P0192 - Use of the Independent Medical Spotter in Identifying Head/Neck Injuries in Division I Football Players

PURPOSE
Sport-related concussion (SRC) is a known risk of contact sports and strategies have been employed to help minimize risk. Multiple NCAA conferences and professional sports leagues have instituted independent medical spotters (IMS) to serve as "eyes in the sky" during events to help identify SRCs. We aimed to determine if the IMS identified more SRCs than would otherwise be detected by the trained sideline medical staff (SMS).

METHODS/STUDY DESIGN
We prospectively reviewed SRCs identified during Division I football games in 2019 at a Big Ten conference school. A new video review system (VRS) was also utilized. We retrospectively reviewed SRCs in the 2015-2018 seasons which utilized the IMS. The SMS included five licensed athletic trainers and four physicians. The IMS was the same licensed athletic trainer over all seasons reviewed. Descriptive statistics were used to compare SRCs identified by SMS [LAT/MD] versus IMS over these five seasons.

RESULTS
Over the 5-year study period there were a total of 24 SRCs during competition. Of those, 19 (79%) were observed directly by the sideline staff and 2 (8.3%) by the IMS. Both of the concussions identified by the IMS occurred during the 2019 season. A total of 3 (12.5%) SRCs were reported to the SMS after competition had ended.

CONCLUSIONS
In the five seasons of collegiate football games at a Division 1 university, the vast majority of SRCs are accurately identified by the SMS, but there are a small number of potential SRCs that were apparent only to the IMS which were later confirmed to be SRC by the trained medical staff. An IMS seemed to add sensitivity to detect SRC overall; however, there remain instances in which SRC recognition and diagnosis were delayed despite trained SMS and IMS.

SIGNIFICANCE
Use of an IMS allows for a small added player protection benefit utilizing a different vantage point to identify SRCs during competition and communicate with SMS in order to further evaluate student athletes. IMS requires added resources, however, and may not be feasible for all levels of competition.