In 2015, the NFL decided to give medical personnel in the press box the authority to call a medical timeout. For the first time in a major sport, these experts off-the-field can freeze the game clock in order to ensure that medical personnel properly evaluate a player.

Another Set of Eyes

High above the football field, inside the press box, independent athletic trainers—called “spotters” or “eyes in the sky”—are tracking all possible injuries on the field.

They’re in constant communication with sideline medical staff to make sure they’re aware of things they might have missed. And they also help identify the proper replays to assist team doctors in diagnosing potentially injured players.

Now, these athletic trainer spotters have the authority to call a timeout if they see a player needing assistance.

It’s the first time in a major sport a non-participant can freeze the game clock for player safety.

A New Rule Designed for a Fast Game

The origin of the program dates back to a violent hit during the 2015 Super Bowl.

During a late drive by the New England Patriots, wide receiver Julian Edelman was sent to the ground by a strong helmet-to-helmet hit from Seattle Seahawks safety Kam Chancellor.

Edelman stayed in the game and eventually caught the game-winning touchdown for the Patriots.

Despite the fact Edelman was never diagnosed with a concussion, the play demonstrated the need for a mechanism through which a player can receive immediate medical attention in the midst of a game.

One month later, NFL owners approved the new medical timeout.

A Particular Expertise

The NFL’s athletic trainer spotters with the authority to call a medical timeout have to meet several standards to prove their medical expertise. Another requirement: they have not been employed by an NFL team in the past 20 years.

Bill Reger has all the credentials. He’s the athletic trainer at Pascack Valley High School in Hillsdale, New Jersey—and spots during Jets and Giants games at MetLife Stadium.

Scott Zema, Associate Athletic Director at Stevenson University in Owensville, Maryland, is also a spotter. This is how he explains his role on his LinkedIn profile:

“Utilizing the injury video review system’s monitor and recording equipment to monitor, the ATC spotter watches and reviews network footage of the game, observes play on the field, and monitors the broadcast feed of that game to identify players who may potentially be injured on a play, with an emphasis on concussions and other head and neck injuries.”

For the 2016 season, the NFL has added a second athletic trainer spotter in the press box to enhance protection for players across a 100-yard field.

Historic Timeout

The NFL’s first medical timeout came during last season.

The Rams, playing in St. Louis at the time, were leading the Pittsburgh Steelers at home in the fourth quarter.

A Rams running back broke through for a seven-yard run before being tackled by Steelers cornerback Antwon Blake.

The independent spotter called a medical timeout and Blake was taken from the field and evaluated for a concussion.

In the end, Blake was cleared—and was able to finish the game.

How a Medical Timeout Works

Here is an explanation of how one of these athletic trainer spotters might call a medical timeout:

  1. If a certified athletic trainer (AT) spotter sees a player with a potential injury staying in the game after a play, the AT can signal the side judge to call a timeout.
  2. The side judge will alert the medical staff of the player’s team.
  3. The game and play clock will freeze as the staff attends to the player, escorting him from the field for evaluation. Teams will not be charged with injury timeouts.
  4. Medical personnel will evaluate the player and make a return-to-play decision based on an injury evaluation. In the case of a possible concussion, the player will undergo the league’s mandatory concussion protocol.