NFL: Improvements in protocol needed after Tom Savage concussion

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HOUSTON – The Houston Texans will not be fined for their action in following the NFL’s concussion protocol involving quarterback Tom Savage during the game against San Francisco on Dec. 10.

The NFL and NFL Players Association released a joint statement on Friday indicating they have completed their review of the application of the concussion protocol and the parties have both concluded that while the medical staff followed protocol, the outcome was unacceptable and therefore further improvements in the protocol are necessary.

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There was a lot of discussion within the locker room and from Texans head coach Bill O’Brien about the video that was shown on the broadcast of Savage displaying the “fencing response” but that went unseen by those involved in implementing and executing the protocol on the sidelines.

On the Monday following the game against the 49ers, O’Brien said, "With benefit of the video -- which I do not have benefit of any video -- there’s no video on the sideline. All there are are tablets. There’s no video. There’s nothing like that. 

"With benefit of seeing the video, obviously, from my standpoint, the care for the player -- I would’ve never let that player back in the game,” O’Brien said. "I don’t believe that (Texans head trainer) Geoff Kaplan would’ve allowed that player back in the game."

The statement from the NFL and NFLPA reads, in part:

"The review showed that following a hard tackle, Savage was immediately removed from the game and evaluated for a concussion. The Unaffiliated Neurotrauma Consultant and team physician reviewed the initial broadcast video, saw the play and Savage's response and followed the protocol by performing a complete sideline concussion evaluation on Savage, which he passed.  

"The slow-motion video, which focused more directly on the fencing posture, was not broadcast until after the doctors had begun the sideline evaluation and thus was not seen by the medical staff prior to the evaluation. The Texans medical staff continued to monitor Mr. Savage after the initial evaluation and shortly after his return to the game, identified symptoms that had not been present during the sideline evaluation and took him to the locker room for further evaluation.

"The NFL and NFLPA recognize that Mr. Savage's return to the game did not reflect the expected outcome of the Protocol. As such, the parties have agreed that no discipline will be assessed, but have already implemented several improvements to the Protocol to prevent such an unacceptable outcome in the future."

According to the statement, the NFL's independent Head, Neck and Spine Committee has recommended the following improvements to the concussion protocol:

1. Implemented a pilot program utilizing a centralized UNC based at the league office to monitor the broadcast feeds of all games. The UNC will contact the team medical staff on the sideline should they observe any signs or symptoms warranting further evaluation.

2. Defined impact seizure and fencing responses as independent signs of potential loss of consciousness, representing "No-Go" criteria under the current Protocol. Players who display either of these signs at any time shall be removed from play and may not return to the game.

3. Require a locker room concussion evaluation for all players demonstrating gross or sustained vertical instability (e.g., stumbling or falling to the ground when trying to stand).    

4. Officials, teammates, and coaching staffs have been instructed to take an injured player directly to a member of the medical team for appropriate evaluation, including a concussion assessment, if warranted. 

5. Require all players who undergo any concussion evaluation on game day to have a follow-up evaluation conducted the following day by a member of the medical staff.

6. Added a third UNC to all playoff games and the Super Bowl to serve as a backup who can step in immediately should one of the original two UNCs be absent from the sideline for a time to attend to a more severely injured player.

"In addition to implementing these changes to the Concussion Protocol, the NFL's Chief Medical Officer and NFLPA's Medical Director have hosted conference calls with every Unaffiliated Neurotrauma Consultant, Booth ATC Spotter and relevant team medical staff members to review the changes to the Protocol and the signs and symptoms of concussion," the statement said in conclusion.

The NFL Head, Neck and Spine Committee, the NFL and the NFLPA will conduct a comprehensive offseason review of all aspects of the protocol with an emphasis on continuous improvement in detection and diagnosis.


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