Question:

I read with interest your answer about concussions caused while playing football. I would like to know if there is a right way to safely remove a football helmet on an injured player. Thank you and I enjoy your column.

Answer:

This is an excellent question and one that we have not previously addressed. Helmet removal requires a careful, methodical approach to avoid compounding a suspected injury to the spinal cord, therefore, spinal cord injury experts advise that if an injured athlete is breathing and does not require airway management, the helmet should be left on to help support the head and neck. For football players in the supine (face up) position, shoulder pads elevate the trunk so that when the helmet is removed the head drops and the neck hyperextends. Leaving the helmet in place keeps the neck from hyperextending. Helmets also fit snugly and cradle the head, minimizing head and neck motion.

According to guidelines established in 1996 by the American Orthopaedic Society for Sports Medicine (AOSSM), removal of a football helmet is usually best done in the controlled environment of a hospital emergency room, rather than on the field. Because it acts as a rigid extension of the skull, the helmet can readily be fixed to a spine board to secure the athlete's neck for transport. Care must be taken at all times to stabilize the head and neck of any athlete with a suspected cervical spine injury. Each head injury is unique and individual circumstances dictate the appropriate course of action.

Most injuries can be visualized with the helmet on and neurological tests can be performed with it in place. If access to the airway is needed, the face mask can be cut away with special tools that allow for quick removal. Once the athlete is in the emergency room, equipment there can be utilized to safely remove the helmet.

Pocket cards with the guidelines for safe football helmet removal are available from the AOSSM, and are helpful to anyone involved in football at any level. A sample card can be requested by mailing a self-addressed, stamped envelope "Helmet Removal Guidelines" to the AOSSM at 6300 North River Road, Suite 200, Rosemont, IL 60018.

To learn more about brain and spinal cord injuries, the national community education and injury prevention THINK FIRST program, offered locally by UAB, provides churches, schools, businesses, and other organizations, the opportunity for learning presentations. Call 934-2843 or e-mail think1st@uab.edu, or visit the national THINK FIRST Web site.