On-Field Management of Athletic Head and Neck Injuries: Spinal Motion Restriction, Equipment Removal, Patient...

Although rare, athletic head and cervical spine injuries can be devastating. All health care professionals involved in the on-field care of athletes with these injuries should be aware of updated national guidelines as well as individual institutional practices regarding head and neck immobilization after on-field injuries. Appropriate prehospital management-including evaluation, equipment removal, spine board immobilization, and patient transfer-can mitigate further risk for these injured athletes.

The goal of spinal-motion restriction is to reduce spinal instability and prevent further neurologic injury. Indications include blunt trauma with altered level of consciousness, cervical spinal pain or tenderness, or concern for spinal instability, loss of cervical motion, bilateral neurologic complaints, or anatomic deformity of the spine after a sports-related injury.

This video will describe critical aspects of on-field management of head and neck injuries, featuring a video demonstration of current care concepts and recommended best practices for spinal motion restriction, removal of athletic equipment, and patient transfer techniques for on-field spine boarding. The video demonstrates removal of the helmet and shoulder pads, as well as transfer techniques for athletes in the supine or prone position. The videos also highlight appropriate communication throughout the transfer process, which is paramount to successful stabilization.

Preinjury preparedness allows health care providers to optimize on-field emergency care safely and efficiently. The appropriate method of spinal-motion restriction is dictated by the athlete's clinical examination, position on the playing field, body position (eg, supine, side-lying, or prone), and the number of rescuers available. Stabilization using more rescuers (≥6) has been shown to minimize spinal motion across an unstable spine injury.

Return to sport is managed on a case-by-case basis, determined by the type and the severity of the injury sustained, and by the necessary interventions performed upon transfer to a higher center of care.

Optimizing on-field management of athletic cervical spine injuries with thorough communication and collaborative stabilization techniques can help mitigate the risk of further neurologic compromise in the injured athlete. Understanding various techniques for immobilization, equipment management, and patient transfer will enable health care professionals to provide safe and reproducible care for these injured athletes.

The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.