A study of emergency American football helmet removal techniques

PurposeThe purpose was to compare head kinematics between the Eject Helmet Removal System and manual football helmet removal.Basic ProceduresThis quasi-experimental study was conducted in a controlled laboratory setting. Thirty-two certified athletic trainers (sex, 19 male and 13 female; age, 33 ± 10 years; height, 175 ± 12 cm; mass, 86 ± 20 kg) removed a football helmet from a healthy model under 2 conditions: manual helmet removal and Eject system helmet removal. A 6-camera motion capture system recorded 3-dimensional head position. Our outcome measures consisted of the average angular velocity and acceleration of the head in each movement plane (sagittal, frontal, and transverse), the resultant angular velocity and acceleration, and total motion. Paired-samples t tests compared each variable across the 2 techniques.Main FindingsManual helmet removal elicited greater average angular velocity in the sagittal and transverse planes and greater resultant angular velocity compared with the Eject system. No differences were observed in average angular acceleration in any single plane of movement; however, the resultant angular acceleration was greater during manual helmet removal. The Eject Helmet Removal System induced greater total head motion.Principal ConclusionsAlthough the Eject system created more motion at the head, removing a helmet manually resulted in more sudden perturbations as identified by resultant velocity and acceleration of the head. The implications of these findings relate to the care of all cervical spine–injured patients in emergency medical settings, particularly in scenarios where helmet removal is necessary.