Scenario
You are the high school AT at a Friday night football game. In the third quarter, the wide receiver is looking over his shoulder as he runs a post route when he is tackled high from behind. After the pile clears, he is lying prone and motionless on the field. His first words to you are “I can’t feel my arms or legs.”
His vocalization indicates he has an airway and is breathing; you then check his pulse, which is 120 bpm. He is a wide receiver and just ran a route, and at the moment his pulse does not bring you concern. You calmly say, “Lie still while more help comes out here.”
As you activate the spinal motion restriction protocol, you provide manual cervical inline stabilization. The team physician, resident, and AT student bring the long spine board and equipment on to the field. The athletic director is instructed to call EMS and inform them that there is a potential cervical spine injured athlete.
It is your school’s protocol to remove the football equipment prior to transporting a patient with an injured spine. The team physician cuts the jersey and shoulder pads in the back prior to the log-roll pull being performed. The 3 rescuers are positioned so that the spine board is alongside the patient with the spine board against their legs. On your command, the patient is log-rolled onto the spine board. The team physician then cuts the jersey and shoulder pads in the front and under the arms. Next, the face mask is removed and chin strap cut. The team physician assumes cervical spine stabilization so that you can remove the helmet. Once the helmet is removed and you have reassumed cervical spine stabilization, the shoulder pads are removed, a rigid cervical collar is placed, and the patient is prepared for transport.
Based on the scenario above, answer the following questions:
What clinical indicators should be present for implementing the SMR (spinal motion restriction) protocol?
What technique would be preferable if more personnel were available?
When could you complete the secondary survey during this scenario?
How many people are recommended to be trained and able to remove the equipment?
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