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NFL outlines concussion management plan

Commissioner Roger Goodell reviewed with NFL clubs today consensus medical recommendations regarding the management of concussions. The standards are based on extensive medical research and discussion.

NASHVILLE (May 22, 2007) -- Commissioner Roger Goodell reviewed with NFL clubs today consensus medical recommendations regarding the management of concussions.

The standards are based on extensive medical research and discussion. They were recommended by the NFL's independent committee on mild-traumatic brain injury (MTBI) chaired by Dr. Ira Casson of the Long Island Jewish Medical Center and the Albert Einstein School of Medicine, and Dr. David Viano of Wayne State University.

"NFL clubs do an excellent job in the care and management of concussions that affect NFL players," Commissioner Goodell said. "It is important that we articulate for our clubs and players, and for the broader medical community, the standards our clubs are applying as we work together to protect the health of our players. The overriding principle governing management of concussions in the NFL is that medical considerations must always have priority over competitive situations."

The recommended standards were presented at the NFL's spring business meeting in Nashville, Tennessee, and include the following elements:

  • Medical decisions must always override competitive considerations.
  • Neuropsychological baseline testing will be required for all NFL players beginning this season, using a standardized test to establish an individual functional baseline. Neuropsychological testing is one tool a physician can use to assist in the management of MTBI. It cannot be used by itself to make clinical decisions. For players removed from games due to concussions, repeat testing will be done during the season to track recovery and to help decide when they can return to play. These players also will be re-tested against their baseline performance the following season at training camp.
  • An NFL MTBI conference will be held on June 19 in Chicago for all NFL team physicians and athletic trainers to share the most up-to-date information on state-of-the-art care and management of concussions.
  • The MTBI Committee will continue to operate as an independent group. Three non-NFL affiliated physician have been added to the committee (Joseph Maroon, Joel Morgenlander, and Thomas Naidich). The goal of the committee remains the advancement of scientific knowledge of MTBI through well-conceived research to protect the health of NFL players and improve the safety of the game.
  • To promote the use of best practices by all teams, the evaluation procedures used by NFL teams will be shared among all medical and training staffs.
  • A brochure will be developed and distributed to NFL players to help educate players and their families about concussions, including how to recognize the symptoms of a concussion and recommended treatment procedures.
  • Return-to-play decisions should continue to be made by team medical personnel using their expertise and professional judgment.
  • The NFL rule requiring every player to wear a chin strap that is completely and properly buckled to the helmet will be strictly enforced. Teams and players will not be permitted to modify the attachment of the chin strap to the helmet or improperly modify the helmet in any other way. The longstanding safety-related rules related to the use of the helmet also will be strictly enforced.
  • The NFL will establish a "whistle blower" system so that anyone may anonymously report any incident in which a doctor is pressured to return a player to play from a concussion or that a player with a concussion is pressured to play. The NFL will investigate any such reports and take whatever action is necessary.
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