away from the crowd and the noise and the weather and the other players and the frenetic atmosphere on the sidelines and the curious head coach and the playing of a game in the background.

The league and its teams presumably want something more efficient and immediate, which will result in players being either cleared or shut down quickly, so that a player without a concussion won’t be kept out of the game for an unduly long period of time.  Still, if the goal is to catch all concussions, the league needs to err on the side of ensuring that no player with a concussion re-enters a game, even if that means keeping a non-concussed player out of action for more than a few plays.

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26 responses to “League announces enhanced concussions protocols

  1. Evaluating a concussion outside will not improve how he scores on the concussion testing. In fact being outside in that environment would potentially make it harder to concentrate further exacerbating symptoms.

    The most common symptoms are difficulty concentrating, blurred or double vision, headache, and balance deficits. What’s harder taking a test in the confines of quite room or outside in a crazed stadium?

  2. “… the league still needs to have independent neurologists present on the sidelines to handle the diagnosis of a possible concussion. ”

    Isn’t it more likely the league fears that the independent neurologist could testify against the NFL or team in the currently filed or future concussion lawsuits.?

  3. All the constant drum-banging regarding concussions is threatening to give me a concussion.

  4. If they want to get some one truly independent they need to get someone not affiliated with any sports team at any level. Players and coaches and trainers all learn to hide injuries long before they reach the pro level.

  5. Dare I say it but, it’s quite possible an independent doctor might also have a rooting interest. So in the event this independent doctor’s opinion supersedes all coaching decisions and team doctor’s opinion, it could inevitably have negative repercussions.

    The game of football is being put in the hands of those not even playing, and it’s quite sickening. Between the erratic rules enforced by the fuhrer, to the inconsistent calls by the refs, and now doctors who can prevent a player from willingly going out to compete. It’s just crazy…

  6. They don’t even keep Neurologists in Emergency Rooms… Doctors and medical staff can diagnose a concussion. If the symptoms don’t clear up, that’s when a Neurologist is needed. Having Neurologists at the game would be the same as having a(n)…

    1) Nutritionist at all McDonalds
    2) Infectionious Disease Physicians at all Wh—houses
    3) SWAT Team at all 7-11’s
    4) feel free to add yours

    It may sound like a good idea at first, but when you really think about it, it’s a situation that has FUBAR written all over it.

  7. “jakek2 says:
    Dec 21, 2011 6:29 PM
    Just put skirts on these players and end it already”

    When discussing brain damage, it’s always good to go to the source.

  8. “Still, if the goal is to catch all concussions, the league needs to err on the side of ensuring that no player with a concussion re-enters a game, even if that means keeping a non-concussed player out of action for more than a few plays.”

    It’s certainly easy to make such proclamations from on high when you have nothing invested in the sport. Get off your soapbox.

  9. The enhanced concussion protocol requires coaches to have on the sidelines a life size cardboard cut out of that picture of Mccoy after that harrison hit. anyone suspected of having a concussion must stand next to that and not babble or drool.

  10. As an actual neurologist who has treated NFL and college players, I would want no part of being on the sidelines or in the locker room evaluating a player during the game. Teams and players have a unique way of manipulating the situation, and the pressure to make a quick decision without a proper period of time for observation and evaluation would be intense.

    As well, the medical liability issues would be tremendous. I don’t believe there is any medical liability carrier that would write a $100-150M policy to cover me in the event of a player who suffered a premature end to his career after my “independent neurological evaluation.”

    The owner of the NFL team would have to sign the team over to me to accept that type of exposure. No thank you.

  11. Independent trainer: “Colt McCoy just got rocked. Check him out for a concussion”

    Browns coaching and training staff: “Colt was hit? We didn’t see anything?”

    Independent trainer: “You didn’t see anything? He was light up brighter than a Taliban training camp”

    Browns: “Didn’t see a thing? He’s good now though, right?”

    Trainer: “Ah, no. He’s laid out on the field. Stiffer than a board”

    Browns: “We will check him out”

    Time elapses …

    Browns: “He says his finger hurts but he is good to go”

    Trainer: “Did you give him a concussion test?”

    Browns: “how can he get a concussion from a sore finger?”

    Trainer: “Sigh. Maybe you guys need the concussion test?”

    Browns: “How would that help Colt’s finger?”

    Later at the press conference …

    Walrus: “Our staff are the best”

  12. “independent neurologist” is becoming a buzz-word around here, repeated often enough to begin to seem normal. But, as jagerbmb pointed out, repetition of the idea does not make the idea the best solution.

    First of all, there are plenty of other steps the league can take (equipment mandates, for example) to begin to address concussions. As has been pointed out, doctors are able to diagnose a concussion. So an alternate to the meme-approaching “independent neurologist” would be that the team is fined (and the medical staff sanctioned) for any player that:

    1) is diagnosed with a concussion in the week following a game, who…
    …..a) was not given the cognitive test during the game, whether or not he returned to the game or was held out as a preventative measure, or…
    …..b) was given the test but returned to the game

    The only way to avoid a fine for the concussed player is if the injury was caught during the game and he was given the test.

    Fine the teams considerably (to help change the culture), and give “cards” to the medical staffs. Two concussed players mishandled during the season? Yellow card. You’re suspended as field-side medical personnel for 4 games without pay. Another concussed player mishandled that season? Red card. You’re suspended for the rest of the season or 8 games, whichever is greater. If you incur two 8 game suspensions, black card. You’re out of a job with any team in the league.

    That would alleviate any concerns that the medical personnel could be “pressured.” The fines to the teams would hopefully help to keep that “pressure” from being applied in the first place.

    And, if you’re concerned that a concussed player would have his diagnosis hidden during the week to avoid that sort of fine and sanction, then include your “independent neurologist” (*gasp*, I used the meme) during the week. This wouldn’t be in the heat of the game. This wouldn’t be in a way that could directly (and immediately) impact a game, by forcing a player to sit out. It would be during the week… maybe even the day after a game… in a doctor’s office.

    You know what else? It would be thorough and effective.

    So don’t make this into, “these people are arguing that ‘concussion-diagnoses shouldn’t interfere with the flow of a game’? Are they serious? The health of a fellow human relegated to secondary importance by a football game?” That’s simply not the case. Not what I’m arguing for. The question is: is there a way to solve the concussion issue *without* interrupting the game, *without* over litigating it, *without* unnecessary delays, *without* keeping a player off the field needlessly, and *without* overly changing the on-field product.

    The system I outlined, above, does just that.

  13. I wonder who the league will suspend next, when/if this new protocol fails.

    That’s the only reason why Harrison was suspended…to divert attention away from the PR nightmare caused by the failure of the league’s concussion protocol.

  14. Glad to see that you mentioned the Steelers and James Harrison. Have to get that “hit” count up on the site.

  15. the more hits up high by a defense during a game now potentially means less offensive players to face during that game

  16. if the browns are so willing to lie and say no one saw the mccoy hit, the replay of the hit, or the spectacle of him writhing in pain… why won’t they just lie and say they didn’t hear the cell phone ring when the trainer calls down?

  17. lawyermalloy says: Dec 22, 2011 7:30 AM

    Ask yourself; If you had concussion symptoms would you consult with an “athletic trainer” or a Neurologist?

    You obviously don’t understand what an athletic trainer is or really does. Most concussions don’t show up on any type of imaging, not that you could do instant imaging on the sideline.

    So one has to rely on quick assessments that question subjective symptoms and have several tests that can show objective data. The problem with concussions is that it is entirely possible to have a concussions and show little or no objective signs, at least ones that can be measured on the sideline. So one often has to rely on the subjective symptoms that an athlete may or may not have…and athletes lie. A LOT.

    For my money, in a sideline assessment situation, I would take an athletic trainer over just about anyone (with the possible exception of a fellowship trained sports medicine specialist). In a case where symptoms are lingering for an extended period, and a long term care situation, a neurologist would be the next step to take. .

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