• Julianne D Toler, Meredith A Petschauer, Jason P Mihalik, Sakiko Oyama, S Doug Halverson, and Kevin M Guskiewicz.
• From the *Department of Exercise and Sport Science; daggerCurriculum in Human Movement Science; and double daggerCampus Health Services, The University of North Carolina, Chapel Hill, North Carolina.
• Clin J Sport Med. 2010 Mar 1; 20 (2): 92-7.

ObjectiveTo determine how head movement and time to access airway were affected by 3 emergency airway access techniques used in American football.DesignProspective counterbalanced design.SettingUniversity research laboratory.ParticipantsEighteen certified athletic trainers (ATCs) and 18 noncertified students (NCSs).InterventionsEach participant performed 1 trial of each of the 3 after airway access techniques: quick release mechanism (QRM), cordless screwdriver (CSD), and pocket mask insertion (PMI).Main Outcome MeasuresTime to task completion in seconds, head movement in each plane (sagittal, frontal, and transverse), maximum head movement in each plane, helmet movement in each plane, and maximum helmet movement in each plane.ResultsWe observed a significant difference between all 3 techniques with respect to time required to achieve airway access (F(2,68) = 263.88; P < 0.001). The PMI allowed for the quickest access followed by the QRM and CSD techniques, respectively. The PMI technique also resulted in significantly less head movement (F(2,68) = 9.06; P = 0.001) and less maximum head movement (F(2,68) = 13.84; P < 0.001) in the frontal plane compared with the QRM and CSD techniques.ConclusionsThe PMI technique should be used to gain rapid airway access when managing a football athlete experiencing respiratory arrest in the presence of a suspected cervical spine injury. In the event the athlete does not present with respiratory arrest, the facemask may be removed carefully with a pocket mask ready. Medical professionals must be familiar with differences in equipment and the effects these may have on the management of the spine-injured athlete.

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