There is lack of consensus among prehospital personnel (athletic therapists, paramedics, sport physiotherapists) concerning specific aspects of initial care and assessment of injured athletes presenting signs and symptoms of a cervical spine injury (CSI). In instances of serious injury involving the head and/or spine, complicated by altered levels of consciousness, protective equipment such as helmets and shoulder pads may provide a hindrance to prompt, safe and efficient management. Specifically, there is disagreement concerning the need or advisability of removing protective head gear, as in the case of hockey athletes.
Using the technique of fluoroscopy, the cervical spine displacement of ten male hockey athletes was determined while wearing protective shoulder pads and protective head equipment during the following conditions: 1) helmet removal, 2) cervical collar application, and 3) as the helmetless head was allowed to rest. Subsequent frame by frame video arthokinematic analysis, using computer assisted digitization, revealed significant alterations in the position of adjacent cervical vertebrae during helmet removal, cervical collar application and head rest.
Results suggest that stabilization and transportation of hockey athletes with suspected CSI in their respective protective equipment is recommended in order to reduce the risk of further trauma by unnecessary cervical spine motion.