Emergency Face-Mask Removal Effectiveness: A Comparison of Traditional and Nontraditional Football Helmet Face-Mask Attachment Systems

Swartz, Erik E.; Belmore, Keith; Decoster, Laura C.; Armstrong, Charles W.

doi:10.4085/1062-6050-45.6.560

Cited by 11 publications

(29 citation statements)

References 9 publications

(46 reference statements)

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“…The full quick-release face mask in both helmet styles allowed for faster removal times than previously reported for helmets with only partial quick-release capability removed from a healthy model. 8,9 Toler et al 9 found that removal of a partial quick-release-style face mask took approximately 50 seconds, whereas Swartz et al 8 noted that removal times were around 33 seconds with the same style. Clearly, the superior face-mask design that allowed the greatest removal speed in our study was the ION 4D helmet, taking only around 20 seconds for complete removal.…”

Section: Discussionmentioning

confidence: 99%

“…8,9,11 Using an a level of .05 and power of 0.8, we determined that a sample of 24 participants (12 pairs) would be needed to demonstrate a large effect. Given that we were exploring equipment that had not been studied, we recruited a conservative sample of 40 participants (20 pairs; 21 men, 19 women; age ¼ 33.7 6 11.2 years, height ¼ 173.1 6 9.2 cm, mass ¼ 80.7 6 17.1 kg, professional AT experience ¼ 10.6 6 10.4 years), and 100% of participants completed the study.…”

Section: Participantsmentioning

confidence: 99%

“…Previous systems incorporated quick-release face-mask attachments at 2 of 4 positions and appeared to allow for faster and safer airway access than traditional attachments. 8,9 A manufacturer also has modified a shoulder-pad design to incorporate a quickrelease feature. Research validating the safety of these designs will provide evidence to support clinical best practices.…”

Section: Ore Than 2 Million Athletes Participate Inmentioning

confidence: 99%

“…A digital stopwatch (Bodytronics 100; TKO Enterprises, Fayetteville, GA) was used to time each trial, and participants reported difficulty associated with each trial using a modified Borg CR-10 scale, which has been used in similar investigations. 8,11 Protocol Participants reported in pairs to the biomechanics laboratory at our institution. They completed a healthhistory questionnaire and informed consent form, and we determined eligibility and recorded participant demographics.…”

Section: Instrumentationmentioning

confidence: 99%

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Emergent Access to the Airway and Chest in American Football Players

Swartz

Mihalik

Decoster³

et al. 2015

Journal of Athletic Training

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Context: American football has the highest rate of fatalities and catastrophic injuries of any US sport. The equipment designed to protect athletes from these catastrophic events challenges the ability of medical personnel to obtain neutral spine alignment and immobilization during airway and chest access for emergency life-support delivery.Objective: To compare motion, time, and difficulty during removal of American football helmets, face masks, and shoulder pads.Design: Quasi-experimental, crossover study. Setting: Controlled laboratory. Patients or Other Participants: We recruited 40 athletic trainers (21 men, 19 women; age ¼ 33.7 6 11.2 years, height ¼ 173.1 6 9.2 cm, mass ¼ 80.7 6 17.1 kg, experience ¼ 10.6 6 10.4 years).Intervention(s): Paired participants conducted 16 trials in random order for each of 4 helmet, face-mask, and shoulder-pad combinations. An 8-camera, 3-dimensional motion-capture system was used to record head motion in live models wearing properly fitted helmets and shoulder pads.Main Outcome Measure(s): Time and perceived difficulty (modified Borg CR-10).Results: Helmet removal resulted in greater motion than face-mask removal, respectively, in the sagittal (14.888, 95% Conclusions: Protective equipment worn by American football players must eventually be removed for imaging and medical treatment. Our results fill a gap in the evidence to support current recommendations for prehospital emergent management in patients wearing protective football equipment. Helmet face masks and shoulder pads with quick-release designs allow for clinically acceptable removal times without inducing additional motion or difficulty.Key Words: cervical spine injury, sudden cardiac event, protective equipment Key PointsFace-mask removal induced less motion than helmet removal when accessing the airway. Helmet face masks and shoulder pads with quick-release designs allowed for clinically acceptable removal times without inducing additional motion or difficulty. The actual ability to effectively ventilate a patient with a helmet on and face mask removed was not studied and has not been established in the literature.

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Section: Discussionmentioning

confidence: 99%

Section: Participantsmentioning

confidence: 99%

Section: Ore Than 2 Million Athletes Participate Inmentioning

confidence: 99%

Section: Instrumentationmentioning

confidence: 99%

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Emergent Access to the Airway and Chest in American Football Players

Swartz

Mihalik

Decoster³

et al. 2015

Journal of Athletic Training

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“…17 Given the inherent challenges of face-mask removal, clinicians must be aware of the advancements that have occurred with respect to face-mask attachment systems. 7,10,18 One advancement in 2002 involved a spring-loaded mechanism nut-and-bolt system that secured the face-mask clip to the helmet. 7 Removal of the clip required a one-quarter turn with a flat-head screwdriver to release the clip from the face mask and helmet.…”

mentioning

confidence: 99%

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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