Management of the helmeted athlete with suspected cervical spine injury.
Publication/Presentation Date
7-1-2004
Abstract
Improper handling of an unstable neck injury may result in iatrogenic neurologic injury. A review of published evidence on cervical management in the helmeted athlete with a suspected spinal injury is discussed. The approach to the neck-injured helmeted athlete and the algorithms for on-field and emergency department evaluations are reviewed. The characteristics of the fitted football helmet allow safe access for airway management, and helmets and shoulder pads should not be initially removed unless absolutely necessary. Prehospital and emergency personnel should be trained in the indications for removal and in proper helmet, shoulder pad, and facemask removal techniques. If required, both helmet and shoulder pads should be removed simultaneously. Radiographs with equipment in place may be inadequate, and the value of computed tomography and magnetic resonance imaging in these helmeted patients has been studied. If adequate films cannot be obtained with equipment in place, helmet and shoulder pads may need to be removed before radiographic clearance. A plan should be formulated to prepare for such unexpected clinical scenarios as cervical spine injuries, and skills should be practiced. Airway and cervical spine management in these helmeted athletes is an area of ongoing research.
Volume
32
Issue
5
First Page
1331
Last Page
1350
ISSN
0363-5465
Published In/Presented At
Waninger KN. Management of the helmeted athlete with suspected cervical spine injury. Am J Sports Med. 2004 Jul-Aug;32(5):1331-50. doi: 10.1177/0363546504264580.
Disciplines
Medicine and Health Sciences
PubMedID
15262662
Department(s)
Department of Medicine
Document Type
Article