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Protocol for Positioning and Helmet Removal-Management in the Emergency Room

After safe transport, the care of the athlete is transferred to the hospital emergency room personnel. If possible, a member of the on-field medical team should accompany the athlete during transport.

This provides an accurate, knowledgeable briefing to the emergency room physicians, which may be essential during the early management of the case. Furthermore, the on-field medical team member may be the only one who is familiar with proper techniques of helmet removal in this setting.

At this point, initial primary and secondary surveys are completed by the emergency room physician. The emergency room physician specifically documents a full neurological examination and any changes from previous examinations.

Radiographic examination should then be performed. Initially, these include an anteroposterior, lateral, and odontoid view of the cervical spine. In any case of suspected catastrophic cervical spine injury, appropriate consultation with the hospital’s spine surgeon should be rapidly obtained.

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