Steve Blados M.Ed., NRP Linda Gibbens, M.S., ATC, LAT

Transcription

1 Steve Blados M.Ed., NRP Linda Gibbens, M.S., ATC, LAT

2 The National Athletic Trainers Association has updated the recommendations pertaining to equipment removal of injured players when spinal immobilization is necessary.

3 Canyon County Paramedics was approached by the Sports Medicine Team at College of Idaho in order to collaborate on how injured athletes would be cared for. This presentation is a quick demonstration of how we can work together to immobilize injured athletes.

4 The Team Physician Athletic Training Staff Football Equipment Manager & Staff Canyon County Paramedics/EMT s & other Emergency Personnel

5 This concept states that true spinal immobilization cannot occur, even with an athlete strapped securely to a spine board. The emphasis is Spinal Motion Restriction (SMR) SMR is preventing further harm to a spinal cord of column injury.

6 Blunt trauma w/altered LOC Spinal Pain or tenderness Neurological Complaint (e.g. numbness or motor weakness High Energy mechanism of injury Drug of alcohol intoxication Inability to communicate Distracting Injury

7 The following slides will demonstrate the equipment removal and immobilization process in a stepwise fashion.

8 The injured athlete is placed in a supine position, maintaining spinal integrity. Notice that the equipment is still in place.

9 The athletic trainers will use scissors to cut the front of the athlete s jersey.

10 The athletic trainers will use scissors to cut both sleeves of the athlete s jersey.

11 The athletic trainers will use a screw driver to remove the facemask from the helmet.

12 The athletic trainers will use scissors to cut the chin strap on the helmet.

13 The athletic trainers will cut the ties on the front of the shoulder pads, as well as the belt & buckles along the sides.

14 An athletic trainer or EMS provider will hold manual cervical spinal immobilization as shown.

15 While maintaining cervical spine immobilization, a provider will place her fingers into the side holes and spread the helmet while removing carefully.

16 The shoulder pads can now be carefully removed by sliding them from beneath the athlete. There is the possibility the shoulder pads will not slide easily from underneath the athlete (e.g. unconscious)

17 Elevated Torso Technique Uses Four people This is the most difficult step in the process One to maintain SMR of the c-spine throughout lift maneuver One to straddle the patient Two on either side to support the athlete s shoulder The athlete s torso is elevated sufficiently to slip the shoulder pads, flap jacket, and back pad from under him and then out to the side simultaneously with lift method. This technique is used as long as the lumbar spine is not damaged, since this technique causes significant motion in this area. Shoulder Pad Removal using the Levitation Technique One person is at the C-spine and directing all providers; Uses 6-8 rescuers, depending on the size of the athlete. shoulders spine(2) legs/knees One person to slide shoulder pads, flap jacket, and back pad out from under the athlete One person to slide scoop stretcher underneath athlete As the pads are remove from the athlete, his body will be lowered to the scoop stretcher The provider will maintain SMR of the c- spine and aware of this change to maintain neutrality of the spine.

18 An appropriately sized cervical collar can now be applied.

19 The spine board/scoop stretcher or similar device should be prepared adjacent to the patient.

20 The spine board/scoop stretcher or similar device should be slid underneath the injured athlete and snapped together.

21 As the shoulder pads are remove from the athlete, he can be lowered to the scoop stretcher Application of rigid cervical stabilization device will be applied at the earliest and most appropriate time possible during this procedure. Cervical stabilization device or collar will be placed with SMR. SMR will be maintained after rigid cervical collar is applied. SMR will be maintained until the athlete has been stabilized on a full body device, in this case a scoop stretcher, and a head immobilization device has been applied

22 The patient may be lifted to the gurney.

23 The spine-injured athlete has been transferred to a long spine board or vacuum mattress using a technique that limits spine motion. Special circumstances include: Mechanism of injury Size and weight of the athlete Number and skill level of sport medical team members. In most cases the scoop stretcher will be used.

24 The spine board/scoop stretcher or similar device may then be removed and the patient left in a supine position on the gurney.

25 Executive Summary Appropriate Prehospital Management of the Spine-Injured Athlete Updated from form 1998 (2015) from the NATA and Inter-Association Task Force for Appropriate Care of the Spine Injured Athlete

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