Winston Moss was still wearing his pads when he went in for the CT scan. The Seattle Seahawks linebacker suffered a neck fracture during a road game in Baltimore in 1997, and the Ravens medical staff's emergency protocol ensured that that he quickly received the proper treatment.
In the aftermath of Buffalo Bills tight end Kevin Everett's severe spinal cord injury, several neurological specialists who work with NFL teams said that the key to giving a player the best chance at recovery from a catastrophic injury is to have a well-rehearsed emergency protocol in place.
Dr. Ralph Dacey, a St. Louis Rams neurosurgeon, said that each year team physicians simulate with trainers how they would respond to a serious spinal injury.
Not all NFL teams require a neurological specialist to attend every game.
``I don't consider it an essential element,'' said Dr. Joseph Maroon, a neurological surgeon for one of the clubs that does insist on it, the Pittsburgh Steelers. ``But I think it is essential that trainers and medical personnel be very well-versed in acute management of concussions and spinal injuries.''
The Carolina Panthers' team neurosurgeon, Dr. Tim Adamson, said his presence is less important than the existence of a predetermined plan that immediately gets an injured player to the right hospital and into the necessary diagnostic tests.
``The difference I make is knowing how to quickly get them through the process of treatment and evaluation,'' Adamson said. ``There's nothing magical to do with my presence at the stadium other than to be available to get started quickly with them.''
Having a neurological specialist on call near the stadium would serve equally well, he said.
On that day 10 years ago, Moss' CT scan showed no neurological damage. Dr. Kevin Auld, the Seahawks' former team physician who recalled the treatment the player received, said he wasn't completely confident that Moss would've have gotten that needed test as promptly and efficiently in every NFL city.
Before Seattle's road games, the home team's medical staff would often share information about the emergency protocol with Seahawks doctors, but not always. Auld hoped every club had the proper procedures in place but wasn't sure.
The NFL requires that the home team have on hand a physician trained in rapid sequence intubation (for players who need help breathing) as part of the on-field emergency crew. There must also be a medevac helicopter, ambulance, stretchers and carts, X-ray service, oxygen and emergency medical information for that city.
Dr. Andrew Cappuccino, a Bills team physician who oversaw Everett's initial treatment, specializes in spinal surgery. He's a ``real star'' in his field, Auld said, but what most helped Everett was Buffalo's excellent emergency protocol system. Auld observed the Bills doctors' care in formulating the plan during conversations between the Buffalo and Seattle staffs at the annual NFL pre-draft combines.
While the Everett saga has focused attention on spinal injuries, the doctors agreed that the greatest need for the input of neurological specialists is with concussions, which are far more common in football.

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