These guidelines are intended to provide relevant information on preventing sudden death in sports and to give specific recommendations for certified athletic trainers and others participating in athletic health care.

Recommendations are based on current evidence pertaining to prevention strategies to reduce the incidence of cervical spine injuries in sport; emergency planning and preparation to increase management efficiency; maintaining or creating neutral alignment in the cervical spine; accessing and maintaining the airway; stabilizing and transferring the athlete with a suspected cervical spine injury; managing the athlete participating in an equipment-laden sport, such as football, hockey, or lacrosse; and considerations in the emergency department.

Professionals responsible for the care of football athletes must be knowledgeable in the types of equipment used and the best option available for effective airway access.

A helmetless-tackling training intervention reduced head impacts in collegiate football players within 1 season.

Sports medicine professionals must be prepared with appropriate tools and techniques to efficiently remove the face mask from an injured football player's helmet.

Combining the cordless screwdriver and cutting tool provided a fast and reliable means of on-field FM removal in this Division II setting. Despite the excellent overall result, 1 FM was not removed in a timely manner. Therefore, we recommend that athletic trainers practice helmet removal to be prepared should FM removal fail.

We speculate that higher skin temperatures before CWI, less shivering, and greater conductive cooling explained the faster cooling in full uniform. Cooling rates were considered ideal when the full uniform was worn during CWI, and wearing the full uniform did not cause a greater postimmersion hypothermic afterdrop. Clinicians may immerse football athletes with hyperthermia wearing a full uniform without concern for negatively affecting body-core cooling.

Context: Football helmet face-mask attachment design changes might affect the effectiveness of face-mask removal.Objective: To compare the efficiency of face-mask removal between newly designed and traditional football helmets.Design: Controlled laboratory study. Setting: Applied biomechanics laboratory. Participants: Twenty-five certified athletic trainers. Intervention(s):The independent variable was face-mask attachment system on 5 levels: (1) Revolution IQ with Quick Release (QR), (2) Revolution IQ with Quick Release hardware altered (QRAlt), (3) traditional (Trad), (4) traditional with hardware altered (TradAlt), and (5) ION 4D (ION). Participants removed face masks using a cordless screwdriver with a backup cutting tool or only the cutting tool for the ION. Investigators altered face-mask hardware to unexpectedly challenge participants during removal for traditional and Revolution IQ helmets. Participants completed each condition twice in random order and were blinded to hardware alteration.Main Outcome Measure(s): Removal success, removal time, helmet motion, and rating of perceived exertion (RPE). Time and 3-dimensional helmet motion were recorded. If the face mask remained attached at 3 minutes, the trial was categorized as unsuccessful. Participants rated each trial for level of difficulty (RPE). We used repeated-measures analyses of variance (a 5 .05) with follow-up comparisons to test for differences.Results: Removal success was 100% (48 of 48) for QR, Trad, and ION; 97.9% (47 of 48) for TradAlt; and 72.9% (35 of 48) for QRAlt. Differences in time for face-mask removal were detected (F 4,20 5 48.87, P 5 .001), with times ranging from 33.96 6 14.14 seconds for QR to 99.22 6 20.53 seconds for QRAlt. Differences were found in range of motion during facemask removal (F 4,20 5 16.25, P 5 .001), with range of motion from 10.106 6 3.076 for QR to 16.916 6 5.366 for TradAlt. Differences also were detected in RPE during face-mask removal (F 4,20 5 43.20, P 5 .001), with participants reporting average perceived difficulty ranging from 1.44 6 1.19 for QR to 3.68 6 1.70 for TradAlt.Conclusions: The QR and Trad trials resulted in superior results. When trials required cutting loop straps, results deteriorated.Key Words: spine injuries, protective equipment, emergency management Key Points N Quick Release face-mask attachments optimized the efficiency of face-mask removal. N Cutting loop straps induced more motion, took more time, and increased difficulty of face-mask removal.