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From Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center, Department of Exercise and Sport Science, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (CSL, JPM, RCL, MAF, MAP); Curriculum in Human Movement Science, Department of Allied Health Sciences, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina (JPM, RCL, MAF); and the Department of Kinesiology, University of New Hampshire, Durham, New Hampshire (EES).
The authors have no financial or proprietary interest in the materials presented herein.
Football athletes are at a higher risk for sustaining cervical spine injuries, and the sport produces the highest total number of catastrophic spine injuries of all sports in the United States. 1 The current standard of care for a football athlete with a spine injury is to leave all equipment (except the facemask) in place while providing rescue care unless one or more of the following conditions are present: (1) airway access and/or rapid facemask removal is not possible; (2) the helmet is not properly fit and unable to sufficiently immobilize the head and spine; or (3) the helmet does not permit spine neutral alignment. 2 In these three conditions, it is necessary to concurrently remove the helmet and shoulder pads 2 to avoid dangerous spine extension caused by the posterior aspect of the shoulder pads elevating neutral alignment positioning. 3 Alternate methods of 'filling the void' may be employed in cases where shoulder pad removal may not be possible. 4,5
The flat torso technique is traditionally used to remove shoulder pads. This method involves two to four rescuers, and is accomplished by unfastening the side straps, cutting the anterior laces, and sliding the shoulder pads over the top of the injured athlete's head. 2,6 If four or more rescuers are available, the elevated torso technique flexes the patient's trunk to 30[degree] to 40[degree] to allow unencumbered removal of the shoulder pads while neutral alignment of the head, neck, and torso are maintained. 6,7 Some consider it to be superior to the flat torso technique, 6 but cadaveric models suggest greater vertebral displacement compared to log roll and five-person lift techniques. 8
The Riddell RipKord (Riddell, Rosemont, IL) technology may address unnecessary patient movement during equipment removal. Riddell RipKord...