AT’s Have your Back…Literally

I am a huge fan of college football and love watching games all day on Saturdays. Watch enough football and you’ll unfortunately be a witness to some rather gruesome injuries. For example this past Saturday Seth Russel (QB for Baylor) dislocated his ankle and was carted off the field (praying for a speedy recovery bud). Other times you’ll see a player be spine boarded when there is a suspected cervical spine injury. Usually this is done for precaution and it is always good to be prepared for this type of injury. With that being said there has been some recent debates over the best way to spine board someone or even to spine board someone at all with a suspected cervical injury. The National Association of EMS Physicians (NAEMSP) and the American College of Surgeons Committee on Trauma (ACS-COT) have published a new position paper on “EMS Spinal Precautions and the Use of the Long Backboard.”

The change in protocol comes from lack of research support for using the long backboard technique. The position statement outlines the benefits and risks for using a spine board. The side effects for using the spine board include increasing pain, pressure ulcers, patient agitation and comprised respiratory system. People who are recommended to be spine boarded include someone with:

  • Blunt trauma and altered level of consciousness
  •  Spinal pain or tenderness
  • Neurologic complaint (e.g., numbness or motor weakness)
  • Anatomic deformity of the spine
  • High-energy mechanism of injury and any of the following:
    • Drug or alcohol intoxication
    • Inability to communicate
    • Distracting injury

People who are no longer needing to be spine boarded include someone with:

  • Normal level of consciousness (Glasgow Coma Score [GCS] 15)
  • No spine tenderness or anatomic abnormality
  • No neurologic findings or complaints
  • No distracting injury
  • No intoxication
  • Patients with penetrating trauma to the head, neck, or torso and no evidence of spinal injury should not be immobilized on a backboard

(EMS Spine Boarding Position Statement)

The National Athletic Trainer’s Association (NATA) has also done some research into spine boarding techniques. A study published in the Journal of Athletic Training compared the different spine boarding techniques with the amount of spine movement. The lifts the study looked at include the traditional Log Roll, Lift and Slide technique, and the  6+ Person Lift. Researchers measured axial rotation, flexion-extension, lateral flexion, anteroposterior displacement, distraction, and medial-lateral translation at the C5-C6 spinal segment.The results from this study concluded that the there is ultimately going to be some spinal movement regardless of the lift technique. The researchers also concluded that the 6+ Person technique minimized the extent of motion generated across a globally unstable spinal segment (1). There was also significantly more lateral flexion and axial rotation during the log roll technique when compared with the two others.

Sport medicine is constantly changing and more research is occurring daily to help make sure the best possible care is available for athletes. The new spine boarding techniques should start being visible within the next year if they haven’t been seen already. As an athletic trainer I am going to do everything I can to help make sure the athlete is cared for safely. Spine boarding is an intense situation for everyone involved and ultimately can save someones’ life and/or limbs! AT’s have your back…literally!

This is only one of many life and limb saving stories! Tommy was indeed back boarded and had a full recovery. His story could have ended very differently had the right protocol not been taken by his athletic trainer!

*Disclaimer: Please use this information only for personal use and only perform actions within your scope of practice*

  1. Del Rossi, G., Horodyski, M. H., Conrad, B. P., Di Paola, C. P., Di Paola, M. J., & Rechtine, G. R. (2008). The 6-Plus–Person Lift Transfer Technique Compared With Other Methods of Spine Boarding. Journal of Athletic Training, 43(1), 6–13.
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Orange Crushing Cam

NFL: Carolina Panthers at Denver Broncos

I am a Colorado native and have grown up cheering hard for the Denver Broncos. The NFL season opener kicked off last Thursday night (9/8/16) with a rematch of last year’s Superbowl contenders; the world champion Denver Broncos vs. the Carolina Panthers! It was a great season opener as each team battled back and forth for the lead. Ultimately the Broncos prevailed to a 21-20 victory! Go team!

However the much anticipated win was soon flooded with controversy concerning the barbaric punishment Cam Newton (Carolina’s Quarterback) faced from Denver’s defense, and the lack of medical attention he received throughout the game concerning the head to head blows. Numerous questions were and still are being raised about not only Carolina’s medical staff but how the trained NFL spotter (whose only job is to watch for players who might have sustained a concussion) failed to act accordingly! Was the team’s potential victory worth more than the health and safety of one their athletes?

A concussion is considered to be a traumatic brain injury. It can greatly alter someone’s orientation and they do not have to lose consciousness in order for it to be diagnosed as a concussion. One of the main mechanisms of injury for a concussion includes a direct impact or blow to the head. Concussions have been an extremely hot topic over the past 15 years. The medical world has learned so much in regards to diagnosing, treating, and the lifelong impacts of multiple sustained concussions.

A study conducted by Kevin Guskiewicz who is renown concussion expert from the University of North Carolina looked at thousands of retired professional NFL players who sustained concussions during their career and their quality of life after retiring. Of the 2,000+ players he researched he concluded that 61% had sustained at least one concussion and 24%  had sustained 3 or more concussions! He also noted that in the players who had 3 or more concussions they reported 5 times as higher as being diagnosed with mild cognitive impairment.They also had a 3 times higher incidence of self reported memory problems compared those players who did not sustain concussions. Guskiewicz concluded that an early on set of dementia symptoms might be initiated by repeated concussions sustained in the National Football League.

For more information here is a LINK to Guskiewicz’s article from Neurosurgery 

Concussions are an extremely hot topic right now and I am glad the NFL is beginning to take steps to protect their players. However, I believe it is inexcusable to allow a players health to be compromised because of who they are or how close the game is when a victory is on the line. I am glad the NFL is taking action to review these hits and Go Broncos!

UPDATE: Since the conclusion of the game Thursday night numerous media outlets and articles have been composed calling out the lack of medical attention Cam Newton received in regards to all of the head hits he sustained. An article from The Denver Post states that “both the NFL and the NFL players association are going to investigate the implementation of the concussion protocol” (http://www.denverpost.com/2016/09/11/panthers-cam-newton-hits-broncos-investigate/). There were four hits that were aimed at Newton’s head, and only one hit was penalized. The NFL has since determined that two of those hits were bad enough to sustain fines. Brandon Marshall was fined $24,000 where as Darian Stewart received an  $18,000 fine.