Sidney Crosby fell headlong into the boards during Game 6. (AP Photo/Carolyn Kaster)

CRANBERRY TOWNSHIP, Pa. — The confusion surrounding the medical evaluation of Sidney Crosby in the aftermath of the Pittsburgh Penguins’ Game 6 loss to the Washington Capitals on Monday was replaced Tuesday by a bevy of questions and much criticism of the NHL’s concussion protocol following the star center’s headfirst collision with the end boards just seven days after sustaining the fourth concussion of his career.

Monday night Crosby said he was evaluated by team doctors after the first period, but in a postgame press conference, Penguins Coach Mike Sullivan said Crosby was not evaluated for a concussion. Crosby clarified the chain of events Tuesday, following the team’s practice, noting that he was attended to by the team trainer and then examined by the team doctor, who decided Crosby did not need to enter the protocol at the first intermission. The play occurred with 2:14 to go in the first period.

Sullivan also added context to his earlier comments by spelling out the process by which the NHL’s coaches are apprised of a player’s status in relation to the league’s concussion protocol.

“The medical staff and [NHL’s concussion] spotters are responsible for identifying players that go through the protocol,” Sullivan said. “If they go through the protocol, then I usually get notified by our medical staff. I did not. And so that’s the process. It’s completely out of our control as coaches. That’s the process as I know it.”

Crosby struck the boards behind the Capitals’ net near the end of the first period after getting tangled up with Capitals defenseman John Carlson and teammate Patric Hornqvist. Crosby was slow to get up after the play, heightening outside concerns for his health because Crosby was concussed one week prior on a cross-check by the Capitals’ Matt Niskanen. Crosby, who never missed a shift in Game 6, said he did not display any concussion symptoms after the play.

Crosby was asked Tuesday about the process he went through during the first intermission.

“I mean, there shouldn’t be any wondering about it,” Crosby said. “You talk to the doctor. We can sit here and I can explain for 10 minutes what concussion protocol is and all that stuff, but I don’t really want to do it. I think that’s up to you guys to understand all that different stuff. But as far as being checked by a doctor, yes, absolutely. Any guy that goes into the boards like that, the first thing is trainer, then the doctor.

“That’s how it goes. I think what you’re talking about is the difference between checking with a doctor and entering the concussion protocol. Those are two separate things.”

That Crosby was not placed in the protocol by the team nor the NHL’s spotters raised many questions regarding the protocol’s effectiveness.

The NHL revamped its policies entering this season by implementing a staff of Central League Spotters, positioned in the NHL’s Player Safety Room in New York, who can remove a player if he displays any symptom or sign of a concussion. They will also contact teams to share their vantage point or perspective on a given play in question.

The Post learned Tuesday morning that a Central League Spotter was in touch with the Penguins after Crosby crashed into the boards. When Sullivan was asked Tuesday afternoon if he could confirm that, he said “No.”

The spotter did not remove Crosby from Game 6, despite Crosby exhibiting what appeared to be a symptom from the league’s list of potential concussion signs: he needed a moment to gather himself following the collision. Crosby lay flat on the ice for a few moments, pushed himself onto his hands and knees, took a deep breath while staring at the ice, and then slowly stood up and skated back toward the action.

That would appear to match the “slow to get up” criterion in the league’s list. But the exact wording of the concussion protocol makes the play not one for which a spotter would pull a player from action. Crosby said Monday night and Tuesday afternoon that the play knocked the wind out of him, thus keeping him down on the ice.

The protocol states that a player can be removed from play by the spotter after he is “slow to get up” or “clutches his head” following three mechanisms of injury: a blow to the head or upper torso from another player’s shoulder, the player’s head making secondary contact with the ice, or if the player is punched in the head with a fist during a fight.

Not listed is a player’s head making secondary contact with the boards, which is what happened with Crosby on Monday. The symptoms and signs are based on research that determines hitting the ice as a predictor for concussions. Hitting the boards has not been identified as such by the NHL’s research, or grounds for the Central League Spotter calling for an automatic “acute evaluation.”

As a result, Crosby was evaluated by the team’s medical staff, and they determined he did not need to enter concussion protocol.

Chris Nowinski, co-founder and executive director of the Concussion Legacy Foundation, thought Crosby’s head hit the ice and boards, and that it would be hard for a spotter to differentiate between one or the other.

He also took exception to spotters not being able to remove a player from action on a play that includes their head hitting the boards.

“I think it’s definitely a bad policy to restrict specific mechanisms off of research data,” Nowinski said. “Having that research data is good to have, but it doesn’t mean that there aren’t going to be concussions caused by heads hitting boards, and so you shouldn’t restrict your spotters.”