Guest guest Posted September 11, 1998 Report Share Posted September 11, 1998 Les, I agree, My oldest son will be going to TCU next year for their Athletic trainer (sports medicine) program. After obtaining his BS in that area he may intern at a professional level ( NFL, NBA etc... and or onto a medical school or other related progam. At that point he would have already passed up his old man. Also in our local high school we have an outstanding Athletic trainer. He also has the common since of a well rounded experienced medical professional. He has greatly encouraged both of my boys to pursue this up and coming field. They are part of the program here and are learning a great deal from it. And I am greatful for that. Weeellll thats my .02 cents Thanks Larry Mc EMT/P IE Paris Jr. College Paris, Texas lmcdonald@... At 20:36 9/29/98 -0500, you wrote: >There are two very good articles in the October 1998 issue of Emergency >Medical Services that ALL EMS personnel who stand by or respond to >sports injuries need to read! >I work very close with Athletic Trainers on a daily basis, and feel that >the role of an Athletic Trainers is as misunderstood as that of EMS >personnel. >These guy and gals are Medical Professionals, and have allot more >training the most EMS personnel. Keep this in mind next time that > " Coach " is taking care of the injured athlete, he or she may be allot >more than a " Coach " ! >One of these articles talks about why the helmet should be left on an >injured football player and not removed, which most EMS personnel wants >to do. Remove the face mask and leave the helmet on! Of course this is >one area that EMS personnel need more education in. > >Les ><!DOCTYPE HTML PUBLIC " -//W3C//DTD HTML 4.0 Transitional//EN " > ><HTML> ><B>There are two very good articles in the October 1998 issue of Emergency >Medical Services that ALL EMS personnel who stand by or respond to sports >injuries need to read!</B> ><BR><B>I work very close with Athletic Trainers on a daily basis, and feel >that the role of an Athletic Trainers is as misunderstood as that of EMS >personnel.</B> ><BR><B>These guy and gals are Medical Professionals, and have allot more >training the most EMS personnel. Keep this in mind next time that " Coach " >is taking care of the injured athlete, he or she may be allot more than >a " Coach " !</B> ><BR><B>One of these articles talks about why the helmet <FONT COLOR= " #CC0000 " >should >be left on an injured football player</FONT> and <FONT COLOR= " #CC0000 " >not >removed,</FONT> which most EMS personnel wants to do. Remove the face mask >and leave the helmet on! & nbsp; Of course this is one area that EMS personnel >need more education in.</B> ><P><B>Les</B></HTML> >Content-Type: text/x-vcard; charset=us-ascii; name= " vcard.vcf " >Content-Transfer-Encoding: 7bit >Content-Description: Card for Les , NREMT-Paramedic >Content-Disposition: attachment; filename= " vcard.vcf " > >Attachment Converted: C:\Eudora\Attach\vcard15.vcf >Content-Type: text/x-vcard; charset=us-ascii; name= " vcard.vcf " >Content-Transfer-Encoding: 7bit >Content-Description: Card for Les , NREMT-Paramedic >Content-Disposition: attachment; filename= " vcard.vcf " > >Attachment Converted: C:\Eudora\Attach\vcard16.vcf > ______________________________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 29, 1998 Report Share Posted September 29, 1998 In a message dated 9/30/98 1:36:39 AM Les writes: << One of these articles talks about why the helmet should be left on an injured football player and not removed, which most EMS personnel wants to do. Remove the face mask and leave the helmet on! Of course this is one area that EMS personnel need more education in. >> Our protocol is to *remove* the helmet. This decision was made actively, not by default, and after very extensive research into the issue. Remind me, and I'll give you a copy of the protocol. Essentially, we remove the helmet because: 1. it is very difficult to establish neutral positioning with the helmet in place, because of the spacing. Adults and older children generally require 1.5 - 2.0 inches of " spacing " behind the occiput to establish neutral positioning. This become much more complex when one adds the spacing created by shoulder pads.... 2. one cannot perform a proper survey of the head, and has limited airway management access, with the helmet in place (even *with* the face mask removed). 3. If we (EMS) do not remove the helmet, the ED will have to. Almost NO ONE in the ED has the training to remove a helmet while maintaining c-spine. The risk of injury to the patient is INFINITELY less if the helmet is removed by EMS personnel who are trained AND experienced in the maneuver, than ED personnel who have NO training or experience. Let's be honest...what are the chances that the ED nursing staff can remove a helmet with B/PHTLS-style skills? Just FYI - EMS Manager City of Beaumont ______________________________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 30, 1998 Report Share Posted September 30, 1998 Just a follow up to my post, if your protocol indicates taking the football helmet off, the shoulder pads also must come off, or some type of support must be provided under the head to prevent hyperextention of the neck. If you plan on taking the shoulder pads off in the field, you need to have several very skilled personnel to maintain your cervical stabilization. This is a very difficult task to accomplish in the field, while limiting the movement of your patient. This is one area that is not often considered. Also the article make a good point of meeting with the Athletic Trainers prior to an emergency situation so there is no conflict on who is in charge and how and when patient care will be transferred to the EMS provider. Remember both EMS Providers and Athletic Trainer work under Physician Medical Directors, and those Medical Directors have different avenues of handling similar situations. Les Attachment: vcard [not shown] Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 30, 1998 Report Share Posted September 30, 1998 I think you make a lot of sense. I would limit this to the times that are critical in nature. If the patient is stable, leave it in place and stabalize as well as possible. Good point, Henry Barber DPEMS500@... wrote: > In a message dated 9/30/98 1:36:39 AM Les writes: > > << One of these articles talks about why the helmet should be left on an > injured football player and not removed, which most EMS personnel wants > to do. Remove the face mask and leave the helmet on! Of course this is > one area that EMS personnel need more education in. >> > > Our protocol is to *remove* the helmet. This decision was made actively, not > by default, and after very extensive research into the issue. Remind me, and > I'll give you a copy of the protocol. Essentially, we remove the helmet > because: > 1. it is very difficult to establish neutral positioning with the helmet in > place, because of the spacing. Adults and older children generally require > 1.5 - 2.0 inches of " spacing " behind the occiput to establish neutral > positioning. This become much more complex when one adds the spacing created > by shoulder pads.... > 2. one cannot perform a proper survey of the head, and has limited airway > management access, with the helmet in place (even *with* the face mask > removed). > 3. If we (EMS) do not remove the helmet, the ED will have to. Almost NO > ONE in the ED has the training to remove a helmet while maintaining c-spine. > The risk of injury to the patient is INFINITELY less if the helmet is removed > by EMS personnel who are trained AND experienced in the maneuver, than ED > personnel who have NO training or experience. Let's be honest...what are the > chances that the ED nursing staff can remove a helmet with B/PHTLS-style > skills? > > Just FYI - > > EMS Manager > City of Beaumont > > ______________________________________________________________________ > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 30, 1998 Report Share Posted September 30, 1998 I agree as well but I'm starting to get confused somewhat . Removing the helmet gives you what? In a BTLS course I was showed and we practiced removing the helmet and maintain the the neck in a neutral position. I 'm only a EMT B but we must all take care of the basics ABC and C spine. So is there a standard or general rule know for handling this type of incident. Everyone has presented what I feel are positive ideas. Shelby Dupnik Karnes County EMS [] Re: Sports Injuries >In a message dated 9/30/98 1:36:39 AM Les writes: > ><< One of these articles talks about why the helmet should be left on an > injured football player and not removed, which most EMS personnel wants > to do. Remove the face mask and leave the helmet on! Of course this is > one area that EMS personnel need more education in. >> > >Our protocol is to *remove* the helmet. This decision was made actively, not >by default, and after very extensive research into the issue. Remind me, and >I'll give you a copy of the protocol. Essentially, we remove the helmet >because: > 1. it is very difficult to establish neutral positioning with the helmet in >place, because of the spacing. Adults and older children generally require >1.5 - 2.0 inches of " spacing " behind the occiput to establish neutral >positioning. This become much more complex when one adds the spacing created >by shoulder pads.... > 2. one cannot perform a proper survey of the head, and has limited airway >management access, with the helmet in place (even *with* the face mask >removed). > 3. If we (EMS) do not remove the helmet, the ED will have to. Almost NO >ONE in the ED has the training to remove a helmet while maintaining c-spine. >The risk of injury to the patient is INFINITELY less if the helmet is removed >by EMS personnel who are trained AND experienced in the maneuver, than ED >personnel who have NO training or experience. Let's be honest...what are the >chances that the ED nursing staff can remove a helmet with B/PHTLS-style >skills? > >Just FYI - > >EMS Manager >City of Beaumont > >______________________________________________________________________ > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 1, 1998 Report Share Posted October 1, 1998 From what I can see, all points are very good, but as far as the question of dealing with helmet removal at the hospital, the C-spine will most likely be cleared before any removal is attempted. Therefore, the need to remove the helmet by BTLS/PHTLS standards not a major issue. Another thought, if the injured player is taken to a trauma center, most nurses working there are trained through TNCC, I believe there is training in this area of helmet removal. I will have to talk with some of my nurse friends at UTMB. I believe we have to handle this situation in a caseby case basis. I have both removed and not removed a helmet. With the face masks on helmets today, gaining airway access is not a problem with the helmets still in place. [] Re: Sports Injuries > > >>In a message dated 9/30/98 1:36:39 AM Les writes: >> >><< One of these articles talks about why the helmet should be left on an >> injured football player and not removed, which most EMS personnel wants >> to do. Remove the face mask and leave the helmet on! Of course this is >> one area that EMS personnel need more education in. >> >> >>Our protocol is to *remove* the helmet. This decision was made actively, >not >>by default, and after very extensive research into the issue. Remind me, >and >>I'll give you a copy of the protocol. Essentially, we remove the helmet >>because: >> 1. it is very difficult to establish neutral positioning with the helmet >in >>place, because of the spacing. Adults and older children generally require >>1.5 - 2.0 inches of " spacing " behind the occiput to establish neutral >>positioning. This become much more complex when one adds the spacing >created >>by shoulder pads.... >> 2. one cannot perform a proper survey of the head, and has limited >airway >>management access, with the helmet in place (even *with* the face mask >>removed). >> 3. If we (EMS) do not remove the helmet, the ED will have to. Almost >NO >>ONE in the ED has the training to remove a helmet while maintaining >c-spine. >>The risk of injury to the patient is INFINITELY less if the helmet is >removed >>by EMS personnel who are trained AND experienced in the maneuver, than ED >>personnel who have NO training or experience. Let's be honest...what are >the >>chances that the ED nursing staff can remove a helmet with B/PHTLS-style >>skills? >> >>Just FYI - >> >>EMS Manager >>City of Beaumont >> >>______________________________________________________________________ >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 1, 1998 Report Share Posted October 1, 1998 To all- I am a paramedic and was a trainer at Rice University for five years. The NATA guidelineds are to keep the helmet and shoulder pads on the patient unless their is a necessity to remove. Remember if you decide that something needs to be removed, it all needs to come off. Here are some simple guidelines: 1. Cut the plastic clamps that hold the face masl on the helmet. This can be done with a tool the trainer may carry called the " trainer's angel " , scalpel, or trauma shears. Whatever is used, make sure someone is stabilizing c-spine as these are not always easy to get off. Now you have access to the airway and ramainder of the face. 2. If you need more access, you need to remove the chin strap and ear pads, while someone maintains c-spine. 3. Next, the person holding c-spine needs to grab the helmet near the anterior base (were the ear pads used to be) and flex the helmet laterally. This will provide you with a little more clearence as you remove the helmet. If the helmet appears to be too tight to remove, you can also remove the air from the top and sides of the helmet with a tool that the trainer or equipment manager should have access to. 4. To remove the helmet, you need three people. The first person will be flexing the helmet and rotating it forward (towards the chin) while he pulls superiorly. This will allow the helmet to clear the occipital protuberance as well as the curvature of the skull. The second person needs to maintain c-spine control anteriorly and inferiorly (from the chin/TMJ) and slide his hands superiorly as the helmet is removed. The second person's hands should move in conjunction with the helmet removal, and should end up in the occipital region. AS soon as the helmet is completely off, the first person will take c-spine control superiorly from rescuer #2. The third person is needed to support the head and to compensate for the elevation from the shoulder pads, as the helmet is removed. 5. The pads can then be removed. This is probably best done under the advice of the trainer/ equipment manager as each set of pads are unique. The are usually held together by a series of shoestrings and elastic bands. Once the anterior side is disassembled enough to allow for removal, you can either log roll the patient to to remove or pull them out superiorly. This is a system that I used and taught at Rice and works very well. Please remember that the Trainers that you come in contact with will have varying knowledge of this technique, and even more variance on the practical application of this knowledge through training. My suggestion is that if your service routinely works with athletic teams, especially if you work stand-by, you should train with the sports medicine staff on this and other emergency situations. This is what I do with the Rice Sports Medicine Staff, as well as having some of them in our EMT classes. Just my $.02 At 10:39 PM 9/30/98 -0500, Shelby Dupnik wrote: >I agree as well but I'm starting to get confused somewhat . Removing the >helmet gives you what? In a BTLS course I was showed and we practiced >removing the helmet and maintain the the neck in a neutral position. I 'm >only a EMT B but we must all take care of the basics ABC and C spine. So >is there a standard or general rule know for handling this type of incident. >Everyone has presented what I feel are positive ideas. > >Shelby Dupnik >Karnes County EMS > [] Re: Sports Injuries > > >>In a message dated 9/30/98 1:36:39 AM Les writes: >> >><< One of these articles talks about why the helmet should be left on an >> injured football player and not removed, which most EMS personnel wants >> to do. Remove the face mask and leave the helmet on! Of course this is >> one area that EMS personnel need more education in. >> >> >>Our protocol is to *remove* the helmet. This decision was made actively, >not >>by default, and after very extensive research into the issue. Remind me, >and >>I'll give you a copy of the protocol. Essentially, we remove the helmet >>because: >> 1. it is very difficult to establish neutral positioning with the helmet >in >>place, because of the spacing. Adults and older children generally require >>1.5 - 2.0 inches of " spacing " behind the occiput to establish neutral >>positioning. This become much more complex when one adds the spacing >created >>by shoulder pads.... >> 2. one cannot perform a proper survey of the head, and has limited >airway >>management access, with the helmet in place (even *with* the face mask >>removed). >> 3. If we (EMS) do not remove the helmet, the ED will have to. Almost >NO >>ONE in the ED has the training to remove a helmet while maintaining >c-spine. >>The risk of injury to the patient is INFINITELY less if the helmet is >removed >>by EMS personnel who are trained AND experienced in the maneuver, than ED >>personnel who have NO training or experience. Let's be honest...what are >the >>chances that the ED nursing staff can remove a helmet with B/PHTLS-style >>skills? >> >>Just FYI - >> >>EMS Manager >>City of Beaumont >> >>______________________________________________________________________ >> >> Quote Link to comment Share on other sites More sharing options...
Guest guest Posted October 3, 1998 Report Share Posted October 3, 1998 Hi: I don't want to start a word war; however, being that this a an obscure move on the part of Beaumont EMS. My name is and I am a little old paramedic that has some street experience. I work near the big City of Houston and have seen some good and some bad. The good are well educated and experienced folks out there that have spent some of their time showing us the proper way of doing some of our skills that we practice every day. One in particular that I remember was a doctor. This doctor had a little bit of experience with c-spine injuries in sport related accidents. I don't remember his name, but really nice guy. I do remember he had a pretty cool job. He was the team doctor for the Houston Oilers. Everybody remeber the Houston Oilers, yes? Anyway, he still lives in Houston, despite not working for the Oilers anymore and is one the leading Sport Medicine MD's in the Houston Area. Anyway, he said that neutral position for the head is not lying below the shoulder pads; therefore, it is just best to leave all the equipment on until X-RAYS are taken. I am understanding that most ER protocol's are to leave everything on and take X-RAYS prior to removal of any equipment. Sounds fair and reasonable to me. If you are at a smaller hospital I'm sure that it would be in their best interest to leave everything on, X-RAY and if there is a problem, ship that person out. I would hope that if an accident happened to me the EMS folks would follow there basic skills and leave everything on, unless I was not breathing. I also remember that the doc told a story of a NFL player that sustained a spinal cord injury not to long ago. It is not an open topic, but he is paralyzed todate due to one of the trainers removing his football helmet. P.S. I have great respect for the doctors and nurses at St. E, Baptist, and Mash when is comes to their skill in Basic Trauma Life Support. Almost everyone of them I taught or they were going through a BTLS Instructor course. Most of the nurses used to do " ride alongs " with BEMS on many occasions. Love EMT/P >From -return-237-kasyd=hotmail.comegroups Wed Sep 30 09:55:11 1998 >Received: (qmail 14624 invoked by uid 505); 30 Sep 1998 12:27:51 -0000 >Mailing-List: contact -owneregroups >Precedence: list >X-URL: /list// >X-Mailing-List: egroups >Reply-To: egroups >Delivered-To: listsaver-egroups-egroups >Received: (qmail 30935 invoked by uid 7770); 30 Sep 1998 02:31:25 -0000 >Received: from imo20.mx.aol.com (198.81.17.10) > by vault.findmail.com with SMTP; 30 Sep 1998 02:31:25 -0000 >Received: from DPEMS500@... > by imo20.mx.aol.com (IMOv16.10) id 7ZTCa03785; > Tue, 29 Sep 1998 22:17:16 +2000 (EDT) >From: DPEMS500@... >Message-ID: >Date: Tue, 29 Sep 1998 22:17:16 EDT >To: lpowell@... >Cc: Andy Foot , > Dan C.Howell@..., LAT , > , Pierce , > @..., " NREMT-P M.Ed " , > Donnie Kron , > EMS Mailing List <egroups>, > Goldstar EMS , > Greg Mc , > Iva Thibodeaux , > " B. Ashby " , > Jerry Romero , > King , > " L. Roquemore " , Kathy Rodgers@..., > RN@..., MSN@..., EMT-P , > LHSCA , S.Stark@..., M.Ed.AT-C@..., > LAT , > " Paramedicine.Comlist@... " , > Ray Jewett , > " Sharon I. Patton " , > Steve Tatum , > Texas Trauma Mailing List <texastrauma-legroups>, > Weslie , Weslie , > " Wiliam E. Grandy " >Mime-Version: 1.0 >Content-type: text/plain; charset=US-ASCII >Content-transfer-encoding: 7bit >X-Mailer: AOL 4.0 for Windows 95 sub 226 >Subject: [] Re: Sports Injuries > >In a message dated 9/30/98 1:36:39 AM Les writes: > ><< One of these articles talks about why the helmet should be left on an > injured football player and not removed, which most EMS personnel wants > to do. Remove the face mask and leave the helmet on! Of course this is > one area that EMS personnel need more education in. >> > >Our protocol is to *remove* the helmet. This decision was made actively, not >by default, and after very extensive research into the issue. Remind me, and >I'll give you a copy of the protocol. Essentially, we remove the helmet >because: > 1. it is very difficult to establish neutral positioning with the helmet in >place, because of the spacing. Adults and older children generally require >1.5 - 2.0 inches of " spacing " behind the occiput to establish neutral >positioning. This become much more complex when one adds the spacing created >by shoulder pads.... > 2. one cannot perform a proper survey of the head, and has limited airway >management access, with the helmet in place (even *with* the face mask >removed). > 3. If we (EMS) do not remove the helmet, the ED will have to. Almost NO >ONE in the ED has the training to remove a helmet while maintaining c-spine. >The risk of injury to the patient is INFINITELY less if the helmet is removed >by EMS personnel who are trained AND experienced in the maneuver, than ED >personnel who have NO training or experience. Let's be honest...what are the >chances that the ED nursing staff can remove a helmet with B/PHTLS-style >skills? > >Just FYI - > >EMS Manager >City of Beaumont > >______________________________________________________________________ > > Quote Link to comment Share on other sites More sharing options...
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