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In this section, we will be looking at American football protective equipment and the important aspects that may be pertinent to the medical emergency practitioner dealing with any incidents that might occur. We will be looking at types of shoulder pads as well as types of helmets. Looking at the particular aspects of shoulder pads, these may obstruct access to the player's chest as well as any extremity injuries that they may have sustained. Looking at particular types and manufacturing specificities that may be available to a particular team's equipment managers. There are certain aspects looking at both ties to the front, shoulder pads that have got fixed bars, or some of the newer models that have got quick release systems to allow for easy access to the front of the chest.
Looking at the first one with the laces. Any shoulder pads that have got laces to the front, these can be easily divided with scissors or untied like a shoelace pattern to be able to then open access the front of the chest. There are also be buckles and straps that may be attached to the front. These can be undone or cut depending upon the emergency requirement. Looking at the shoulder pads that have got bars to the front, these can sometimes be necessary to be divided. A pair of Tuff Cut scissors would easily divide these. However, if this needs to be done in a slower fashion, then undoing the straps that secure the padding can be sufficient to be able to slide them off as required.
The quick-release system that is available from this particular manufacturer has a little cable tie positioned underneath in the inside of the left-hand lapel. Once cut, this can allow for the core to be pulled out, connecting the back section, and then these will be open to the front to be able to take them off the player.
Moving towards the helmets. There are certain aspects that would be very important that may be different from other types of helmets application and removal. Players face are protected by a face cage with metal wires covered in plastic. They are also be secured into the helmet by a chin strap that tends to have a 4-point buckle system. The face cage can be removed in an emergency setting either with the use of an electric screwdriver or certain manufacturers have developed quick-release systems that require depression of a single central button and then will allow a quick release. Emergency access to the airway of a patient can be achieved by quick-release of the face cage either through the use of an electric screwdriver or the quick-release mechanism which requires simple depression of the central button. For players that have sustained a spinal injury or a neck injury, maintaining the helmet in a situ may aid the positioning in a neutral alignment as the shoulder pads will raise their torso up. If the helmet is removed in isolation, then this may lead to hyperextension of the cervical spine. Removal of the face cage will then allow for comfortable access to the player's face and allow them to feel more comfortable while maintaining the helmet in situ while further spinal precautions can be adhered to.
If the helmet is required to be removed, removing the face cage would be the primary option, then removing the buckles from around the face to remove the chin strap will be the next stage. Then through a team approach, both requiring stabilization of the head from the top end and allowing for the cheek pad to be flexed open to allow for maximal access for a second person to then slide hands into the side of a player's face to secure access and stabilization from the body end to then allow for the helmet to be removed from the head, and then re-secured to maintain cervical alignment.
