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Transfer player to emergency room
1%
42/4084
Remove the helmet and shoulder pads
30/4084
Remove helmet and sit the player upright to help with breathing
0%
15/4084
Remove the facemask, leaving the helmet in place, followed by appropriate airway managment
97%
3969/4084
Perform tracheostomy
10/4084
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Following ATLS protocol, airway management is the essential first step in the treatment algorithm. The facemask must be removed rapidly to gain access to the airway. The cervical spine should be immobilized in a neutral position. Attempting to remove the helmet without simultaneously removing the shoulder pads is contraindicated because it could pull traction on an injured c-spine or result in immobilization in extension because the shoulder pads lift the chest forward. This was shown radiographically in a cadaveric flexion-distraction model study by Gastel et al. They concluded that in order to maintain a neutral position and minimize secondary injury to the cervical neural elements, the helmet and shoulder pads should be either both removed or left on. The 2015 NATA recommendations now allow for skilled teams to simultaneously remove both the helmet and shoulder pads prior to transfer if it can be done safely. However, initial efforts still need to focus on airway management, which includes rapid facemask removal.
3.7
(21)
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