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Use of the Independent Medical Spotter in Identifying Head Injuries in Division I Football Players.

OBJECTIVE: Sport-related concussion (SRC) is a known risk of contact sports and strategies to minimize risk have been used. We aimed to determine if an independent medical spotter (IMS) identified more SRCs than would otherwise be detected by trained sideline medical staff (SMS).

DESIGN: Prospective review of SRCs during competition in the 2019 season and retrospective review of SRCs in the 2015 to 2018 seasons, which also used an IMS.

SETTING: Division I football games (home and away) of a Big 10 Conference institution.

PARTICIPANTS: All football team members who participated in competition.

INDEPENDENT VARIABLES: Occurrence of SRC during competition and whether the IMS or SMS directly visualized the injury.

MAIN OUTCOME MEASURES: The total number of SRCs that occurred during competition in the 2015 to 2019 football seasons and whom observed the SRC-SMS or IMS-or if a student athlete reported symptoms after competition.

RESULTS: Over the 5-year study period, 24 SRCs occurred during competition. Of those, 19 (79.2%) were observed by SMS, 2 (8.3%) by the IMS, and 3 (12.5%) were reported to SMS after competition ended.

CONCLUSIONS: Most SRCs are accurately identified by SMS, but a small number were apparent only to the IMS who seemed to add sensitivity in detecting a SRC. Instances remain in which SRC recognition and diagnosis were delayed despite trained SMS and IMS.

CLINICAL RELEVANCE: An IMS allows for a small-added player protection benefit using different vantage points to identify potential SRCs during competition.

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