Lesson 2:-
All football players with a suspected or clinically symptomatic spinal injury must be adequately and appropriately stabilised to prevent neurological injury to the spinal cord or further injury. This means that all healthcare staff on duty should be fully trained in the recognition, evaluation, treatment, stabilisation and transfer of the head and/or neck injured player. The correct equipment must also be available (rigid spinal board, scoop stretcher or Stokes-type basket stretcher or vacuum mattress).
Please note that use of the traditional “NATO”-type soft stretcher is no longer acceptable on the field of play. A hard cervical collar is also no longer recommended.
The basic principles of spinal column stabilisation comprise the following actions:
- Carefully, gently and slowly, realign the head into the neutral position relative to the spine and maintain this position thereafter. If this slow, gentle realignment causes any neck or spinal pain, muscle spasm, abnormal neurological signs or symptoms, offers resistance or compromises the integrity of the airway, then immobilise the head in the position found and transfer as such to hospital on an appropriate stabilisation device at hand.
- Once the head has been adequately realigned and stabilised, carefully, gently and slowly align the entire spinal column into the neutral position, following the same principles as stated above.
- If the player is lying on their back (supine), the player needs to be stabilised on a long, rigid, spinal-type board (RSB). This may be undertaken by a careful, gentle and coordinated log-roll manoeuvre to turn the player onto their side, placing the RSB behind the player’s back and then performing a careful, gentle coordinated log-roll to move the player onto the RSB in the supine position for stabilisation. Alternatively, the player may carefully, gently and with coordination be lifted off the ground by a team straddling the player while an RSB is slipped under the player, who is then gently lowered onto the RSB.
- All players strapped to a stabilisation device should be strapped sufficiently securely so that the device can be urgently turned into the lateral position if the player vomits, without creating excess movement of the spine as a result.
- If the player is lying on their side (lateral), an RSB can be positioned behind the player’s back and the player is then carefully, gently log-rolled onto the RSB into the supine position for stabilisation.
- If the player is lying face down (prone), a number of careful, gentle coordinated steps are required by the medical team to first realign the head into the neutral position, then log-roll the player onto his/her side, and finally log-roll the player onto a RSB into the supine position for stabilisation.
- Once the player has been adequately and appropriately aligned in the supine position, anatomically neutral onto an stabilisation device, manual cervical spinal stabilisation should be converted into external stabilisation using external devices (e.g. foam-based head blocks).
Thank you for reading, keep supporting given link below.
Jatin Tyagi 