Credit NHL for Smart, Safe Concussion Strategy

By Erik Lief — Dec 07, 2016
Largely overshadowed by the NFL, the National Hockey League, working in conjunction with its Player's Association, deserves credit for implementing a smart concussion prevention and management plan. It shows considerable promise, and one that demonstrates a joint commitment to making pro hockey safer.        
Concussions in hockey

When it comes to concussion prevention, and the ways to reduce brain trauma in professional sports, for years now the spotlight has steadily shone on the National Football League and the efforts it has made. And it's been thrust onto center stage for good reason.

First, the sport is relentless, inherently brutal and violent, and so many high-impact areas of the game need to be addressed. Second, it's the most popular sport in America, so naturally what executives are doing to address concussion mitigation is being very closely watched. And the league, while it has its many critics, is making progress by instituting rule changes and strengthening medical safeguards.

But there's another sport that's also putting effective measures in place, and since it operates in the NFL's massive shadow its own efforts may be overlooked. Therefore, the National Hockey League, working in conjunction with its Player's Association, deserves a great deal of credit for constructing, and now implementing, a plan with considerable promise that demonstrates their joint commitment to making their sport safer.

And a recent incident, where an excess of caution superceded a star player's desire to remain on the ice at a pivotal moment -- which ultimately proved detrimental to his team -- indicates that the NHL has a smart, strong plan in place. 

The essence of the plan, called the Concussion Evaluation and Management Protocol and put into effect in October, is that "spotters" have been placed in all arenas to observe games with the purpose of determining if a player has sustained a head blow that requires medical intervention.

These spotters, according to the league, are "certified athletic trainers" with "hockey expertise." In addition, there's another contingent of spotters, watching live game broadcasts from NHL offices, who can be in immediate contact with on-ice game officials if they perceive, utilizing video-tape replay, a player is at risk.

Risk is determined by comparing what spotters see to a list of six "Symptoms and Signs" that detail when a concussive incident may have occurred. When there's a match, according to the NHL, this "Protocol requires the mandatory removal of a Player from play for an acute evaluation as soon as possible if a concussion is suspected."

The six triggers are:

1. "Symptoms": The Player reports or exhibits one or more “Symptoms” of possible concussion, including:

  • Headache
  • Dizziness
  • Balance or coordination difficulties
  • Nausea
  • Amnesia for the circumstances surrounding the injury
  • Cognitive slowness
  • Light/sound sensitivity
  • Disorientation
  • Visual disturbance
  • Tinnitus

2. Sign: "Lying Motionless on the Ice"

3. Sign: "Motor Incoordination/Balance Problems"

4. Sign: "Blank or Vacant Look"

5. Signs: "Slow to Get Up" or "Clutches his Head"

6. "Any other sign, symptom or behavior that leads Club medical personnel to suspect" a concussion

With the spotters in place on Dec. 4, the protocol was invoked when Connor McDavid, the captain of the Edmonton Oilers, tripped over the stick of an opposing player for the Minnesota Wild during a sequence when his team had a power-play, or a tactical advantage to score. McDavid, who leads the entire NHL in scoring, fell and hit the area around his mouth on the ice. But when he reached to grab his chin, to see whether he might be bleeding, the spotters signaled to the game referee that McDavid needed to be evaluated.

Citing the protocol's 5th Sign -- "Clutches his Head" -- the word was passed to McDavid that he needed to leave the game, which "shocked" him and his team. Without their best player, the Oilers lost their scoring opportunity. They then went on to lose the game, 2-1.

Reading through the seven-page protocol reveals that it's comprehensive, well intentioned and precise. And it provides the framework to view every incident from multiple vantage points -- on site or via broadcast -- taking advantage of video replays, if needed, to evaluate situations quickly, as they arise.

And as this case illustrates, best of all is the fact that the league's participants stuck to the protocol -- while ignoring the circumstances involving a star player during a key moment in the game -- to err on the side of safety. These are the rules the players' association agreed to, so while the moment may not have been the most compelling or dangerous, safety ended up being the paramount concern.

It's still early in the season, and if the protocol needs to be revised after enough incidents are documented then that can occur. But it's reassuring to see that despite the controversy generated from the McDavid incident, which produced criticism for NHL officials, the league stuck with its plan.  

There's much more to this incident, which demonstrates the NHL's commitment to protecting its players. In Part 2 we'll detail how the process works, as well as the type of medical procedures that serve as the foundation for the protocol. 

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