On February 9, 1994, medical professionals from the Wenatchee Valley met to discuss the management of cervical neck injury with particular emphasis on football. The following are the general guidelines that were suggested in handling these injuries:
A full evaluation should be performed when arriving on the scene. The evaluation should always begin with a check of the ABC's (Airway, Breathing, Circulation). This should be performed by the certified athletic trainer, or in their absence, a designated coach.
If the athlete is conscious, the history of the injury and present symptoms should be obtained from the athlete. If the athlete unconscious from the injury, they must treated as if they have a severe neck injury (especially if the injury involved head and/or neck trauma).
The football helmet or shoulder pads should not be removed in most cases on the field by the athletic trainer, coach, physician, or EMS personnel in the case of a suspected cervical fracture.
If the athlete is face down or side lying, they should be turned as a unit (log roll). If there are no airway problems, coaches can wait for EMS personnel to perform the log roll procedure. However, all coaches must be familar with the "log roll" in the event of a airway emergency.
If there is a question of maintaining the athlete's airway, the face mask should be removed while the head and neck are stabilized. This can be done with a device to cut the plastic face mask holders. Do not unfasten the chin strap.
Face mask cutting device may include theTrainer's Angel (recommended) or box knife. Every football medicine kit at every level should contain a face mask cutting tool. All coaching and EMS personnel should be skilled in use of these tools.
The evaluation should be performed to the level of evaluator's ability. Coaches should understand the basic principles of a neurological evaluation (ask about sensation and test motor function).
If there is any question to the well-being of the athlete's cervical spine, i.e. motor/sensory neurological deficits that do not resolve, emergency medical services (EMS) should be called.
It is not advisable (and very difficult) to use a cervical collar with the helmet and shoulder pads in place. Other stabilitizing devices should be used when the athlete is on the backboard.
The helmet, shoulder pads and other equipment should be removed as a unit by emergency room personnel, preferably after basic cervical films.
If present, the team physician will take priority in handling such on-the-field emergency situations. However, those physicians and other allied health practitioners that are in casual attendance at contest will not take priority in these situations. Any "spectator practitioners" must must be identified in advance by school personnel before they can be asked to handle such a situation since they may not be familar with this protocol.
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