Counted by
|
| The
on-field evaluation of an athlete with head and/or neck
injuries is critical in preventing potentially catastrophic
sequelae. The appropriate care of these patients begins
with a plan involving trainer, physicians, and emergency
medical personnel. It is extremely important to have all
necessary equipment available. This would include a spine
board with straps, small garden pruners (ratchet or anvil
type) for removing face masks, screwdriver, emergency shears,
oxygen and rigid cervical collars. The following guidelines
are for the evaluation and management of these athletes. |
| No
Altered Consciousness? |
| • |
Make
an accurate diagnosis of level of consciousness |
| • |
Assess
airway, breathing, and circulation (ABC's) |
| • |
Do
not remove the face mask or helmet unless respiratory
difficulty at this point. |
| • |
Do
not move the patient until the assessment is complete,
unless there is difficulty with the airway, breathing
or circulation. |
| • |
If
movement is required, one person stabilizes the head
while a team "log rolls" the patient supine. |
| • |
If
transportation is required, be sure to secure the
body to the spine board with straps or tape before
securing the head. Secure the head to the board with
tape or straps. Sandbags are not recommended due to
their weight, which shifts against the cervical spine,
if log rolling is necessary due to vomiting. Rolled
towels, blankets or foam blocks are good alternatives. |
| • |
Face
mask removal should be performed before transport
to an emergency facility. |
| • |
Helmet
removal is usually not preferred or required with
the following exceptions:
1. The head is not held securely within the
helmet.
2. The airway cannot be controlled even with
face mask removal.
3. The face mask cannot be removed in an adequate
period of time prior to transport |
| • |
Helmet
removal is facilitated by removing check pads and/or
deflating air padding. |
| • |
In
the event of helmet removal, use a rolled towel under
the head to prevent cervical hyperextension. |
|
| Altered
Consciousness |
| • |
Make
an accurate diagnosis of level of consciousness (concussion-alteration
of cerebral function) |
| • |
Assess
airway, breathing, and circulation (ABC's) |
| • |
Assume
the athlete has a cervical spine injury until proven
otherwise (see above guidelines). |
| • |
Perform
a brief neurological assessment (determine Glasgow
coma score, orientation). |
| • |
If
cervical injury can be ruled out and confusion and
orientation have improved, the patient may sit. |
| • |
Assist
the athlete to the sideline and continue the assessment
if strength and coordination allows, otherwise proceed
with transport as outlined above. |
| • |
The
athlete should be observed for a minimum of 15 minutes
with serial neurological evaluations. |
| • |
The
athlete may return to play the same day if:
1. Signs and symptoms are cleared within
15 minutes or less at rest and exertion.
2. Normal neurological evaluation.
3. No documented loss of consciousness.
|
| • |
The
athlete is excluded from same day participation if:
1. Signs and symptoms do not clear in 15 minutes
at rest or exertion.
2. Documented loss of consciousness. |
| • |
BEWARE
of the athlete with vomiting after suspected head
injury or new headaches in the first 48 - 72 hours
after a concussion (these require further medical
evaluation). |
These
procedures were created based on the information provided
in the guidelines produced by the Inter-Association Task
Force for Appropriate Care of the Spine and the Concussion
in Sports manuscript published in the Sept./Oct. 1999 issue
of the American Journal of Sports Medicine.©
©
January 2000 |
Back
to Sports Tips
American
Orthopaedic Society
for Sports Medicine
6300 North River Road, Suite 200
Rosemont, Illinois 60018
http://www.sportsmed.org
|
National
Athletic
Trainers Association
2952 Stemmons Freeway
Dallas, Texas 75247
http://www.nata.org |
|
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