From Afar, an Extra Set of Eyes to Spot Concussions in the N.H.L.


But McDavid expressed his frustrations about the latest change to the league’s concussion protocol, which players and coaches are still growing accustomed to.

“I was pretty shocked, to be honest,” he told reporters after the game. “I hit my mouth on the ice. You reach up and grab your mouth when you get hit in the mouth. It’s a pretty normal thing. Obviously, the spotter thought he knew how I was feeling and he pulled me off.”

In previous years, teams reserved the right to use their own spotters. The in-arena concussion spotters employed by the N.H.L. as off-ice officials were introduced last season. But this year the league installed the central spotters to monitor each game.

Stationed in the same New York war room as the N.H.L.’s Department of Player Safety, a group of one to four spotters — depending on the number of games that day — is responsible for seeking any players exhibiting concussion symptoms.

Working in conjunction with in-arena spotters, the New York-based central spotters, who are certified athletic trainers with training in the visible signs of concussions, communicate with team medical staff if a player requires an evaluation as outlined by the protocol.

“Our goal every year is to evaluate the system we have in place and, to the extent it can be improved, to make the changes necessary to improve it,” N.H.L. Deputy Commissioner Bill Daly said in an email. “The changes we have made to our program and protocol from year to year, and there have been changes made every year, are a reflection of that process and philosophy.”

The central spotters have added a wrinkle to game management. Coaches can be told at a moment’s notice and without warning that a player must be removed without knowing when he will return.

“You do what you’re told; that’s the one thing I’ve learned when you play with the N.H.L. and they set guidelines and rules,” Anaheim Ducks Coach Randy Carlyle said. “To me, it’s not any different from a player who needs his skates sharpened or needs to get stitches or needs to get some equipment adjusted. He’s not available to you. They make that decision. It’s out of your hands.”

Taking the decision out of the hands of players and teams is precisely the point of the spotters.

The N.F.L., which like the N.H.L. has been under scrutiny in recent years for its handling of head injuries, began using in-game concussion spotters in 2013. Those spotters, who are selected, trained and paid by the N.F.L., are in the press box in the upper level of stadiums at every game, monitoring both teams and communicating with the athletic trainers and doctors on the field.

After several high-profile incidents in which concussed players were not removed from games, the N.F.L. revised its protocol this year, allowing teams to be heavily fined or possibly lose draft picks if they failed to take players out of games after they had sustained head injuries. The league and the players’ union also now each appoint a person to monitor games to ensure that players are tested for concussions when warranted.

In the N.H.L., the central spotters make their decision based on specific indicators. The symptoms include headaches, nausea, disorientation and dizziness. If the central spotter identifies such symptoms in a player, the spotter can order the removal of that player so that he can undergo examination by team medical staff in a distraction-free environment, popularly known as a quiet room.

It was McDavid hitting his head and then reaching for his face that probably earned the spotter’s attention. The telltale signs outlined in the league protocol include “a player clutches his head, including any part of his face.”

McDavid’s criticisms were the highest-profile reservations about the system so far during the regular season. Players are operating under the understanding that they could be removed from a game at an inopportune moment.

It would be bad “if you were up or down by a goal in the last few minutes and they tell you to get off the ice,” Kings defenseman Drew Doughty said, adding, “But I understand why they’re doing it.”

Though the N.H.L. has expressed satisfaction with the current protocol, further changes have not been ruled out.

“We are pleased with the operation of the revised protocol to date, but like anything else, it remains a work in progress,” Daly said. “Part of the necessary process of evaluating the effectiveness of any system that is employed on a leaguewide basis is to engage in frequent discussions and dialogue with the clubs. They understand what we are trying to do with the revised concussion protocol, and they share our objectives in ensuring the best possible care for our players.”

The McDavid incident demonstrated that the protocol could play a substantial role in the outcome of an important game.

“It’s going to be interesting when a guy takes one off the mask in Game 7 of overtime and he’s a goalie,” said Carolina Hurricanes Coach Bill Peters, who supports the protocol change. “Now what are we going to do?”

A situation similar to what Peters describes occurred on Nov. 8, when a spotter removed Rangers goaltender Antti Raanta in the third period of a game against the Vancouver Canucks after a collision with forward Markus Granlund. Henrik Lundqvist entered a 2-2 game and, without the benefit of a warm-up, allowed two goals on just six shots in less than four minutes before Raanta was cleared to return. Vancouver won, 5-3.

Lundqvist later told The New York Daily News that he wanted the spotter rule, as it applied to goalies, to be examined.

“If someone is calling to tell me I need to leave the ice and I’m feeling fine, at some point you’ve got to trust the player, because I think the goalie situation is very different compared to a skater,” he said.

If the same situation happened in a playoff game, he said, “I’m not going off easy, I’m telling you that.”

Peters said the central spotters were bound to have an effect on the postseason.

“It has to happen if we stay true to the protocol,” he said. “Obviously those injuries happen throughout the preseason and the regular season. They’re going to happen in the playoffs.”

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