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Pregame Planning

Personnel and staff who are responsible for the care of athletes need to ensure that necessary pre-event planning and preparations are accomplished. These tasks may be summarized as follows:

(a) establish a protocol for prehospital care of the injured athlete,

(b) organize all necessary equipment for on-field management, and

(c) select a hospital system for the transfer of care.

A well-devised diagnostic and therapeutic protocol allows all staff to be effective team members in the execution of an emergency plan. A standard chain of command exists, with the sports medicine physician or head athletic trainer responsible for on-field direction. The protocol should be easily understood by each member.

Necessary emergency equipment includes items for airway management and cardiopulmonary resuscitation. A backboard and means for rapid immobilization of the cervical spine must be available. Additionally, face mask shears and other tools for the removal of protective athletic gear should be available as well.

Emergency medical technicians are essential team members when transport of the athlete is necessary. Working relationships and clear communication are essential between these health care providers and the on-field medical team. A standard protocol for ambulance transport, including which personnel should accompany the athlete, should be decided as well. Optimally, the medical facility chosen for transfer will have expertise in definitive treatment of cervical spinal cord injuries.

All hospital systems will have the services necessary for initial resuscitation of a critically injured athlete. Early consultation with a spine surgeon, however, will be essential, because early definitive care of cervical spine injuries has been demonstrated to improve patient outcomes.

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