A Three Dimensional Analysis of Facemask Removal Tools in Inducing Head Movement

Swartz, Erik E.; Armstrong, Charles W.; Rankin, Jonathan; Rogers, Bonnie Lida; Campbell, Brian

doi:10.1097/00005768-200105001-00822

Cited by 7 publications

(22 citation statements)

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“…The participants knelt and positioned themselves with the helmet between their knees to stabilize the model's head and minimize motion of the helmet and cervical spine during the FMR trial. As other investigators have, 10,14,16,17 we selected this position to simulate the worstcase scenario of a single rescuer simultaneously stabilizing the head and removing the facemask.…”

Section: Methodsmentioning

confidence: 99%

Lacrosse Helmet Facemask Removal

Bradney

Bowman²

2013

Journal of Athletic Training

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Context: Facemask removal (FMR) is required to access the airway of a catastrophically injured football or ice hockey athlete. However, the best method of caring for the helmeted lacrosse athlete with suspected catastrophic injury remains unclear.Objective: To evaluate the effects of sex and grip strength on the speed and ease of use of various FMR methods across different lacrosse helmet types.Design: Cross-sectional study. Conclusions: Based on our results, FMR of lacrosse helmets should be attempted with a CSD. We recommend carrying a pruner as a backup cutting tool in case the CSD fails, practicing FMR regularly, and inspecting helmets for faulty hardware to reduce the chance of CSD failure.Key Words: emergency care, catastrophic injury, cervical spine Key PointsParticipants removed the facemasks of 5 different types of lacrosse helmets with a cordless screwdriver (CSD), which was fastest with helmets that do not require a cutting step, and reported this method was easier to use than the Face Mask Extractor 2, pruner, and Trainer's Angel. Grip strength and FMR times were strongly associated for the 3 techniques using cutting methods but not for the CSD. Facemask removal on lacrosse helmets should be attempted first with a CSD and second with a pruner if screw removal fails. Athletic trainers should practice regularly, be prepared to perform FMR on various types of helmets, and perform FMR using the tool with which they are most comfortable.

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Section: Methodsmentioning

confidence: 99%

Lacrosse Helmet Facemask Removal

Bradney

Bowman²

2013

Journal of Athletic Training

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“…With respect to clip cutting, some of the cutting tools seem to be more effective than others for limiting helmet and spine motion. 4,8,9,13 However, and more importantly, the evidence clearly indicates that removal of the clips via a screwdriver results in far less motion of and force being applied to the helmet than cutting face-mask clips. 7,10 The results for the QR clip have been favorable as they relate to head and cervical motion generated during face-mask removal.…”

Section: Discussionmentioning

confidence: 99%

“…We are unsure if our success rate would have been higher if we had used the combinedtool approach that has been advocated in a number of similar studies 6,11,12,18,19 to facilitate successful and timely face-mask removal. The time limits often associated with ''successful'' face-mask removal range from 30 seconds to 4 minutes and have been based on the amount of time it takes to use various face-mask removal tools under varying conditions 4,[7][8][9]11,12,14,18 and the time frame in which irrecoverable brain damage is likely if resuscitation does not occur and circulation is not restored. 20,21 Considerable evidence also has been presented on speed, efficiency, and movement generated with various face-mask clip conditions and clip-removal devices.…”

Section: Discussionmentioning

confidence: 99%

“…To this end, many investigators have examined questions related to equipment removal and cervical spine motion, [1][2][3] airway access techniques, 4,5 and techniques and efficiency of face-mask removal. [6][7][8][9][10][11][12][13] Evidence has suggested that airway access can be obtained in the football-helmeted athletes without the removal of the face mask, ultimately reducing motion of the cervical spine often associated with face-mask removal. 4,5,14 However, the National Athletic Trainers' Association 15 and the InterAssociation Task Force for the Appropriate Care of the Spine-Injured Athlete 16 advocate full removal of the football face mask under all circumstances.…”

mentioning

confidence: 99%

“…However, the efficiency of facemask removal and the extent to which cervical spinal motion is generated by using these tools have been questioned considerably. 8,9,11,13,14 Gale et al 12 and Copeland et al 6 suggested a combined-tool approach, indicating that using a cordless screwdriver and the FM Extractor when screws fail is fast, easy, and reliable. More recently, Toler et al 14 reported that access was quicker and helmet motion was less when using the Revolution IQ (Riddell Sports, Inc, Elyria, OH) helmets equipped with the Quick Release (QR) Face Guard Attachment System (Riddell Sports, Inc) than when using helmets that require removing clips with a cordless screwdriver.…”

mentioning

confidence: 99%

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Successful Removal of Football Helmet Face-Mask Clips After 1 Season of Use

Scibek

Gatti

McKenzie

2012

Journal of Athletic Training

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Context: Whereas many researchers have assessed the ability to remove loop straps in traditional face-mask attachment systems after at least 1 season of use, research in which the effectiveness of the Riddell Quick Release (QR) Face Guard Attachment System clip after 1 season has been assessed is limited.Objective: To examine the success rate of removing the QR clips after 1 season of use at the Football Championship Subdivision level. We hypothesized that 1 season of use would negatively affect the removal rate of the QR clip but repeated clip-removal trials would improve the removal rate.Design: Retrospective, quasi-experimental design. Setting: Controlled laboratory study.Patients or Other Participants: Sixty-three football helmets from a National Collegiate Athletic Association Division I university located in western Pennsylvania used during the 2008 season were tested.Intervention(s): Three certified athletic trainers (2 men, 1 woman; age ¼ 31.3 6 3.06 years, time certified ¼ 9.42 6 2.65 years) attempted to remove the QR clips from each helmet with the tool provided by the manufacturer. Helmets then were reassembled to allow each athletic trainer to attempt clip removal.Main Outcome Measure(s): The dependent variables were total left clips removed (TCR-L), total right clips removed (TCR-R), and total clips removed (TCR). Success rate of clip removal (SRCR) also was assessed.Results: Percentages for TCR-L, TCR-R, and TCR were 100% (189 of 189), 96.30% (182 of 189), and 98.15% (371 of 378), respectively. A paired-samples t test revealed a difference between TCR-R and TCR-L (t 188 ¼À2.689, P ¼ .008, l d ¼ 0.037, 95% confidence interval [CI] ¼À0.064, À0.010). The percentage for SRCR was 96.30% (n ¼ 182), whereas SRCR percentages for trials 1, 2, and 3 were 95.24% (n ¼ 60), 98.41% (n ¼ 62), and 95.24% (n ¼ 60), respectively, and did not represent a difference (F 2,186 ¼ 0.588, P ¼ .56, 95% CI ¼ 0.94, 0.99).Conclusions: Our results indicated favorable and consistent success rates for QR clip removal after 1 season of use. Whereas the QR clip is an advancement in face-mask technology, continued examination of this system is required to ensure the highest level of function, allowing for effective management of the helmeted athlete.Key Words: quick release attachment system, protective equipment, equipment removal, emergency management Key PointsAfter 1 season of collegiate football use, the Riddell Quick Release Face Guard Attachment System side clips demonstrated favorable results, with 98% of all clips being removed successfully within a clinically acceptable time frame. Both side clips could be removed in approximately 96% of cases, allowing for face-mask retraction. The removal rate did not increase over time. Regular equipment maintenance, refurbishment, and reconditioning must be emphasized at all levels of football. Athletic trainers must practice and familiarize themselves with the improvements and challenges that new equipment developments might present during potentially life-threatening situations.

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