Browns' medical staff prepared intensely for trip to London

Browns team doctor James Voos tends to an injured player. Voos and the team's medical staff has had to prepare for virtually every contingency as the team prepares to play in London on Sunday. UH Cleveland Medical Center

LONDON -- The Cleveland Browns' medical staff arrived in London early Friday morning with the team.

Their work began the moment they landed.

“We go right to the practice facility, and then right to Twickenham where we play our game [vs. the Vikings, 9:30 a.m. ET Sunday] and walk through there with our host medical staff,” team physician James Voos of UH Cleveland Medical Center said in an interview before the team departed.

The goal is to learn everything they can about the facility, from where supplies will be to where X-rays can be taken and what to do in case of serious injury or emergency.

“We started talking and planning this about six months ago,” Voos said. “Whether it’s even traveling with IV fluid or having the appropriate medical supplies, assuring that you are following all the appropriate rules taking them into another country, we have to have a plan. Fortunately we’re not the first team that’s traveled over there.”

The preparation of Voos and his staff illustrates a small part of the logistics involved in transporting a team across an ocean and five time zones. Not only does the team have to pack its equipment, but all the ancillary support personnel have to re-create in London what they do in the United States, for one weekend in a foreign country.

Teams talk about game plans all the time and spend hours on them. Voos and his medical team -- that includes UH Cleveland Medical Center doctors Mike Salata, Sean Cupp and Rob Flannery -- have a plan every bit as detailed, for any eventuality. It might be the most important plan for the trip.

“The goal is to provide the exact level of care in the United Kingdom that we provide here in Cleveland,” he said.

That means moving medical supplies, ensuring all are appropriate for the United Kingdom and developing detailed care and treatment plans Voos hopes never have to be used. The first step is the most fundamental: obtaining a temporary license, which Voos said is needed simply for practicing medicine in another country. Doctors can’t write a simple prescription without a license.

Though the process has been streamlined somewhat by the NFL, the British do not bend on requirements.

“It still has the same scrutiny of having to provide all of our appropriate documentation,” Voos said. “We have to provide the exact same credentials as we would applying for a medical license in Ohio.”

The medical team also ensures care for the staff and family at hours when the game is not being played.

“Traveling back and forth and in between the game,” Voos said. “Someone could get sick or get appendicitis or trip and fall. We start the second we get on the plane and don’t stop until we land back in Cleveland.”

The Friday walk-through at Twickenham includes going over ambulance personnel, knowing where to send a player for an X-ray, meeting the independent neurological consultant who will be at the game and setting up the sideline medical tent that all teams now use.

A “host” medical staff from England will be present to work with the Browns staff, and for more serious situations if hospital care is needed.

“They can help with MRIs, a prescription for an antibiotic, or God forbid someone has an injury that needs to have surgery,” Voos said. “They really help to facilitate through the health care system there. That way there are no barriers and they really allow for a smooth transition of care.”

Discussions with the host staff from England began with a face-to-face meeting at the NFL scouting combine in Indianapolis in February and continued until this week.

“We’ve had multiple phone calls over the last several months regarding our medications, our emergency action plans and what everyone’s roles are once we arrive,” Voos said.

There also are action plans in case a player has to stay behind because of serious injury. The host staff will monitor care along with a member of the Browns' medical and training staff who would also stay in London.

“You hope that none of those events ever occur, but we practice this and have the plans in place so that if those events do happen, we activate that portion of the plan,” Voos said. “If we’re playing in L.A. or Arizona or Miami, we have that plan in place as well.”

The planning is not new for Voos and his team. They have to prepare for any eventuality on any road game. It’s just a more complicated process in a country that is across the Atlantic Ocean.

“The goal for us is to have it streamlined so that no one even notices,” Voos said. “We want it to be a nice, quiet process. And God forbid if something does happen, then we’ve got everything in place.”