In sports injuries, what is the correct on-scene procedure for helmet and shoulder pads if the patient is helmeted and/or shoulder padded?

• A. Remove helmet and pads on scene
• B. Leave helmet on and remove pads only
• C. Remove helmet only and leave pads
• D. Do not remove anything

Answer: (A)

When a sports injury involves a helmet and/or shoulder pads, the priority on scene is to protect the spine while still being able to manage the airway and assess breathing and circulation. The bulky equipment can obscure the airway, hinder chest auscultation and evaluation of breathing, and interfere with proper spinal immobilization. Removing both the helmet and shoulder pads allows you to stabilize the head and neck in a neutral position, provide airway management if needed, and securely apply a cervical collar and backboard without equipment getting in the way. The helmet is removed with careful in-line stabilization of the spine, and the face mask can be cut or removed if airway control or suctioning is required; shoulder pads are removed to facilitate chest assessment and secure immobilization.

Keeping everything on would impede airway access, hinder accurate assessment of breathing and chest movement, and complicate immobilization. Removing only one component still leaves obstacles to proper evaluation and stability. In this on-scene protocol, taking off both pieces of equipment is the safest and most effective approach.