For goaltenders and skaters, the ATO may only be used according to section 13-13(m)(ii) of the NHL-NHLPA CBA, when Emergency conditions shall be established when the playing strength of the Loaning Club, by reason of incapacitating injury or illness or by League suspension to its Players is reduced below the level of two (2) goalkeepers, six (6) defensemen and twelve (12) forwards.
On December 31, 2016, the Carolina Hurricanes signed emergency goaltender Jorge Alves, who serves as the team's equipment manager, to an ATO after goalie Eddie Läck came down with food poisoning hours before face off for the game in Tampa Bay.
Alves replaced starting goalie Cam Ward in net with 7.6 seconds remaining in the game and a faceoff at the other end of the rink, after the Lightning were called for icing the puck.
[13] On November 14, 2018, the Washington Capitals signed goaltender Gavin McHale to an ATO after Braden Holtby sustained an upper body injury.
[15] On October 10, 2021, the Toronto Maple Leafs signed goaltender Alex Bishop to an ATO after Petr Mrázek sustained a lower body injury.
Berlin served as the backup to Jack Campbell and entered the game for the final 2 minutes in the Oilers' 7-3 win over the Chicago Blackhawks.
[18] On April 12, 2023, the Toronto Maple Leafs signed Mathias Onuska to an ATO as a back up goaltender as Ilya Samsonov and Matt Murray were both injured and unable to play.
On December 8, 2024, the Seattle Kraken signed goaltender Michael Matyas to an ATO to back up Philipp Grubauer after Joey Daccord was ruled out for illness earlier that day.
As of the 2022–23 season, only Scott Foster, Jorge Alves, David Ayres, Matt Berlin, and Jett Alexander have actually played in an NHL game.