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  • 21 June 2019

    For those who think game plans and play calls are
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    , it would be helpful to take a behind-the-scenes look at the
    medical setups that go into an NFL game.

    Talk about multi-faceted.

    The league provided such an opportunity at US Bank Stadium this week, and it
    was enlightening.

    From the spotters’ booth upstairs to the exam rooms, locker rooms and ETM
    facilities in the bowels of the building to the blue tent on the sideline,
    dozens of people are involved in health and safety protocols.

    They range from neurotrauma physicians and athletic trainers to data
    technicians to ambulance drivers and emergency personnel, with perhaps 30
    medical folks on the sideline.

    Even the game referee is a part of the procedures.

    The league has been criticized for years that it rarely has had player safety
    and health as a focal point, and it’s placed a high priority on upgrading every
    such area.

    Game day includes a pregame meeting, new this season, held 60 minutes before
    kickoff that involves everybody on the health side of football.

    ”It’s a big group,” said Dr. Allen Sills, the league’s chief medical

    That group goes over the Emergency Action
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    , an exhaustive outline that describes who does what in
    virtually every case of injury or emergency. It’s so detailed that it includes
    arm or hand signals to help all involved determine what action is needed.

    ”The collaborative effort between teams is where it should be … seamless and
    flawless,” said Vikings head athletic trainer Eric Sugarman.

    The emphasis, of course, is on immediate treatment whenever an injury occurs.
    The hour-long meeting’s value became apparent when Bears tight end Zach Miller
    dislocated his left knee and tore an artery that supplies blood to the lower leg
    in a game at New Orleans. Miller could have lost the leg had it not been for the
    quick action by the well-schooled medical staffs.

    ”These are the kind of situations we’re practicing for,” Sills said. ”They’re
    incredibly rare, but we want to be prepared for it.”

    They need to be prepared for injuries large and small, ranging from
    situations when a visit to the blue tent is enough – a retaped ankle, perhaps –
    to sending a player inside to an examination room, or even to the hospital for
    particularly major issues.

    U.S. Bank Stadium has a specific ”quiet room” for examining concussions – all
    stadiums must have an area for such exams. Naturally, with revelations in recent
    years about the dangers of concussions in
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    , more attention is paid to head trauma than ever.

    In that ”quiet room” are the unaffiliated neurotrauma consultant and a team
    physician or member of the team medical staff. They compare the player’s
    baseline test to his current status. Sugarman said he has never seen a
    disagreement between them about a player’s condition after the 10-12 minute

    ”Sometimes, after two minutes you know they’ll fail the test,” Sugarman

    No one from a team – coaches, executives, owners – is allowed into any of the
    exam areas, not even the blue tent just a few yards away on the sideline.

    ”I don’t have owners telling me to get him ready … sooner,” Sugarman

    The roles of the concussion spotters have increased in importance and
    attention after a handful of players, most notably Houston quarterback Tom
    Savage, clearly were hurt but didn’t get the immediate care required. There will
    be four UNCs – unaffiliated neurotrauma consultants – at this Super Bowl.
    Typically, each sideline is staffed by one. After the protocol changed in
    December following the Savage
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    , an additional one was added for the playoffs, as well
    as a centralized UNC based at the league. That central UNC will be in the
    spotter booth for the Super Bowl.

    The jobs are usually filled in each city by certified athletic trainers
    charged with noticing player head injuries from their upstairs booth. The
    spotters are paired with video technicians who watch the broadcast feed and tag
    plays that result in injuries – although they’re not always easy to spot.

    A spotter can communicate with sideline medical personnel in a variety of
    ways. If there’s a reason to stop the game to get an injured player off the
    field, he has that power, often shouting into his device: ”Medical Timeout.”

    The referee will stop the game when so instructed; Sills estimated it
    occurred eight to 10 times this season.

    A sideline monitor then can show video of the play to team or unaffiliated
    medical personnel. A decision can be made more quickly and accurately about the
    next steps, if any are needed, and the medical staff has a better idea of what
    happened than how the player might describe it.

    Sugarman is more than grateful for the assistance and the technology that
    makes it possible.

    ”People like me might have looked at it with a crooked eye,” he said with a
    smile. ”Big Brother looking over your shoulder. But it’s been invaluable. You
    can’t see everything. It’s very protective to know they’re looking out for

    Last summer for the first time the league brought together all sorts of
    medical staffers from each team, plus unaffiliated consultants and spotters for
    a training session dedicated to head trauma and concussions. Those sessions will

    Sills bristles when he hears that the NFL is not doing enough regarding head
    injuries. Standing in a specialized X-ray room underneath the Super Bowl
    stadium, he vigorously defends the NFL concussion policy.

    A look at what’s happening around the majors today:


    Alex Bregman is red-hot at the plate as the Astros travel to Tampa Bay for a
    four-game series, and he’s been especially good late in games. Bregman has
    homered in three
    straight Christian
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    , including a game-ending two-run shot Wednesday to cap
    Houston’s rally from five runs down against Toronto. That was the second
    walk-off hit this month for Bregman, who also had a game-ending single in Game 5
    of last year’s World Series. Bregman is 9 for 17 with three homers and five
    doubles since shaving his mustache midway through a game Sunday.


    Dodgers ace Clayton Kershaw looks to sharpen his stuff against the Cubs in
    his second start since ending a DL stint for a lower back strain. Kershaw
    stumbled through three innings against the Mets last Saturday after surprisingly
    nixing a scheduled minor league rehab assignment, though Los Angeles beat New
    York 8-3 that day behind stellar relief work from rookie Caleb Ferguson. The
    21-year-old left-hander is set to follow Kershaw again against Chicago. Kershaw
    acknowledged feeling some rust at Citi Field, when he was limited to 55 pitches.
    He’s hoping to go deeper and pitch more effectively this time at Dodger


    The Tigers fired pitching coach Chris Bosio on Wednesday, saying he made
    insensitive comments to another employee of the team. General manager Al Avila
    said Bosio made the comments recently and they were brought to Avila’s attention
    Tuesday. Avila decided Wednesday to terminate Bosio’s contract after the team
    investigated the situation and spoke to all of the people involved. Detroit
    promoted bullpen coach Rick Anderson to replace Bosio. Roving pitching
    instructor A.J. Sager will be the team’s bullpen coach until Triple-A Toledo
    pitching coach Jeff Pico takes his place next week. The Tigers are set to wrap a
    four-game series against Oakland.


    The Nationals try to solve the Phillies’ Aaron Nola five days after the
    right-hander won a 5-3 decision in Washington. Nola (9-2, 2.58) allowed two
    runs, four hits and three walks over six innings while striking out five in that
    game. Nola is fifth in the NL in ERA, and only Mets ace Jacob deGrom has allowed
    fewer home runs per nine innings than Nola (0.53) among qualified NL