Field-side and prehospital management of the spine-injured athlete.

Rapid on-field diagnosis and early stabilization can help to optimize the outcomes of spinal injury, which can have devastating consequences. Several basic principles will guide the rescuer through this process. Preinjury planning should include appointing a team leader, assessing the athletes' equipment, acquiring appropriate equipment to facilitate stabilization, and establishing lines of communication to emergency medical services (EMS). When an athlete is down, the team leader should proceed to quickly assess airway, breathing, circulation, level of consciousness, and activation of EMS. This should be followed by stabilization of the head and neck, a coordinated log roll, and ultimately complete spinal immobilization for transport. Specific techniques for stabilizing the cervical spine, removing the facemask, log rolling the athlete, and lifting the athlete, will improve outcome. The helmet and shoulder pads should remain in place during transport unless specific indications require their removal, in which case a specific protocol should be strictly followed.