Toler Julianne D, Petschauer Meredith A, Mihalik Jason P, Oyama Sakiko, Doug Halverson S, Guskiewicz Kevin M
From the *Department of Exercise and Sport Science; †Curriculum in Human Movement Science; and ‡Campus Health Services, The University of North Carolina, Chapel Hill, North Carolina.
Clin J Sport Med. 2010 Mar;20(2):92-97. doi: 10.1097/JSM.0b013e3181d2de5f.
To determine how head movement and time to access airway were affected by 3 emergency airway access techniques used in American football.
Prospective counterbalanced design.
University research laboratory.
Eighteen certified athletic trainers (ATCs) and 18 noncertified students (NCSs).
Each participant performed 1 trial of each of the 3 after airway access techniques: quick release mechanism (QRM), cordless screwdriver (CSD), and pocket mask insertion (PMI).
Time to task completion in seconds, head movement in each plane (sagittal, frontal, and transverse), maximum head movement in each plane, helmet movement in each plane, and maximum helmet movement in each plane.
We observed a significant difference between all 3 techniques with respect to time required to achieve airway access (F2,68 = 263.88; P < 0.001). The PMI allowed for the quickest access followed by the QRM and CSD techniques, respectively. The PMI technique also resulted in significantly less head movement (F2,68 = 9.06; P = 0.001) and less maximum head movement (F2,68 = 13.84; P < 0.001) in the frontal plane compared with the QRM and CSD techniques.
The PMI technique should be used to gain rapid airway access when managing a football athlete experiencing respiratory arrest in the presence of a suspected cervical spine injury. In the event the athlete does not present with respiratory arrest, the facemask may be removed carefully with a pocket mask ready. Medical professionals must be familiar with differences in equipment and the effects these may have on the management of the spine-injured athlete.
