Lacrosse Equipment and Cervical Spinal Cord Space During Immobilization: Preliminary Analysis

Higgins, Michael J.; Tierney, Ryan; Driban, Jeffrey B.; Edell, Steven L.; Watkins, Randall

doi:10.4085/1062-6050-45.1.39

Cited by 12 publications

(13 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Researchers have found that spine boarding an athlete who is not wearing a helmet alters the alignment of the cervical spine 5 but not the space available for the spinal cord in healthy participants 24 because space did not differ by more than the 1-mm cutoff 25 at any cervical level. Nevertheless, how injury may affect spinal cord space remains unclear.…”

Section: Recommendations and Clinical Relevancementioning

confidence: 99%

Lacrosse Helmet Facemask Removal

Bradney

Bowman²

2013

Journal of Athletic Training

View full text Add to dashboard Cite

Context: Facemask removal (FMR) is required to access the airway of a catastrophically injured football or ice hockey athlete. However, the best method of caring for the helmeted lacrosse athlete with suspected catastrophic injury remains unclear.Objective: To evaluate the effects of sex and grip strength on the speed and ease of use of various FMR methods across different lacrosse helmet types.Design: Cross-sectional study. Conclusions: Based on our results, FMR of lacrosse helmets should be attempted with a CSD. We recommend carrying a pruner as a backup cutting tool in case the CSD fails, practicing FMR regularly, and inspecting helmets for faulty hardware to reduce the chance of CSD failure.Key Words: emergency care, catastrophic injury, cervical spine Key PointsParticipants removed the facemasks of 5 different types of lacrosse helmets with a cordless screwdriver (CSD), which was fastest with helmets that do not require a cutting step, and reported this method was easier to use than the Face Mask Extractor 2, pruner, and Trainer's Angel. Grip strength and FMR times were strongly associated for the 3 techniques using cutting methods but not for the CSD. Facemask removal on lacrosse helmets should be attempted first with a CSD and second with a pruner if screw removal fails. Athletic trainers should practice regularly, be prepared to perform FMR on various types of helmets, and perform FMR using the tool with which they are most comfortable.

show abstract

Section: Recommendations and Clinical Relevancementioning

confidence: 99%

Lacrosse Helmet Facemask Removal

Bradney

Bowman²

2013

Journal of Athletic Training

View full text Add to dashboard Cite

show abstract

“…20 If the helmet alone is removed and the head is placed in extension on the ground or spine board, cervical lordosis and spinal cord space decrease. 21,22 Gastel et al 20 reported a 108 decrease in lordosis in a helmet-only condition contrasted with a 148 increase in lordosis with a shoulder-pad-only condition. In our study, protocol H resulted in an average 118 increase in extension ( Figure 3A) and a 4-cm drop in head position ( Figure 3B), values that were larger than that for any other protocol.…”

Section: Applicationmentioning

confidence: 99%

“…21 Our methods may be applied to future research on sportspecific or manufacturer-or model-specific equipment to assess the potential benefits of the pack-and-fill method with other protective athletic equipment. Another future direction is investigation of the different segments of the entire treatment process from initial assessment through spine boarding.…”

Section: Applicationmentioning

confidence: 99%

Cervical Spine Motion During Football Equipment-Removal Protocols: A Challenge to the All-or-Nothing Endeavor

Jacobson

Cendoma²,

Gdovin

et al. 2014

Journal of Athletic Training

View full text Add to dashboard Cite

Context: The National Athletic Trainers' Association position statement on acute management of the cervical spineinjured athlete recommended the all-or-nothing endeavor, which involves removing or not removing both helmet and shoulder pads, from equipment-laden American football and ice hockey athletes. However, in supporting research, investigators have not considered alternative protocols.Objective: To measure cervical spine movement (head relative to sternum) produced when certified athletic trainers (ATs) use the all-or-nothing endeavor and to compare these findings with the movement produced using an alternative packand-fill protocol, which involves packing the area under and around the cervical neck and head with rolled towels.Design: Crossover study. Setting: Movement analysis laboratory.Patients or Other Participants: Eight male collegiate football players (age ¼ 21.4 6 1.4 years; height ¼ 1.87 6 0.02 m; mass ¼ 103.6 6 12.5 kg).Intervention(s): Four ATs removed equipment under 4 conditions: removal of helmet only followed by placing the head on the ground (H), removal of the helmet only followed by packand-fill (HP), removal of the helmet and shoulder pads followed by placing the head on the ground (HS), and removal of the helmet and shoulder pads followed by pack-and-fill (HSP). Motion capture was used to track the movement of the head with respect to the sternum during equipment removal.Main Outcome Measure(s): We measured head movement relative to sternum movement (translations and rotations). We used 4 3 4 analyses of variance with repeated measures to compare discrete motion variables (changes in position and total excursions) among protocols and ATs.Results: Protocol HP resulted in a 0.1 6 0.6 cm rise in head position compared with a 1.4 6 0.3 cm drop with protocol HS (P , .001). Protocol HP produced 4.98 less total angular excursion (P , .001) and 2.1 cm less total vertical excursion (P , .001) than protocol HS.Conclusions: The pack-and-fill protocol was more effective than shoulder pad removal in minimizing cervical spine movement throughout the equipment-removal process. This study provides evidence for including the pack-and-fill protocol in future treatment recommendations when helmet removal is necessary for on-field care.Key Words: National Athletic Trainers' Association position statement, pack and fill, motion analysis, helmet removal Key PointsThe pack-and-fill protocol resulted in less overall motion than removal of the helmet and shoulder pads followed by placing the head on the ground, which is currently endorsed by the National Athletic Trainers' Association. Using pack and fill, the athletic trainers could position the head at release in, on average, nearly the identical position as at initiation. Removal of the helmet and shoulder pads resulted in a drop in linear and angular head position, placing the cervical spine into increased extension.

show abstract

“…Further, leaving the helmet and shoulder pads in place did not affect the space available for the spinal cord, which also supported leaving the helmet in place and performing FMR. 11 Once the airway is accessible, using the most common airway-management device, the pocket mask (PM), may not be feasible. Providing rescue breaths via a PM or bag valve mask may not be possible due to the inability to perform a jaw-thrust maneuver and to maintain an adequate seal of the mask to the patient's face because of interference by the helmet chinstrap.…”

mentioning

confidence: 99%