Medical timeouts can be called by spotters looking for signs of head injury

Independent certified athletic trainers (referred to as ATC spotters by the NFL) will be able to call a medical timeout in very specific situations under a new rule this year. The rule is intended to prevent a player from continuing to play when there are clear signs that they need to be evaluated by medical personnel. A medical timeout may only be called when a player is showing obvious signs of disorientation or is clearly unstable and the player is attempting to stay in the game without receiving medical attention.

The intervention by the ATC spotters is as a fail-safe measure in case the team’s trainers, other players, and the officials do not see a player who needs medical attention. Spotters will first allow for the on-field officials to call for a standard injury timeout, and only if there is no intervention, the ATC spotter will stop the game by communicating with the officiating crew’s wireless headset.

Because this is outside of the typical injury protocol, a medical timeout is not an injury timeout. The game clock and the play clock will freeze at the point of the medical timeout, and resume when the injured player leaves the field and the opponent has made a matching substitution at its option. (If there is less than 10 seconds on the play clock, it will be reset to 10.) This is not a charged timeout to either team after the two-minute warning in the half if the timeout is initiated by the ATC spotter, but the normal injury timeout rules apply when the stoppage comes from the officials.

An injured player must leave the field for at least one down, but  a player exhibiting a head injury will be evaluated as required and medical staff will determine the whether the player can return to the game.

A medical timeout can only be called for an injury to the head or neck, and not for any other purpose. If the officials determine that a player is acting in a manner to draw a medical timeout by deception, it will be penalized as a palpably unfair act, and the referee may make any equitable ruling as a result. (A palpably unfair act has never been called in the NFL.)

The NFL has employed independent certified athletic trainers to act as ATC spotters since 2012 as part of the NFL’s attempts to ensure that potential player injuries don’t go unnoticed. The ATC spotter observes the game from the press box looking for indications of potential injuries on the field. When the ATC spotter observes a potential injury, they alert the team’s medical staff to evaluate the player in question. This year’s new rule expands that role to allow the ATC spotter to stop the game when a player with an obvious injury isn’t receiving needed medical attention.

ATC spotters cannot be affiliated with any NFL team. Anyone who has been employed by an NFL team within the last 20 years or who has ever been a head athletic trainer for an NFL team is disqualified from being an ATC spotter.

The role of the ATC spotter started with an incident on Dec. 8, 2011 when Cleveland Browns quarterback Colt McCoy took a helmet-to-helmet hit in a late-season game against the Pittsburgh Steelers. After the injury, McCoy was allowed to return to the game without having been checked for a concussion. The Browns said that the team’s trainers didn’t see the hit that took McCoy out of the game and weren’t informed of the nature of the hit. After the game, McCoy was diagnosed with a concussion. Within two weeks, the NFL had placed ATC spotters at every game to watch out for potential injuries.