1. Chapter 7 Extrication

2. Removing an injured athlete from a playing field or court or dangerous situation to get them care without causing additional harm.

3. Equipment Removal Treatment can be carried our with equipment still in place, but it is necessary to remove the face mask in all breathing emergencies and the shoulder pads and face mask in all cardiac emergencies.

4. Face Mask Necessary to be removed in order to gain access to the athlete’s airway. If the athlete experiences breathing problems, the trainer should suspect a head or neck injury. When removing the face mask, a second person must stabilize the players head and neck in line to prevent excessive movement.

5. Face Mask continued Football face mask: using a cutting tool, the athletic trainer cuts the two side mounting loops and flips the face mask up. This gives access to the athlete’s face and mouth. Anytime the athlete is transported to medical care, his face mask and mouth guard should be removed, but the chin strap should be left in place because it holds the head and neck securely.

6. Face Mask continued Hockey Face Mask: The ATC unsnaps the straps on each side of the mask and flips the cage up. Baseball Face Mask: The face mask is held in place by screws or loops, similar to a football mask. If held together by screws, they must be removed by a screwdriver and the face mask can be lifted off. When loops are present, they can be cut on each side and the face mask will flip away.

7. Jersey and Shoulder Pads When evaluating a shoulder, the athletic trainer can reach the injured area by sliding a hand up the sleeve or through the neck opening. 1 st remove the jersey: may need to be cut off. While someone holds the athletes head and neck in line, a second person bends the pads backward around the first persons arms and the pads are removed.

8. Removing shoulder pads Remove jersey first Unhook the chest straps and unlace or cut the laces or straps in the front and back of the pads. Someone must maintain the position of the head and neck while another person pulls the shoulder pads on the side that is lying on the ground so that it can be removed easily as the athlete’s being placed on a backboard.

9. Neck Roll Removing the neck roll will depend on what type it is. If the neck roll is attached by string to the shoulder pads, the trainer can cut the string. If the neck roll is attached by screws the ATC may decide to remove the shoulder pads with the neck roll still attached.

10. Helmet A helmet should be left in place at all times unless it interferes with the ability of the ATC to give proper care. If a helmet is removed, the shoulder pads and neck roll must also be removed, or the athlete’s neck will be placed in extension, which can aggravate head or neck injuries and may cause further harm.

11. How to remove a helmet 1. The ATC will control the head and keep it in line 2. The first aider will remove the cheek pads 3. The first aiders will control the head from inside the helmet. 4. The ATC unsnaps the chin straps 5. The ATC pulls the helmet up over the head while pulling the helmet opening apart. 6. The ATC fills the gap between the head and the ground with towels or other comforting cloth to keep the head and neck in line with the back 7. The ATC again takes control of the head

12. Uniforms and Padding If the athletic trainer needs to assess a non- serious injury, the athlete can remove his uniform if he can do it without further harm to himself. If the injured part is a limb, it is generally best to first remove the uniform from the non- injured extremity. This will allow more room to manipulate the uniform around the injured body part. A sock can be removed from an injured leg or foot by widening the diameter of the sock while removing it.

13. Padding Continued Padding around an injured body part should be cut off carefully to keep the injured body part from moving causing unnecessary pain. Padding on the rest of the body can be removed in the normal fashion.

14. Lifting and Moving an athlete Once an athlete has been assessed, the ATC will decide how he should be removed from the field. If the injury is minor, the athlete may be able to walk off on his own or with minimal help. If the injury is more serious the ATC can use straps, stretchers, or backboards to move the athlete. When lifting an athlete, the ATC must have a good base of support, keep his feet shoulder- width apart, and always look upward. Once the athlete is secure he should be moved feet first, in order to prevent nausea.

15. Back boarding Backboard an athlete for… For any spinal or back injury When the extent if injuries cannot be determined, or When there is not enough time to splint obvious fractures, and the injury is serious.

16. Back Boarding Procedures 1. Control the head 2. Call 911 3. Place a cervical collar on the injured athlete 4. Prepare the backboard a. make sure all the straps are in place b. match the straps, buckles and clips c. remove the head block and ready it to be placed.

17. Back Boarding Procedures 5. Under the direction of the person in control of head, roll the athlete onto the back board so that his head is at the top and he is centered on the board. 6. Place both cross-chest straps on over the collar bone and tighten. 7. Put head block (or sandbags or rolled blanket) in place. 8. Tape the head to the board, on strip over the forehead and another over the chin.

18. Back Boarding Procedures 9. Place a hip strap. 10. Place a foot strap At least 4 people are necessary to carry the backboard. One on each end and 2 in the middle.

19. Short Boarding Short boarding is done when an athlete reports spinal pain, but is in a seated position. Short board according to this following procedure with the person in charge holding the head and neck.

20. Short Boarding Procedure 1. Control head from behind 2. Call 911 3. Place a cervical collar on the injured athlete 4. Prepare a short board –Make sure all the straps are in place –Match the straps, buckle and clip

21. Short Boarding Procedure 5. With the person in charge holding tension on the head and neck, wedge the short board between the athlete and the chair. 6. Put chest strap in place 7. Control the head from the front, and strap head to board 8. Strap the legs, hips flexed 9. Place a long back board perpendicular to the athletes chair.

22. Short Boarding Procedure 10. Rotate the athlete onto the long backboard, keeping the athlete knees drawn up toward the chest. 11. Release the leg straps so the legs can lie flat on the backboard. 12. Place straps across the chest, but not over the heart area. 13. Place a hip strap 14. Place a foot strap

23. Ambulatory Movement of Athlete Ambulatory: an athlete that is able to walk from the field without support. The athlete should not be allowed to get up and walk around before the athletic trainer or team physician has made a decision about the extent of the injury. Serious injuries should be immobilized before extrication, and an athlete with a suspected serious lower-extremity injury should not be allowed to walk without support.

24. Ambulatory movement continued If two people are providing ambulatory aid, the athlete can place one are over each assistant’s shoulders and they can grasp the athlete’s back or pants to give support. The athlete should not be allowed to apply pressure on the injured body part. If only one assistant is available, the assistant should be on the same side as the injury with the athlete’s arm over the assistants shoulder.

25. Ambulatory Movement Some More An athlete who is not seriously injured can be removed using a seated carry. Two assistants face each other and lock their arms together. The athlete sits on one set of the locked arms while the other set supports the athlete’s upper back. Then he places his arms around the shoulders of the assistants. That athlete is carried off in the direction he is facing.

26. Other Methods of Moving an Athlete Stretcher –Difference between a stretcher and a backboard: A backboard is used to immobilize spinal injuries. A stretcher is made of canvas and is used to transport an athlete without spinal injuries. –A stretcher is used appropriately for an athlete suffering from a variety of injuries or conditions.

27. Stretcher continued… –After primary assessment and caring for all injuries, log roll the athlete onto the stretcher and secure the athlete in place with three straps, one at the chest, hips, and feet. The athlete may be able to just slide onto the strecher, which is fine as long as no pressure is placed upon the injured body part. –It takes about 4 people to carry a stretcher- one at each end and two in the middle- and the athlete should be moved feet first or head first.

28. Scoop Stretcher Made of metal and can be separated into two parts. Once provides a thin metal structure that slides underneath the athlete, and then the two parts are reattached at the head and feet. This is less risky because the athlete does not have to be rolled or lifted.