Strike Flashcards
A 20-year-old college football player is struck by another athlete and is lying still in the supine position on the field. On examination on the field, the athlete reports bilateral numbness, tingling, and pain radiating to his fingertips but does not appear to be confused. He is alert and apprehensive of cervical range of motion but does not exhibit weakness of the upper extremities.
Which one of the following would be the most appropriate management for this athlete? (check one)
- Immediate examination for neurologic compromise and return to play if the examination is unremarkable
-Return to play if symptoms resolve in less than 15 minutes and a repeat neurologic examination is normal
- Serial neurologic examinations; if there is no progression of neurologic symptoms, he may remain on the sideline but may not re-enter the same game
- Immediate removal of his helmet and pads sequentially, log-rolling him, and transporting him to the emergency department (ED) via EMS if symptoms continue for more than 15 minutes
-Keeping his helmet and pads intact, log-rolling him, and transporting him to the ED via EMS
Keeping his helmet and pads intact, log-rolling him, and transporting him to the ED via EMS
According to consensus recommendations, athletes with suspected neck injuries and red flags such as bilateral symptoms of pain, numbness, tingling, and apprehension of cervical range of motion should be assumed to have a cervical spine injury and should be log-rolled without removal of helmet and pads, and transported via EMS to the emergency department (SOR C). Due to red flags concerning neck injury in this athlete, it is not safe for him to return to the field and he should be emergently transported for further assessment and diagnostic imaging. This athlete reported bilateral symptoms, and 15 minutes of resolution is not considered acceptable for release and return to play. In the case of a cervical spine injury with associated altered mental status and/or airway compromise, the helmet and pads may be removed but only simultaneously to avoid further cervical injury. Resolution of symptoms within 5 minutes, lack of bilaterality, and a normal neurologic examination may allow for return to play at the physician’s discretion
