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It is a parents' nightmare: A son lies unmoving in the middle of a football field and says he can't get up. Nor can he feel his legs. Coaches and emergency medical technicians (EMTs) sprint onto the field. Should they move him? Should they remove his helmet and shoulder pads before hoisting him to an ambulance?

A group of Brown researchers have definitively answered the question: don't touch that equipment; removing even one piece can worsen a spinal injury. As Assistant Professor of Orthopedics Mark Palumbo and several of his Brown medical school colleagues write in the October issue of the Annals of Emergency Medicine, as many as 25 percent of spinal injuries occur after a football player has already hit the dirt. Many of these, Palumbo says, actually happen during transport to the hospital or during the early stages of handling a downed player.

Working in the lab, researchers discovered that removing the helmet or shoulder pads dangerously changed the position of the head and spinal cord. In an emergency, when an EMT needs to clear an airway for a player to breathe, cutting off the face guard or cutting open the shoulder pads is preferable, Palumbo says. As a last resort, the helmet and pads should be removed - but never one without the other.

Although spinal-cord injuries in football are mercifully rare - the rate from 1977 to 1989 was about 1.65 for every 100,000 college football players - Palumbo and colleagues Jonathan A. Gastel, Michael J. Hulstyn, Paul D. Fadale, and Phillip Lucas want their findings widely known. They are now writing a manual for those EMTs running in from the sidelines when a player goes down.

"Personnel responsible for players during game-day need to be well-versed," Palumbo says. "The time to learn is not on the football field."





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