National Athletic Trainers' Association Position Statement: Acute Management of the Cervical Spine–Injured Athlete

This NATA position statement, led by Erik Swartz, gives athletic trainers, team physicians, emergency responders and other providers recommendations for managing a potentially catastrophic cervical spine injury in an athlete. Recommendations carry SORT evidence grades.

It covers prevention, emergency planning and rehearsal, maintaining or restoring neutral alignment, gaining and keeping access to the airway, immobilizing and transferring the athlete, managing protective equipment in sports such as football, hockey and lacrosse, and hand-off to the emergency department.

Among its points: rescuers should be trained and practiced in head and neck stabilization, transfer techniques and equipment management; a lift-and-slide transfer is favored over the log roll where it can be used; and face masks that block the airway should be fully removed. It advises leaving the helmet and shoulder pads on until the athlete reaches an emergency facility, except when the equipment does not hold the head securely or prevents neutral alignment or airway access, and in football and ice hockey it treats their removal as all or nothing.