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Protocol for Positioning and Helmet Removal-The Prone Athlete

  • If an athlete is found in the prone position after an injury, cervical spine injury should be assumed. The team physician and the training staff should complete their initial evaluation (i.e., primary survey) without moving the athlete.
  • The team physician and athletic trainer position themselves by the patient. The trainer stabilizes the cervical spine while the physician completes the primary survey.
  • The athlete’s cervical spine is stabilized by placing one hand on each side of the player’s helmet. The trainer’s hands are crossed, which will facilitate turning the athlete.
  • Once the primary survey is completed, turn the patient to a supine position to complete the evaluation and prepare the patient for transport. This step requires a minimum of four members of the athletic training team.One member is positioned above the athlete and is solely responsible for control of the head and neck. The other three members position themselves as shown above, kneeling next to the patient. The athlete’s body is held at the torso, hip, and legs to facilitate turning.
  • The patient is turned slowly on the command of the person who is stabilizing the cervical spine. Take care to maintain a neutral position of the body relative to the cervical spine.
  • The patient may be rolled directly onto a spine board to prepare for transport. Alternatively, the patient may be rolled first to a supine position to allow completion of the medical evaluation; once the decision to transport the athlete has been made, the patient is then rolled onto the spine board.
  • Once the patient is positioned supine on the spine board, the cervical spine is immobilized with foam blocks, and straps are placed across the helmet and the body. The cervical spine should be manually stabilized until it is securely immobilized.

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