The NFL and the NFLPA continue to look at potential modifications to the concussion protocol to ensure they are applied consistently and conservatively, and reflect the most up-to-date medical consensus on the identification, diagnosis, and treatment of concussions.
The following were developed with the NFLPA and are now being implemented:
-- Impact seizure and fencing responses are each independent signs of loss of consciousness and represent "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.
-- A player who stumbles and/or falls to the ground when trying to stand, unrelated to an orthopedic injury, should be sent directly to the locker room to undergo the standard locker room exam. If he passes all phases of this exam and is cleared by the UNC and the team MD in charge of concussion care then the player could return to the game.
-- Officials, teammates, and coaching staffs are instructed to take an injured player directly to a member of the medical team for a concussion assessment.
-- All players who undergo any concussion evaluation on game day shall have a follow-up evaluation conducted the following day by a member of the medical staff.
-- The implementation of 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 to ensure it is aware of the play's video.
The adjustments were implemented Dec. 11 by the NFL's head, neck and spine committee and communicated in two conference calls headed by Sills and Dr. Thom Mayer, the chief medical officer for the NFL Players Association, with 400 people involved in the concussion process, including every team physician, every athletic trainer, every UNC and every booth spotter.
From Dr. Sills: "We are constantly looking at the protocol and how it's applied and trying to get better. The process happens throughout the season."
There have been 540 game day concussion evaluations conducted this season with two reviews.