Rugby Football Union - Spinal Injury - Essential Equipment and Training

Spinal Injury - Essential Equipment and Training

“Where’s the stretcher? The scrum’s collapsed, the prop’s not moving and I think he has a neck injury.”

These words will be familiar to all involved in our great game, from players to physiotherapists, medics to managers. Stop and think for a moment: is your stretcher up to the job? Are your staff trained to stabilise a spine? Luckily, in the game of rugby union serious spinal injuries are a rare occurrence. They do occur, however, and spare no one from the grass roots right up to the elite professional. The effects of spinal injuries can be devastating to player, family and friends, yet more could be done to minimise the risks involved.

There are two basic requirements:
1 - Essential equipment.
2 - Appropriately trained staff.

The only safe way to remove a potential spinal injury from the pitch is using trained staff and a long spinal board with head immobiliser and semi-rigid collar. Old or new canvas-type stretchers offer little or no protection for the spine and are thus not appropriate in the management of this type of injury.

Essential Equipment
A long spinal board with collar and immobiliser will provide as complete protection as possible until the player arrives in hospital, thus minimising risks of further damage. What price to pay for such an essential piece of equipment and peace of mind? Well for around £350 you can have both. Where can we get this equipment? There are several stockists of emergency care equipment:

www.premier-sportsmed.com
www.spservices.co.uk
www.scoot.co.uk/mueller
www.mueller.co.uk
Appropriate training
What about the training for your staff? This is an issue that has become increasingly important in today’s game. Training does exist but the quality can be variable. The United Kingdom Association of Doctors in Sport offer a two day intensive course for physiotherapists and doctors in pre-hospital emergencies encountered on the field of play. The Resuscitation and Emergency Management On Field (REMO) course details are on www.ukadis.org. There are several other organisations that run similar pre hospital trauma courses, however, these are not specific for sports medicine. Examples of such providers are the British Association of Immediate Care (BASICS) who run a Pre-Hospital Emergency Care Course (PHEC) and an Immediate Care Course (ICC), specifically to prepare candidates for a diploma course in immediate care.

Other courses include Advanced Trauma Life Support (ATLS), Pre-Hospital Trauma Life Support (PHTLS) and Advanced Life Support (ALS) run by the Resuscitation Council. While these courses are excellent, they again lack the specificity for sports medicine. If it is merely training to equip your staff with the ability to manage a spinal injury and transfer the injured player to a spinal board safely until the paramedics arrive that is required, I suggest the local ambulance stations chief paramedic is contacted. They will be aware of any specific accredited training and would probably be able to run a course themselves.

Dr James Brown is the Team Sports Physician for the RFU England U21. He has worked with both codes of rugby for the past eight years. He co-founded UKADIS United Kingdom Association of Doctors in Sport (www.ukadis.org) and works in Leeds as a Consultant in Sport and Musculoskeletal Medicine.