RE: a reminder for Foot ball season: pads and helmets

[Guest guest]

When I was in England last year I saw a product for removing helmets. It was

a multi-compartment inflatable device. You slid it inside the helmet and

slowly inflated it and it gently pushed the helmet off. I have not seen it

in this country. I have a few pictures but the lists will not allow them to

attach.

BEB

_____

From: texasems-l [mailto:texasems-l ] On

Behalf Of krin135@...

Sent: Sunday, October 29, 2006 7:47 PM

To: Paramedicine

Cc: Texas_EMTs_and_Paramedics ; EMS-L@...;

texasems-l ; bbledsoe@...; Grayson902@...;

Trauma51@...

Subject: a reminder for Foot ball season: pads and helmets

After having two different football players brought in to the ED for

evaluation of concussion, I've come to the conclusion that we need to re

think how

we are handling these young players if they are not being taken straight off

the field. This also came up in the ATLS class that I took last week, and

many

of those docs, if they weren't from small towns, seemed to have never had to

remove a helmet and pads from a football player.

In both cases, the concussion was not noted until after the player got off

the field under their own power, and in both cases, the pads were left on

when

the seated/standing take down was done to get them on the board...while the

void under the head was well and appropriately padded, the head was less

than

optimally restrained. Getting the pads out from under the kid so that we

could do an appropriate evaluation and CT exam was not fun while trying to

maintain appropriate C spine precautions.

A modest suggestion: if you (as a field Medic/Basic) are doing a

standing/seated takedown on a football ball player with his helmet already

off...Please,

Please, PLEASE! stop and cut the jersey off, unlace the pads and remove them

PRIOR to doing the takedown! It is so much easier to do it then, and reduces

the amount of movement of the head and C spine en route...not to mention

removing the pads at that time will result in NOT having to cut them off in

the

ED...saving the school system a fair chunk of money.

Similar rational applies to the player who still has his helmet on, but who

is still coherent enough that they are standing or seated...it's easy enough

to get the helmet (and then the pads) off while maintaining C spine

precautions prior to the take down (and to make it easier, the coach/trainer

should

have their nice little adjustment device that will often loosen the helmet

while still on the side lines)....and it's much easier to secure the patient

to

the back board without 50 pounds of body armor on the kid.

You should indeed put the kid in full board with helmet and pads intact if

he is not conscious and cooperative (ie, unconscious on the field)...but you

should at least remove the face mask to provide adequate airway- remember

that

the face masks are held on with simple plastic/nylon straps that can be cut

with a pair of diagonal cutters with ease.

I realize that many of you do work the sidelines at home town ball games and

are aware of these practices, but a reminder seemed to be in order after

seeing two cases in two different EDs and seeing the response at the ATLS

course.

ck

S. Krin, DO FAAFP

[Guest guest]

In a message dated 10/30/2006 2:42:42 P.M. Central Standard Time,

bbledsoe@... writes:

Protocol for Care of Helmeted Texas High-School Football Player:

If player wearing a football helmet remains on the field after the play:

Hey it worked in Friday night Lights didn't it?

Louis N. Molino, Sr., CET

FF/NREMT-B/FSI/EMSI

Freelance Consultant/Trainer/Author/Journalist/Fire Protection Consultant

LNMolino@...

(Cell Phone)

(Home Phone)

(IFW/TFW/FSS Office)

(IFW/TFW/FSS Fax)

" A Texan with a Jersey Attitude "

" Great minds discuss ideas; Average minds discuss events; Small minds

discuss people " Eleanor Roosevelt - US diplomat & reformer (1884 - 1962)

The comments contained in this E-mail are the opinions of the author and the

author alone. I in no way ever intend to speak for any person or

organization that I am in any way whatsoever involved or associated with unless

I

specifically state that I am doing so. Further this E-mail is intended only for

its

stated recipient and may contain private and or confidential materials

retransmission is strictly prohibited unless placed in the public domain by the

original author.

[Guest guest]

One of the Athletic Trainer's associations has a video demonstrating the

process of removing the helmet/pads from a player. We worked with our

school district, the trainers and their physicians to develop a protocol

which would define the process of helmet/pad removal prior to transporting

the player to the hospital. We held joint training sessions with the

Athletic trainers, their physicians, and our staff prior to each football

season to train new personnel and refresh the skills for everyone else.

Besides developing a new 'unique' protocol, it helped bridge many of the

gaps between Athletic Medicine and Pre-Hospital Care. Win.. win for

everyone involved.

Jack

_____

From: texasems-l [mailto:texasems-l ] On

Behalf Of Bledsoe, DO

Sent: Monday, October 30, 2006 8:24 AM

To: texasems-l ; Paramedicine

Cc: Texas_EMTs_and_Paramedics ; EMS-L@...;

Grayson902@...; Trauma51@...

Subject: RE: a reminder for Foot ball season: pads and helmets

When I was in England last year I saw a product for removing helmets. It was

a multi-compartment inflatable device. You slid it inside the helmet and

slowly inflated it and it gently pushed the helmet off. I have not seen it

in this country. I have a few pictures but the lists will not allow them to

attach.

BEB

_____

From: texasems-l@yahoogro <mailto:texasems-l%40yahoogroups.com> ups.com

[mailto:texasems-l@yahoogro <mailto:texasems-l%40yahoogroups.com> ups.com]

On

Behalf Of krin135 (AT) aol (DOT) <mailto:krin135%40aol.com> com

Sent: Sunday, October 29, 2006 7:47 PM

To: Paramedicine@ <mailto:Paramedicine%40yahoogroups.com> yahoogroups.com

Cc: Texas_EMTs_and_ <mailto:Texas_EMTs_and_Paramedics%40yahoogroups.com>

Paramedics ; EMS-L (AT) ems-l (DOT) <mailto:EMS-L%40ems-l.org> org;

texasems-l@yahoogro <mailto:texasems-l%40yahoogroups.com> ups.com;

bbledsoe (AT) earthlink (DOT) <mailto:bbledsoe%40earthlink.net> net; Grayson902 (AT) aol (DOT)

<mailto:Grayson902%40aol.com> com;

Trauma51 (AT) aol (DOT) <mailto:Trauma51%40aol.com> com

Subject: a reminder for Foot ball season: pads and helmets

After having two different football players brought in to the ED for

evaluation of concussion, I've come to the conclusion that we need to re

think how

we are handling these young players if they are not being taken straight off

the field. This also came up in the ATLS class that I took last week, and

many

of those docs, if they weren't from small towns, seemed to have never had to

remove a helmet and pads from a football player.

In both cases, the concussion was not noted until after the player got off

the field under their own power, and in both cases, the pads were left on

when

the seated/standing take down was done to get them on the board...while the

void under the head was well and appropriately padded, the head was less

than

optimally restrained. Getting the pads out from under the kid so that we

could do an appropriate evaluation and CT exam was not fun while trying to

maintain appropriate C spine precautions.

A modest suggestion: if you (as a field Medic/Basic) are doing a

standing/seated takedown on a football ball player with his helmet already

off...Please,

Please, PLEASE! stop and cut the jersey off, unlace the pads and remove them

PRIOR to doing the takedown! It is so much easier to do it then, and reduces

the amount of movement of the head and C spine en route...not to mention

removing the pads at that time will result in NOT having to cut them off in

the

ED...saving the school system a fair chunk of money.

Similar rational applies to the player who still has his helmet on, but who

is still coherent enough that they are standing or seated...it's easy enough

to get the helmet (and then the pads) off while maintaining C spine

precautions prior to the take down (and to make it easier, the coach/trainer

should

have their nice little adjustment device that will often loosen the helmet

while still on the side lines)....and it's much easier to secure the patient

to

the back board without 50 pounds of body armor on the kid.

You should indeed put the kid in full board with helmet and pads intact if

he is not conscious and cooperative (ie, unconscious on the field)...but you

should at least remove the face mask to provide adequate airway- remember

that

the face masks are held on with simple plastic/nylon straps that can be cut

with a pair of diagonal cutters with ease.

I realize that many of you do work the sidelines at home town ball games and

are aware of these practices, but a reminder seemed to be in order after

seeing two cases in two different EDs and seeing the response at the ATLS

course.

ck

S. Krin, DO FAAFP

[Guest guest]

Jack:

Would you be interested in emailing that protocol to me?

Thank you!

-Wes Ogilvie

a reminder for Foot ball season: pads and helmets

After having two different football players brought in to the ED for

evaluation of concussion, I've come to the conclusion that we need to re

think how

we are handling these young players if they are not being taken straight off

the field. This also came up in the ATLS class that I took last week, and

many

of those docs, if they weren't from small towns, seemed to have never had to

remove a helmet and pads from a football player.

In both cases, the concussion was not noted until after the player got off

the field under their own power, and in both cases, the pads were left on

when

the seated/standing take down was done to get them on the board...while the

void under the head was well and appropriately padded, the head was less

than

optimally restrained. Getting the pads out from under the kid so that we

could do an appropriate evaluation and CT exam was not fun while trying to

maintain appropriate C spine precautions.

A modest suggestion: if you (as a field Medic/Basic) are doing a

standing/seated takedown on a football ball player with his helmet already

off...Please,

Please, PLEASE! stop and cut the jersey off, unlace the pads and remove them

PRIOR to doing the takedown! It is so much easier to do it then, and reduces

the amount of movement of the head and C spine en route...not to mention

removing the pads at that time will result in NOT having to cut them off in

the

ED...saving the school system a fair chunk of money.

Similar rational applies to the player who still has his helmet on, but who

is still coherent enough that they are standing or seated...it's easy enough

to get the helmet (and then the pads) off while maintaining C spine

precautions prior to the take down (and to make it easier, the coach/trainer

should

have their nice little adjustment device that will often loosen the helmet

while still on the side lines)....and it's much easier to secure the patient

to

the back board without 50 pounds of body armor on the kid.

You should indeed put the kid in full board with helmet and pads intact if

he is not conscious and cooperative (ie, unconscious on the field)...but you

should at least remove the face mask to provide adequate airway- remember

that

the face masks are held on with simple plastic/nylon straps that can be cut

with a pair of diagonal cutters with ease.

I realize that many of you do work the sidelines at home town ball games and

are aware of these practices, but a reminder seemed to be in order after

seeing two cases in two different EDs and seeing the response at the ATLS

course.

ck

S. Krin, DO FAAFP

[Guest guest]

The device in question:

http://www.motorcycle-uk.com/acatalog/Hats_Off_Emergency_Helmet_Removal_Syst

em.html

http://www.hatsoff.info/

BEB

_____

From: Paramedicine [mailto:Paramedicine ] On

Behalf Of Bledsoe, DO

Sent: Monday, October 30, 2006 8:24 AM

To: texasems-l ; Paramedicine

Cc: Texas_EMTs_and_Paramedics ; EMS-L@...;

Grayson902@...; Trauma51@...

Subject: RE: a reminder for Foot ball season: pads and helmets

When I was in England last year I saw a product for removing helmets. It was

a multi-compartment inflatable device. You slid it inside the helmet and

slowly inflated it and it gently pushed the helmet off. I have not seen it

in this country. I have a few pictures but the lists will not allow them to

attach.

BEB

_____

From: texasems-l@yahoogro <mailto:texasems-l%40yahoogroups.com> ups.com

[mailto:texasems-l@yahoogro <mailto:texasems-l%40yahoogroups.com> ups.com]

On

Behalf Of krin135 (AT) aol (DOT) <mailto:krin135%40aol.com> com

Sent: Sunday, October 29, 2006 7:47 PM

To: Paramedicine@ <mailto:Paramedicine%40yahoogroups.com> yahoogroups.com

Cc: Texas_EMTs_and_ <mailto:Texas_EMTs_and_Paramedics%40yahoogroups.com>

Paramedics ; EMS-L (AT) ems-l (DOT) <mailto:EMS-L%40ems-l.org> org;

texasems-l@yahoogro <mailto:texasems-l%40yahoogroups.com> ups.com;

bbledsoe (AT) earthlink (DOT) <mailto:bbledsoe%40earthlink.net> net; Grayson902 (AT) aol (DOT)

<mailto:Grayson902%40aol.com> com;

Trauma51 (AT) aol (DOT) <mailto:Trauma51%40aol.com> com

Subject: a reminder for Foot ball season: pads and helmets

After having two different football players brought in to the ED for

evaluation of concussion, I've come to the conclusion that we need to re

think how

we are handling these young players if they are not being taken straight off

the field. This also came up in the ATLS class that I took last week, and

many

of those docs, if they weren't from small towns, seemed to have never had to

remove a helmet and pads from a football player.

In both cases, the concussion was not noted until after the player got off

the field under their own power, and in both cases, the pads were left on

when

the seated/standing take down was done to get them on the board...while the

void under the head was well and appropriately padded, the head was less

than

optimally restrained. Getting the pads out from under the kid so that we

could do an appropriate evaluation and CT exam was not fun while trying to

maintain appropriate C spine precautions.

A modest suggestion: if you (as a field Medic/Basic) are doing a

standing/seated takedown on a football ball player with his helmet already

off...Please,

Please, PLEASE! stop and cut the jersey off, unlace the pads and remove them

PRIOR to doing the takedown! It is so much easier to do it then, and reduces

the amount of movement of the head and C spine en route...not to mention

removing the pads at that time will result in NOT having to cut them off in

the

ED...saving the school system a fair chunk of money.

Similar rational applies to the player who still has his helmet on, but who

is still coherent enough that they are standing or seated...it's easy enough

to get the helmet (and then the pads) off while maintaining C spine

precautions prior to the take down (and to make it easier, the coach/trainer

should

have their nice little adjustment device that will often loosen the helmet

while still on the side lines)....and it's much easier to secure the patient

to

the back board without 50 pounds of body armor on the kid.

You should indeed put the kid in full board with helmet and pads intact if

he is not conscious and cooperative (ie, unconscious on the field)...but you

should at least remove the face mask to provide adequate airway- remember

that

the face masks are held on with simple plastic/nylon straps that can be cut

with a pair of diagonal cutters with ease.

I realize that many of you do work the sidelines at home town ball games and

are aware of these practices, but a reminder seemed to be in order after

seeing two cases in two different EDs and seeing the response at the ATLS

course.

ck

S. Krin, DO FAAFP

[Guest guest]

Protocol for Care of Helmeted Texas High-School Football Player:

If player wearing a football helmet remains on the field after the play:

1. Have assistant coach come out and tell player to " get up and walk it

off. "

2. If that fails, have coach come out and say, " Cowboy Up! Don't you

know the girls are watching you? You want me to bench you boy? "

3. If that fails, have the Grade IV acne-covered assistant trainer

" Mongo " go out. He will grab player and pick him up by the helmet and shake

him like a rag doll. At this point, the assistant coach will come and say to

the trainer, " Boy.are you stupid or something? You forgot to undo his chin

strap. "

4. Trainer comes out and checks player's shoes and genitalia.

5. Coach calls all of the linemen. They proceed to shake player out of

helmet.

6. Trainer verifies that genitalia are indeed uninjured and signals for

EMS crew to come onto the field.

7. Trainer and Mongo then proceed to tell EMS crew how to immobilize

the patient.

8. Proceeds of next game will go to help pay the medical expenses of

player.

Sound accurate?

_____

From: texasems-l [mailto:texasems-l ] On

Behalf Of ExLngHrn@...

Sent: Monday, October 30, 2006 10:36 AM

To: texasems-l

Subject: Re: a reminder for Foot ball season: pads and helmets

Jack:

Would you be interested in emailing that protocol to me?

Thank you!

-Wes Ogilvie

a reminder for Foot ball season: pads and helmets

After having two different football players brought in to the ED for

evaluation of concussion, I've come to the conclusion that we need to re

think how

we are handling these young players if they are not being taken straight off

the field. This also came up in the ATLS class that I took last week, and

many

of those docs, if they weren't from small towns, seemed to have never had to

remove a helmet and pads from a football player.

In both cases, the concussion was not noted until after the player got off

the field under their own power, and in both cases, the pads were left on

when

the seated/standing take down was done to get them on the board...while the

void under the head was well and appropriately padded, the head was less

than

optimally restrained. Getting the pads out from under the kid so that we

could do an appropriate evaluation and CT exam was not fun while trying to

maintain appropriate C spine precautions.

A modest suggestion: if you (as a field Medic/Basic) are doing a

standing/seated takedown on a football ball player with his helmet already

off...Please,

Please, PLEASE! stop and cut the jersey off, unlace the pads and remove them

PRIOR to doing the takedown! It is so much easier to do it then, and reduces

the amount of movement of the head and C spine en route...not to mention

removing the pads at that time will result in NOT having to cut them off in

the

ED...saving the school system a fair chunk of money.

Similar rational applies to the player who still has his helmet on, but who

is still coherent enough that they are standing or seated...it's easy enough

to get the helmet (and then the pads) off while maintaining C spine

precautions prior to the take down (and to make it easier, the coach/trainer

should

have their nice little adjustment device that will often loosen the helmet

while still on the side lines)....and it's much easier to secure the patient

to

the back board without 50 pounds of body armor on the kid.

You should indeed put the kid in full board with helmet and pads intact if

he is not conscious and cooperative (ie, unconscious on the field)...but you

should at least remove the face mask to provide adequate airway- remember

that

the face masks are held on with simple plastic/nylon straps that can be cut

with a pair of diagonal cutters with ease.

I realize that many of you do work the sidelines at home town ball games and

are aware of these practices, but a reminder seemed to be in order after

seeing two cases in two different EDs and seeing the response at the ATLS

course.

ck

S. Krin, DO FAAFP

[Guest guest]

that is a very pro-active approach, great job Jack. We can all learn from this.

a reminder for Foot ball season: pads and helmets

After having two different football players brought in to the ED for

evaluation of concussion, I've come to the conclusion that we need to re

think how

we are handling these young players if they are not being taken straight off

the field. This also came up in the ATLS class that I took last week, and

many

of those docs, if they weren't from small towns, seemed to have never had to

remove a helmet and pads from a football player.

In both cases, the concussion was not noted until after the player got off

the field under their own power, and in both cases, the pads were left on

when

the seated/standing take down was done to get them on the board...while the

void under the head was well and appropriately padded, the head was less

than

optimally restrained. Getting the pads out from under the kid so that we

could do an appropriate evaluation and CT exam was not fun while trying to

maintain appropriate C spine precautions.

A modest suggestion: if you (as a field Medic/Basic) are doing a

standing/seated takedown on a football ball player with his helmet already

off...Please,

Please, PLEASE! stop and cut the jersey off, unlace the pads and remove them

--- message truncated ---

[Guest guest]

After looking at the site the device invented by an American and has been

widely accepted in the UK in many different racing applications. The site

states the Indy Racing League (IRL) and Champ Car World Series (CART), the

two US Indy car style racing leagues require this product for all racers. I

wonder if it could be adapted for a different application such as a football

helmet. After looking at the site this product appears to be very useful and

I would love to see it demonstrated.

Bernie Stafford EMTP

_____

From: texasems-l [mailto:texasems-l ] On

Behalf Of Bledsoe, DO

Sent: Monday, October 30, 2006 11:06 AM

To: Paramedicine ; texasems-l

Cc: Texas_EMTs_and_Paramedics ; EMS-L@...;

Grayson902@...; Trauma51@...

Subject: RE: a reminder for Foot ball season: pads and helmets

The device in question:

HYPERLINK

" http://www.motorcycle-uk.com/acatalog/Hats_Off_Emergency_Helmet_Removal_Sys

t " http://www.motorcyc-le-uk.com/-acatalog/-Hats_Off_-Emergency_-Helmet_Remov

al_-Syst

em.html

HYPERLINK " http://www.hatsoff.info/ " http://www.hatsoff.-info/

BEB

_____

From: HYPERLINK

" mailto:Paramedicine%40yahoogroups.com " Paramedicine@-yahoogroups.-com

[mailto:HYPERLINK

" mailto:Paramedicine%40yahoogroups.com " Paramedicine@-yahoogroups.-com] On

Behalf Of Bledsoe, DO

Sent: Monday, October 30, 2006 8:24 AM

To: HYPERLINK

" mailto:texasems-l%40yahoogroups.com " texasems-l@...; HYPERLINK

" mailto:Paramedicine%40yahoogroups.com " Paramedicine@-yahoogroups.-com

Cc: HYPERLINK

" mailto:Texas_EMTs_and_Paramedics%40yahoogroups.com " Texas_EMTs_and_-Paramedi

cs@-yahoogroups.-com; HYPERLINK " mailto:EMS-L%40ems-l.org " EMS-L (AT) ems-l (DOT) -org;

HYPERLINK " mailto:Grayson902%40aol.com " Grayson902 (AT) aol (DOT) -com; HYPERLINK

" mailto:Trauma51%40aol.com " Trauma51 (AT) aol (DOT) -com

Subject: RE: a reminder for Foot ball season: pads and helmets

When I was in England last year I saw a product for removing helmets. It was

a multi-compartment inflatable device. You slid it inside the helmet and

slowly inflated it and it gently pushed the helmet off. I have not seen it

in this country. I have a few pictures but the lists will not allow them to

attach.

BEB

_____

From: texasems-l@yahoogro <mailto:texasems--l%40yahoogroups.-com> ups.com

[mailto:texasems--l@yahoogro <mailto:texasems--l%40yahoogroups.-com>

ups.com]

On

Behalf Of krin135 (AT) aol (DOT) <mailto:krin135%-40aol.com> com

Sent: Sunday, October 29, 2006 7:47 PM

To: Paramedicine@ <mailto:Paramedicin-e%40yahoogroups.-com> yahoogroups.-com

Cc: Texas_EMTs_and_ <mailto:Texas_-EMTs_and_-Paramedics%-40yahoogroups.-com>

HYPERLINK " mailto:Paramedics%40yahoogroups.com " Paramedics@...;

EMS-L (AT) ems-l (DOT) <mailto:EMS--L%40ems-l.-org> org;

texasems-l@yahoogro <mailto:texasems--l%40yahoogroups.-com> ups.com;

bbledsoe (AT) earthlink (DOT) <mailto:bbledsoe%-40earthlink.-net> net; Grayson902 (AT) aol (DOT)

<mailto:Grayson902%-40aol.com> com;

Trauma51 (AT) aol (DOT) <mailto:Trauma51%-40aol.com> com

Subject: a reminder for Foot ball season: pads and helmets

After having two different football players brought in to the ED for

evaluation of concussion, I've come to the conclusion that we need to re

think how

we are handling these young players if they are not being taken straight off

the field. This also came up in the ATLS class that I took last week, and

many

of those docs, if they weren't from small towns, seemed to have never had to

remove a helmet and pads from a football player.

In both cases, the concussion was not noted until after the player got off

the field under their own power, and in both cases, the pads were left on

when

the seated/standing take down was done to get them on the board...while the

void under the head was well and appropriately padded, the head was less

than

optimally restrained. Getting the pads out from under the kid so that we

could do an appropriate evaluation and CT exam was not fun while trying to

maintain appropriate C spine precautions.

A modest suggestion: if you (as a field Medic/Basic) are doing a

standing/seated takedown on a football ball player with his helmet already

off...Please,

Please, PLEASE! stop and cut the jersey off, unlace the pads and remove them

PRIOR to doing the takedown! It is so much easier to do it then, and reduces

the amount of movement of the head and C spine en route...not to mention

removing the pads at that time will result in NOT having to cut them off in

the

ED...saving the school system a fair chunk of money.

Similar rational applies to the player who still has his helmet on, but who

is still coherent enough that they are standing or seated...it'-s easy

enough

to get the helmet (and then the pads) off while maintaining C spine

precautions prior to the take down (and to make it easier, the coach/trainer

should

have their nice little adjustment device that will often loosen the helmet

while still on the side lines)....and it's much easier to secure the patient

to

the back board without 50 pounds of body armor on the kid.

You should indeed put the kid in full board with helmet and pads intact if

he is not conscious and cooperative (ie, unconscious on the field)...but you

should at least remove the face mask to provide adequate airway- remember

that

the face masks are held on with simple plastic/nylon straps that can be cut

with a pair of diagonal cutters with ease.

I realize that many of you do work the sidelines at home town ball games and

are aware of these practices, but a reminder seemed to be in order after

seeing two cases in two different EDs and seeing the response at the ATLS

course.

ck

S. Krin, DO FAAFP

[Guest guest]

I emailed them and asked them to send a few. Seems like a good JEMS article

(or maybe Texas EMS Messenger).

BEB

_____

From: texasems-l [mailto:texasems-l ] On

Behalf Of Bernie Stafford

Sent: Monday, October 30, 2006 12:49 PM

To: texasems-l

Subject: RE: a reminder for Foot ball season: pads and helmets

After looking at the site the device invented by an American and has been

widely accepted in the UK in many different racing applications. The site

states the Indy Racing League (IRL) and Champ Car World Series (CART), the

two US Indy car style racing leagues require this product for all racers. I

wonder if it could be adapted for a different application such as a football

helmet. After looking at the site this product appears to be very useful and

I would love to see it demonstrated.

Bernie Stafford EMTP

_____

From: texasems-l@yahoogro <mailto:texasems-l%40yahoogroups.com> ups.com

[mailto:texasems-l@yahoogro <mailto:texasems-l%40yahoogroups.com> ups.com]

On

Behalf Of Bledsoe, DO

Sent: Monday, October 30, 2006 11:06 AM

To: Paramedicine@ <mailto:Paramedicine%40yahoogroups.com> yahoogroups.com;

texasems-l@yahoogro <mailto:texasems-l%40yahoogroups.com> ups.com

Cc: Texas_EMTs_and_ <mailto:Texas_EMTs_and_Paramedics%40yahoogroups.com>

Paramedics ; EMS-L (AT) ems-l (DOT) <mailto:EMS-L%40ems-l.org> org;

Grayson902 (AT) aol (DOT) <mailto:Grayson902%40aol.com> com; Trauma51 (AT) aol (DOT)

<mailto:Trauma51%40aol.com> com

Subject: RE: a reminder for Foot ball season: pads and helmets

The device in question:

HYPERLINK

" http://www.motorcyc

<http://www.motorcycle-uk.com/acatalog/Hats_Off_Emergency_Helmet_Removal_Sys

> le-uk.com/acatalog/Hats_Off_Emergency_Helmet_Removal_Sys

t " http://www.motorcyc

<http://www.motorcyc-le-uk.com/-acatalog/-Hats_Off_-Emergency_-Helmet_Remov>

-le-uk.com/-acatalog/-Hats_Off_-Emergency_-Helmet_Remov

al_-Syst

em.html

HYPERLINK " http://www.hatsoff. <http://www.hatsoff.info/>

info/ " http://www.hatsoff. <http://www.hatsoff.-info/> -info/

BEB

_____

From: HYPERLINK

" mailto:Paramedicine%40yahoogroups.com " Paramedicine@-yahoogroups.-com

[mailto:HYPERLINK

" mailto:Paramedicine%40yahoogroups.com " Paramedicine@-yahoogroups.-com] On

Behalf Of Bledsoe, DO

Sent: Monday, October 30, 2006 8:24 AM

To: HYPERLINK

" mailto:texasems-l%40yahoogroups.com " texasems-l@yahoogro

<mailto:texasems-l%40yahoogro-ups.com> -ups.com; HYPERLINK

" mailto:Paramedicine%40yahoogroups.com " Paramedicine@-yahoogroups.-com

Cc: HYPERLINK

" mailto:Texas_EMTs_and_Paramedics%40yahoogroups.com " Texas_EMTs_and_-Paramedi

cs@-yahoogroups.-com; HYPERLINK " mailto:EMS-L%40ems-l.org " EMS-L (AT) ems-l (DOT) -org;

HYPERLINK " mailto:Grayson902%40aol.com " Grayson902 (AT) aol (DOT) -com; HYPERLINK

" mailto:Trauma51%40aol.com " Trauma51 (AT) aol (DOT) -com

Subject: RE: a reminder for Foot ball season: pads and helmets

When I was in England last year I saw a product for removing helmets. It was

a multi-compartment inflatable device. You slid it inside the helmet and

slowly inflated it and it gently pushed the helmet off. I have not seen it

in this country. I have a few pictures but the lists will not allow them to

attach.

BEB

_____

From: texasems-l@yahoogro <mailto:texasems--l%40yahoogroups.-com> ups.com

[mailto:texasems--l@yahoogro <mailto:texasems--l%40yahoogroups.-com>

ups.com]

On

Behalf Of krin135 (AT) aol (DOT) <mailto:krin135%-40aol.com> com

Sent: Sunday, October 29, 2006 7:47 PM

To: Paramedicine@ <mailto:Paramedicin-e%40yahoogroups.-com> yahoogroups.-com

Cc: Texas_EMTs_and_ <mailto:Texas_-EMTs_and_-Paramedics%-40yahoogroups.-com>

HYPERLINK " mailto:Paramedics%40yahoogroups.com " Paramedics@yahoogro

<mailto:Paramedics%40yahoogro-ups.com> -ups.com;

EMS-L (AT) ems-l (DOT) <mailto:EMS--L%40ems-l.-org> org;

texasems-l@yahoogro <mailto:texasems--l%40yahoogroups.-com> ups.com;

bbledsoe (AT) earthlink (DOT) <mailto:bbledsoe%-40earthlink.-net> net; Grayson902 (AT) aol (DOT)

<mailto:Grayson902%-40aol.com> com;

Trauma51 (AT) aol (DOT) <mailto:Trauma51%-40aol.com> com

Subject: a reminder for Foot ball season: pads and helmets

After having two different football players brought in to the ED for

evaluation of concussion, I've come to the conclusion that we need to re

think how

we are handling these young players if they are not being taken straight off

the field. This also came up in the ATLS class that I took last week, and

many

of those docs, if they weren't from small towns, seemed to have never had to

remove a helmet and pads from a football player.

In both cases, the concussion was not noted until after the player got off

the field under their own power, and in both cases, the pads were left on

when

the seated/standing take down was done to get them on the board...while the

void under the head was well and appropriately padded, the head was less

than

optimally restrained. Getting the pads out from under the kid so that we

could do an appropriate evaluation and CT exam was not fun while trying to

maintain appropriate C spine precautions.

A modest suggestion: if you (as a field Medic/Basic) are doing a

standing/seated takedown on a football ball player with his helmet already

off...Please,

Please, PLEASE! stop and cut the jersey off, unlace the pads and remove them

PRIOR to doing the takedown! It is so much easier to do it then, and reduces

the amount of movement of the head and C spine en route...not to mention

removing the pads at that time will result in NOT having to cut them off in

the

ED...saving the school system a fair chunk of money.

Similar rational applies to the player who still has his helmet on, but who

is still coherent enough that they are standing or seated...it'-s easy

enough

to get the helmet (and then the pads) off while maintaining C spine

precautions prior to the take down (and to make it easier, the coach/trainer

should

have their nice little adjustment device that will often loosen the helmet

while still on the side lines)....and it's much easier to secure the patient

to

the back board without 50 pounds of body armor on the kid.

You should indeed put the kid in full board with helmet and pads intact if

he is not conscious and cooperative (ie, unconscious on the field)...but you

should at least remove the face mask to provide adequate airway- remember

that

the face masks are held on with simple plastic/nylon straps that can be cut

with a pair of diagonal cutters with ease.

I realize that many of you do work the sidelines at home town ball games and

are aware of these practices, but a reminder seemed to be in order after

seeing two cases in two different EDs and seeing the response at the ATLS

course.

ck

S. Krin, DO FAAFP

[Guest guest]

Jack I would appreciate it also. Just this last week we were working with

trainer on getting a new life pak 1000 to match the ones we are equipping our

volunteers with. We have also been disucssing helmet removal and securing to

backboards. Its one of those topics you don't think about until football season

each year. We work very well with our local trainer and this would be just one

more tool in the box. By the way the Calhoun SandCrabs are in the playoffs for

the first time since the 80's. As a matter of fact it is the first time since I

have been Calhoun County that we have won more than a couple of games in the

same year.

Henry

a reminder for Foot ball season: pads and helmets

After having two different football players brought in to the ED for

evaluation of concussion, I've come to the conclusion that we need to re

think how

we are handling these young players if they are not being taken straight off

the field. This also came up in the ATLS class that I took last week, and

many

of those docs, if they weren't from small towns, seemed to have never had to

remove a helmet and pads from a football player.

In both cases, the concussion was not noted until after the player got off

the field under their own power, and in both cases, the pads were left on

when

the seated/standing take down was done to get them on the board...while the

void under the head was well and appropriately padded, the head was less

than

optimally restrained. Getting the pads out from under the kid so that we

could do an appropriate evaluation and CT exam was not fun while trying to

maintain appropriate C spine precautions.

A modest suggestion: if you (as a field Medic/Basic) are doing a

standing/seated takedown on a football ball player with his helmet already

off...Please,

Please, PLEASE! stop and cut the jersey off, unlace the pads and remove them

PRIOR to doing the takedown! It is so much easier to do it then, and reduces

the amount of movement of the head and C spine en route...not to mention

removing the pads at that time will result in NOT having to cut them off in

the

ED...saving the school system a fair chunk of money.

Similar rational applies to the player who still has his helmet on, but who

is still coherent enough that they are standing or seated...it's easy enough

to get the helmet (and then the pads) off while maintaining C spine

precautions prior to the take down (and to make it easier, the coach/trainer

should

have their nice little adjustment device that will often loosen the helmet

while still on the side lines)....and it's much easier to secure the patient

to

the back board without 50 pounds of body armor on the kid.

You should indeed put the kid in full board with helmet and pads intact if

he is not conscious and cooperative (ie, unconscious on the field)...but you

should at least remove the face mask to provide adequate airway- remember

that

the face masks are held on with simple plastic/nylon straps that can be cut

with a pair of diagonal cutters with ease.

I realize that many of you do work the sidelines at home town ball games and

are aware of these practices, but a reminder seemed to be in order after

seeing two cases in two different EDs and seeing the response at the ATLS

course.

ck

S. Krin, DO FAAFP

[Guest guest]

Hey, I was an intern in Odessa the season of Friday Night Lights and lived a

few blocks from Permian High School. One day, I went to pick up my son from

elementary school. He did not come out. Turns out the coaches from Permian

were watching all of the boys pitch trying to identify potential pitchers.

_____

From: texasems-l [mailto:texasems-l ] On

Behalf Of lnmolino@...

Sent: Monday, October 30, 2006 2:54 PM

To: texasems-l

Subject: Re: a reminder for Foot ball season: pads and helmets

In a message dated 10/30/2006 2:42:42 P.M. Central Standard Time,

bbledsoe (AT) earthlink (DOT) <mailto:bbledsoe%40earthlink.net> net writes:

Protocol for Care of Helmeted Texas High-School Football Player:

If player wearing a football helmet remains on the field after the play:

Hey it worked in Friday night Lights didn't it?

Louis N. Molino, Sr., CET

FF/NREMT-B/FSI/EMSI

Freelance Consultant/Trainer/Author/Journalist/Fire Protection Consultant

LNMolino (AT) aol (DOT) <mailto:LNMolino%40aol.com> com

(Cell Phone)

(Home Phone)

(IFW/TFW/FSS Office)

(IFW/TFW/FSS Fax)

" A Texan with a Jersey Attitude "

" Great minds discuss ideas; Average minds discuss events; Small minds

discuss people " Eleanor Roosevelt - US diplomat & reformer (1884 - 1962)

The comments contained in this E-mail are the opinions of the author and the

author alone. I in no way ever intend to speak for any person or

organization that I am in any way whatsoever involved or associated with

unless I

specifically state that I am doing so. Further this E-mail is intended only

for its

stated recipient and may contain private and or confidential materials

retransmission is strictly prohibited unless placed in the public domain by

the

original author.

[Guest guest]

Dr. B,

That would be damned funny...If I had not watched it happen at a high school

football game last Friday night.

Vernon Gresham

a reminder for Foot ball season: pads and helmets

>

> After having two different football players brought in to the ED for

> evaluation of concussion, I've come to the conclusion that we need to re

> think how

> we are handling these young players if they are not being taken straight

off

>

> the field. This also came up in the ATLS class that I took last week, and

> many

> of those docs, if they weren't from small towns, seemed to have never had

to

>

> remove a helmet and pads from a football player.

>

> In both cases, the concussion was not noted until after the player got off

> the field under their own power, and in both cases, the pads were left on

> when

> the seated/standing take down was done to get them on the board...while

the

> void under the head was well and appropriately padded, the head was less

> than

> optimally restrained. Getting the pads out from under the kid so that we

> could do an appropriate evaluation and CT exam was not fun while trying to

> maintain appropriate C spine precautions.

>

> A modest suggestion: if you (as a field Medic/Basic) are doing a

> standing/seated takedown on a football ball player with his helmet already

> off...Please,

> Please, PLEASE! stop and cut the jersey off, unlace the pads and remove

them

>

> PRIOR to doing the takedown! It is so much easier to do it then, and

reduces

>

> the amount of movement of the head and C spine en route...not to mention

> removing the pads at that time will result in NOT having to cut them off

in

> the

> ED...saving the school system a fair chunk of money.

>

> Similar rational applies to the player who still has his helmet on, but

who

> is still coherent enough that they are standing or seated...it's easy

enough

>

> to get the helmet (and then the pads) off while maintaining C spine

> precautions prior to the take down (and to make it easier, the

coach/trainer

> should

> have their nice little adjustment device that will often loosen the helmet

> while still on the side lines)....and it's much easier to secure the

patient

> to

> the back board without 50 pounds of body armor on the kid.

>

> You should indeed put the kid in full board with helmet and pads intact if

> he is not conscious and cooperative (ie, unconscious on the field)...but

you

>

> should at least remove the face mask to provide adequate airway- remember

> that

> the face masks are held on with simple plastic/nylon straps that can be

cut

> with a pair of diagonal cutters with ease.

>

> I realize that many of you do work the sidelines at home town ball games

and

>

> are aware of these practices, but a reminder seemed to be in order after

> seeing two cases in two different EDs and seeing the response at the ATLS

> course.

>

> ck

> S. Krin, DO FAAFP

>

>

[Guest guest]

Hey, what's all that genitalia stuff? Are they playin Brokeback Football

there?

G

>

> Protocol for Care of Helmeted Texas High-School Football Player:

>

> If player wearing a football helmet remains on the field after the play:

>

> 1. Have assistant coach come out and tell player to " get up and walk it

> off. "

> 2. If that fails, have coach come out and say, " Cowboy Up! Don't you

> know the girls are watching you? You want me to bench you boy? "

> 3. If that fails, have the Grade IV acne-covered assistant trainer

> " Mongo " go out. He will grab player and pick him up by the helmet and shake

> him like a rag doll. At this point, the assistant coach will come and say to

> the trainer, " Boy.are you stupid or something? You forgot to undo his chin

> strap. "

> 4. Trainer comes out and checks player's shoes and genitalia.

> 5. Coach calls all of the linemen. They proceed to shake player out of

> helmet.

> 6. Trainer verifies that genitalia are indeed uninjured and signals for

> EMS crew to come onto the field.

> 7. Trainer and Mongo then proceed to tell EMS crew how to immobilize

> the patient.

> 8. Proceeds of next game will go to help pay the medical expenses of

> player.

>

> Sound accurate?

>

> _____

>

> From: texasems-l@yahoogrotexasem [mailto:texasems-l@yahoogrotexasem] On

> Behalf Of ExLngHrn@...

> Sent: Monday, October 30, 2006 10:36 AM

> To: texasems-l@yahoogrotexasem

> Subject: Re: a reminder for Foot ball season: pads and helmets

>

> Jack:

>

> Would you be interested in emailing that protocol to me?

>

> Thank you!

> -Wes Ogilvie

>

> a reminder for Foot ball season: pads and helmets

>

> After having two different football players brought in to the ED for

> evaluation of concussion, I've come to the conclusion that we need to re

> think how

> we are handling these young players if they are not being taken straight off

>

> the field. This also came up in the ATLS class that I took last week, and

> many

> of those docs, if they weren't from small towns, seemed to have never had to

>

> remove a helmet and pads from a football player.

>

> In both cases, the concussion was not noted until after the player got off

> the field under their own power, and in both cases, the pads were left on

> when

> the seated/standing take down was done to get them on the board...while the

> void under the head was well and appropriately padded, the head was less

> than

> optimally restrained. Getting the pads out from under the kid so that we

> could do an appropriate evaluation and CT exam was not fun while trying to

> maintain appropriate C spine precautions.

>

> A modest suggestion: if you (as a field Medic/Basic) are doing a

> standing/seated takedown on a football ball player with his helmet already

> off...Please,

> Please, PLEASE! stop and cut the jersey off, unlace the pads and remove them

>

> PRIOR to doing the takedown! It is so much easier to do it then, and reduces

>

> the amount of movement of the head and C spine en route...not to mention

> removing the pads at that time will result in NOT having to cut them off in

> the

> ED...saving the school system a fair chunk of money.

>

> Similar rational applies to the player who still has his helmet on, but who

> is still coherent enough that they are standing or seated...it' is still coh

>

> to get the helmet (and then the pads) off while maintaining C spine

> precautions prior to the take down (and to make it easier, the coach/trainer

> should

> have their nice little adjustment device that will often loosen the helmet

> while still on the side lines)....and it's much easier to secure the patient

> to

> the back board without 50 pounds of body armor on the kid.

>

> You should indeed put the kid in full board with helmet and pads intact if

> he is not conscious and cooperative (ie, unconscious on the field)...but you

>

> should at least remove the face mask to provide adequate airway- remember

> that

> the face masks are held on with simple plastic/nylon straps that can be cut

> with a pair of diagonal cutters with ease.

>

> I realize that many of you do work the sidelines at home town ball games and

>

> are aware of these practices, but a reminder seemed to be in order after

> seeing two cases in two different EDs and seeing the response at the ATLS

> course.

>

> ck

> S. Krin, DO FAAFP

>

>

[Guest guest]

Don't forget to have the parents, coach, trainer, six teacher and eleven

crying hysterical friends climb into to box with you and expect to ride. The

ones that don't fit will slam the back doors backwards, slam them again

properly and thump on the Box until you leave.....

[Guest guest]

Why not break out the Jaws of Life? It would get a helmet off before quick.

Jim.

>

>Reply-To: texasems-l

>To: <texasems-l >

>CC: <Paramedicine >

>Subject: Re: a reminder for Foot ball season: pads and helmets

>Date: Mon, 30 Oct 2006 16:45:18 -0600

>

>Dr. B,

>

>That would be damned funny...If I had not watched it happen at a high

>school

>football game last Friday night.

>

>Vernon Gresham

>

>

> a reminder for Foot ball season: pads and helmets

> >

> > After having two different football players brought in to the ED for

> > evaluation of concussion, I've come to the conclusion that we need to re

> > think how

> > we are handling these young players if they are not being taken straight

>off

> >

> > the field. This also came up in the ATLS class that I took last week,

>and

> > many

> > of those docs, if they weren't from small towns, seemed to have never

>had

>to

> >

> > remove a helmet and pads from a football player.

> >

> > In both cases, the concussion was not noted until after the player got

>off

> > the field under their own power, and in both cases, the pads were left

>on

> > when

> > the seated/standing take down was done to get them on the board...while

>the

> > void under the head was well and appropriately padded, the head was less

> > than

> > optimally restrained. Getting the pads out from under the kid so that we

> > could do an appropriate evaluation and CT exam was not fun while trying

>to

> > maintain appropriate C spine precautions.

> >

> > A modest suggestion: if you (as a field Medic/Basic) are doing a

> > standing/seated takedown on a football ball player with his helmet

>already

> > off...Please,

> > Please, PLEASE! stop and cut the jersey off, unlace the pads and remove

>them

> >

> > PRIOR to doing the takedown! It is so much easier to do it then, and

>reduces

> >

> > the amount of movement of the head and C spine en route...not to mention

> > removing the pads at that time will result in NOT having to cut them off

>in

> > the

> > ED...saving the school system a fair chunk of money.

> >

> > Similar rational applies to the player who still has his helmet on, but

>who

> > is still coherent enough that they are standing or seated...it's easy

>enough

> >

> > to get the helmet (and then the pads) off while maintaining C spine

> > precautions prior to the take down (and to make it easier, the

>coach/trainer

> > should

> > have their nice little adjustment device that will often loosen the

>helmet

> > while still on the side lines)....and it's much easier to secure the

>patient

> > to

> > the back board without 50 pounds of body armor on the kid.

> >

> > You should indeed put the kid in full board with helmet and pads intact

>if

> > he is not conscious and cooperative (ie, unconscious on the field)...but

>you

> >

> > should at least remove the face mask to provide adequate airway-

>remember

> > that

> > the face masks are held on with simple plastic/nylon straps that can be

>cut

> > with a pair of diagonal cutters with ease.

> >

> > I realize that many of you do work the sidelines at home town ball games

>and

> >

> > are aware of these practices, but a reminder seemed to be in order after

> > seeing two cases in two different EDs and seeing the response at the

>ATLS

> > course.

> >

> > ck

> > S. Krin, DO FAAFP

> >

> >

[Guest guest]

This device is also used in the motorcross society. it actuallys fits inside

the helmet and then is used only in emergency.

a reminder for Foot ball season: pads and helmets

After having two different football players brought in to the ED for

evaluation of concussion, I've come to the conclusion that we need to re

think how

we are handling these young players if they are not being taken straight off

the field. This also came up in the ATLS class that I took last week, and

many

of those docs, if they weren't from small towns, seemed to have never had to

remove a helmet and pads from a football player.

In both cases, the concussion was not noted until after the player got off

the field under their own power, and in both cases, the pads were left on

when

the seated/standing take down was done to get them on the board...while the

void under the head was well and appropriately padded, the head was less

than

optimally restrained. Getting the pads out from under the kid so that we

could do an appropriate evaluation and CT exam was not fun while trying to

maintain appropriate C spine precautions.

A modest suggestion: if you (as a field Medic/Basic) are doing a

standing/seated takedown on a football ball player with his helmet already

off...Please,

Please, PLEASE! stop and cut the jersey off, unlace the pads and remove them

PRIOR to doing the takedown! It is so much easier to do it then, and reduces

the amount of movement of the head and C spine en route...not to mention

removing the pads at that time will result in NOT having to cut them off in

the

ED...saving the school system a fair chunk of money.

Similar rational applies to the player who still has his helmet on, but who

is still coherent enough that they are standing or seated...it' -s easy

enough

to get the helmet (and then the pads) off while maintaining C spine

precautions prior to the take down (and to make it easier, the coach/trainer

should

have their nice little adjustment device that will often loosen the helmet

while still on the side lines)....and it's much easier to secure the patient

to

the back board without 50 pounds of body armor on the kid.

You should indeed put the kid in full board with helmet and pads intact if

he is not conscious and cooperative (ie, unconscious on the field)...but you

should at least remove the face mask to provide adequate airway- remember

that

the face masks are held on with simple plastic/nylon straps that can be cut

with a pair of diagonal cutters with ease.

I realize that many of you do work the sidelines at home town ball games and

are aware of these practices, but a reminder seemed to be in order after

seeing two cases in two different EDs and seeing the response at the ATLS

course.

ck

S. Krin, DO FAAFP

[Guest guest]

MONGO LIKE CANDY !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

" Vernon A. Gresham " wrote:

Dr. B,

That would be damned funny...If I had not watched it happen at a high school

football game last Friday night.

Vernon Gresham

a reminder for Foot ball season: pads and helmets

>

> After having two different football players brought in to the ED for

> evaluation of concussion, I've come to the conclusion that we need to re

> think how

> we are handling these young players if they are not being taken straight

off

>

> the field. This also came up in the ATLS class that I took last week, and

> many

> of those docs, if they weren't from small towns, seemed to have never had

to

>

> remove a helmet and pads from a football player.

>

> In both cases, the concussion was not noted until after the player got off

> the field under their own power, and in both cases, the pads were left on

> when

> the seated/standing take down was done to get them on the board...while

the

> void under the head was well and appropriately padded, the head was less

> than

> optimally restrained. Getting the pads out from under the kid so that we

> could do an appropriate evaluation and CT exam was not fun while trying to

> maintain appropriate C spine precautions.

>

> A modest suggestion: if you (as a field Medic/Basic) are doing a

> standing/seated takedown on a football ball player with his helmet already

> off...Please,

> Please, PLEASE! stop and cut the jersey off, unlace the pads and remove

them

>

> PRIOR to doing the takedown! It is so much easier to do it then, and

reduces

>

> the amount of movement of the head and C spine en route...not to mention

> removing the pads at that time will result in NOT having to cut them off

in

> the

> ED...saving the school system a fair chunk of money.

>

> Similar rational applies to the player who still has his helmet on, but

who

> is still coherent enough that they are standing or seated...it's easy

enough

>

> to get the helmet (and then the pads) off while maintaining C spine

> precautions prior to the take down (and to make it easier, the

coach/trainer

> should

> have their nice little adjustment device that will often loosen the helmet

> while still on the side lines)....and it's much easier to secure the

patient

> to

> the back board without 50 pounds of body armor on the kid.

>

> You should indeed put the kid in full board with helmet and pads intact if

> he is not conscious and cooperative (ie, unconscious on the field)...but

you

>

> should at least remove the face mask to provide adequate airway- remember

> that

> the face masks are held on with simple plastic/nylon straps that can be

cut

> with a pair of diagonal cutters with ease.

>

> I realize that many of you do work the sidelines at home town ball games

and

>

> are aware of these practices, but a reminder seemed to be in order after

> seeing two cases in two different EDs and seeing the response at the ATLS

> course.

>

> ck

> S. Krin, DO FAAFP

>

>

[Guest guest]

I've just uploaded " Pre-Hospital Care of the Spine Injured Athlete " to the

file section. This document was used to develop our protocols and

procedures. It has detailed procedures on helmet/pad removal, along with

references for those who like to read the studies. I figured it would be

easier to look at the source materials rather than our own policies.

You'll note that it does state that the helmet/pad removal should take place

in the hospital, in a controlled environment. We elected to allow our staff

to remove the equipment on site because of the difficulty in training (and

keeping current) staff at the various destination hospitals.

The only 'issues' have come from the visiting teams' athletic training staff

and physicians.. And those issues dissolve when our team physician takes

them aside and says " Please let them do their job. "

Jack

_____

From: texasems-l [mailto:texasems-l ] On

Behalf Of ExLngHrn@...

Sent: Monday, October 30, 2006 10:36 AM

To: texasems-l

Subject: Re: a reminder for Foot ball season: pads and helmets

Jack:

Would you be interested in emailing that protocol to me?

Thank you!

-Wes Ogilvie

a reminder for Foot ball season: pads and helmets

After having two different football players brought in to the ED for

evaluation of concussion, I've come to the conclusion that we need to re

think how

we are handling these young players if they are not being taken straight off

the field. This also came up in the ATLS class that I took last week, and

many

of those docs, if they weren't from small towns, seemed to have never had to

remove a helmet and pads from a football player.

In both cases, the concussion was not noted until after the player got off

the field under their own power, and in both cases, the pads were left on

when

the seated/standing take down was done to get them on the board...while the

void under the head was well and appropriately padded, the head was less

than

optimally restrained. Getting the pads out from under the kid so that we

could do an appropriate evaluation and CT exam was not fun while trying to

maintain appropriate C spine precautions.

A modest suggestion: if you (as a field Medic/Basic) are doing a

standing/seated takedown on a football ball player with his helmet already

off...Please,

Please, PLEASE! stop and cut the jersey off, unlace the pads and remove them

PRIOR to doing the takedown! It is so much easier to do it then, and reduces

the amount of movement of the head and C spine en route...not to mention

removing the pads at that time will result in NOT having to cut them off in

the

ED...saving the school system a fair chunk of money.

Similar rational applies to the player who still has his helmet on, but who

is still coherent enough that they are standing or seated...it's easy enough

to get the helmet (and then the pads) off while maintaining C spine

precautions prior to the take down (and to make it easier, the coach/trainer

should

have their nice little adjustment device that will often loosen the helmet

while still on the side lines)....and it's much easier to secure the patient

to

the back board without 50 pounds of body armor on the kid.

You should indeed put the kid in full board with helmet and pads intact if

he is not conscious and cooperative (ie, unconscious on the field)...but you

should at least remove the face mask to provide adequate airway- remember

that

the face masks are held on with simple plastic/nylon straps that can be cut

with a pair of diagonal cutters with ease.

I realize that many of you do work the sidelines at home town ball games and

are aware of these practices, but a reminder seemed to be in order after

seeing two cases in two different EDs and seeing the response at the ATLS

course.

ck

S. Krin, DO FAAFP