NFL Collective Bargaining Agreement

Article 39
Players’ Rights To Medical Care and Treatment

Section 4
Emergency Action Plan

The parties shall jointly select an expert in the field of emergency medicine (the “EAP Expert”) to help them establish minimum standards, protocols, and a standardized format for an Emergency Action Plan (“EAP”) that shall be required to be submitted by every NFL Club to address player medical, cardiac and/or surgical emergencies that occur at games hosted at their home stadium, as well as at the practice facility (if different from the game day venue). The EAP Expert will also be responsible for reviewing every EAP submitted and offering an opinion as to whether such EAP meets the criteria set forth by the parties. The parties (through the NFL Chief Medical Officer and the NFL Players Association Medical Director) must review all EAPs prior to the start of the season and, following consideration of the EAP Expert’s opinion, approve, deny, or request modification of the submitted EAP. Every NFL Club is required to have an approved EAP in place prior to their first preseason home game. At the end of each season, the parties, in consultation with the retained expert, shall review the minimum requirements for EAPs and update as appropriate (any changes requires consent of both parties). The EAP requirements shall be published to every NFL Club prior to March 15 of each year to ensure that Club medical staffs have adequate notice of any changes.

(a)Emergency Action Plan Components. .

EAPs shall, at a minimum:

(a)(i)

Identify a suitable Level I or Level II Trauma Center to which neurological, medical, cardiac and/or surgical emergencies shall be transported.

(a)(ii)

Identify a suitable group of Airway Management Physicians (AMPs) (see Subsection (b) below);

(a)(iii)

Define the method of transport and route(s);

(a)(iv)

Schedule at least two drills that must be completed prior to the Club’s first preseason home game, one at the practice facility and one at the stadium venue. The drills must address the following scenarios (at a minimum):

  • Spine/head trauma
  • Isolated head trauma
  • Heat Illness
  • Cardiac arrest/arrhythmia
  • Truncal Trauma w/ hypotension

(a)(v)

Contain a listing of Visiting Team Medical Liaison (VTML) physicians available for Clubs visiting the Club’s home city to coordinate local medical care and prescriptions, if necessary.

(b)Airway Management Physician. .

Every NFL Club is required to provide an Airway Management Physician (AMP) at every home game hosted by the Club. Each Club must identify at least two but not more than four physicians that they intend to retain to serve as an AMP for the upcoming season by July 1. The EAP Expert shall review each physician proposed and make a recommendation as to whether the physician recommended is suitable for the role. The parties (through the NFL Chief Medical Officer and NFLPA Medical Director) must jointly approve a physician in order for him/her to be retained by a Club to serve as an AMP. In order to serve as an NFL Club’s AMP, a physician must have the following qualifications:

(b)(i)

Board certified in Emergency Medicine or Anesthesia.

(b)(ii)

Credentialed at a Level I or Level II trauma center where (s)he performs a minimum of eight intubations and airway management in a trauma resuscitation environment annually. It is preferred that AMPs have privileges at the trauma center designated by the EAP.

(b)(iii)

Capable, at a minimum, of performing airway management via rapid-sequence intubation, laryngeal mask airway, and/or video laryngoscopy.

(b)(iv)

Capable of performing intubations with the patient on the ground and on a stretcher in an on-field environment. Experienced in using capnometry post-intubation or post-airway control, including maintaining eucapnia in head-injured patients.