“LaLiga is very good at making sure the three referees have 17 perfectly inflated balls. Let’s ask ourselves how much detail there is in the medical protocol.” That pointed question, posed by Real Madrid team doctor Niko Mihic at a sports medicine conference, has reignited debate over how detailed medical protocols actually are at football matches in Spain, days after a violent collision between Tenerife players Jesús de Miguel and Jesús Owono put the medical staff at Estadio Heliodoro Rodríguez López on high alert, elmundo.es reported.
The incident, which occurred last Monday, also drew questions about the medical team’s response, staffing levels and preparation at the Tenerife stadium. While De Miguel was being treated on the pitch, other medical personnel at the Heliodoro simultaneously attended to as many as five spectators who fainted at the sight of the collision, according to the report.
What LaLiga’s Rulebook Actually Requires
Every stadium in Spain must have a preventive health plan for contingencies that could occur inside it. LaLiga requires all 42 clubs in Primera and Segunda División to submit the document by Aug. 1 each season. Under Article 3 of Book XIII of the league’s regulations, the plan must contain “the stadium’s medical resources and set out the functions and responsibilities of emergency services in protecting attendees,” elmundo.es reported.
But the text does not specify a minimum number of medical personnel. Article 9.2 calls for “an infirmary in the dressing-room area” reserved for “players, coaches and staff, a stretcher and a first-aid kit with the minimum legal supplies” — with no further detail. Article 11 requires that “each section of the public must have essential services, including first aid.”
Responsibility for filling in those details falls to the clubs, though LaLiga must then validate each plan using ratios and regional legislation. The league says its obligation is one stand doctor, one advanced life support ambulance and one stand infirmary; it also provides a pitch defibrillator to each member club.
Where the Rules Come From — and Where They Fall Short
A stadium’s medical setup is not determined solely by the competition organizer. State, regional and municipal regulations apply, as do rules from the Royal Spanish Football Federation. Article 175.6 of the federation’s competition regulations requires “an ambulance with the specifications required” for its tournaments — in this case, one with basic life support — while professional competitions follow whatever the corresponding professional league decides. In Primera and Segunda, that means LaLiga’s word governs.
UEFA, by contrast, is far more specific in its Medical Regulations for its own competitions. The European governing body requires, among other things, that the emergency doctor at pitch level speak English, that a pre-match meeting take place between him and the club doctors to review protocols, and it specifies the number of ambulances and the characteristics of medical equipment.
Clubs Say They Exceed the Minimums
After elmundo.es consulted three professional clubs, all three agreed that the medical setup they deploy exceeds LaLiga’s recommendations. At Tenerife’s stadium, which holds 22,824 spectators, the health plan consists — in addition to the clubs’ own doctors — of one doctor and one nurse in the stadium, seven pairs of medical technicians (one per stand) equipped with defibrillators, one advanced life support ambulance, two or three basic ambulances and one infirmary. That totals roughly 24 personnel per match.
“They call us exaggerated, but LaLiga’s minimum requirements aren’t enough,” sources familiar with the setup said, a point they have repeatedly made in their annual report on interventions carried out.
A safety and emergencies coordinator at a Primera club said response time at his stadium is five minutes. That club fields four doctors at full capacity, three at half capacity and two when attendance is lower, plus four infirmaries. “If something has to happen to someone, let it be in a stadium,” the coordinator said, reflecting the awareness among professional clubs that nothing should happen in their facilities, on the pitch or in the stands. Last Monday, that did not hold.
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