Airway Management in Athletes Wearing Lacrosse Equipment

Thomas G Bowman; Richard J Boergers; Monica R Lininger

doi:10.4085/1062-6050-4-17

Airway Management in Athletes Wearing Lacrosse Equipment

J Athl Train. 2018 Mar;53(3):240-248. doi: 10.4085/1062-6050-4-17. Epub 2018 Feb 8.

Authors

Thomas G Bowman¹, Richard J Boergers², Monica R Lininger³

Affiliations

¹ Department of Athletic Training, Lynchburg College, VA.
² Department of Athletic Training, Seton Hall University, South Orange, NJ.
³ Department of Physical Therapy and Athletic Training, Northern Arizona University, Flagstaff.

Abstract

Context: Patient ventilation volume and rate have been found to be compromised due to the inability to seal a pocket mask over the chinstrap of football helmets. The effects of supraglottic airway devices such as the King LT and of lacrosse helmets on these measures have not been studied.

Objective: To assess the effects of different airway management devices and helmet conditions on producing quality ventilations while performing cardiopulmonary resuscitation on simulation manikins.

Design: Crossover study.

Setting: Simulation laboratory.

Patients or other participants: Thirty-six athletic trainers (12 men, 24 women) completed this study.

Intervention(s): Airway-management device (pocket mask, oral pharyngeal airway, King LT airway [KA]) and helmet condition (no helmet, Cascade helmet, Schutt helmet, Warrior helmet) served as the independent variables. Participant pairs performed 2 minutes of 2-rescuer cardiopulmonary resuscitation under 12 trial conditions.

Main outcome measure(s): Ventilation volume (mL), ventilation rate (ventilations/min), rating of perceived difficulty (RPD), and percentage of quality ventilations were the dependent variables.

Results: A significant interaction was found between type of airway-management device and helmet condition on ventilation volume and rate ( F_12,408 = 2.902, P < .0001). In addition, a significant interaction was noted between airway-management device and helmet condition on RPD scores ( F_6,204 = 3.366, P = .003). The no-helmet condition produced a higher percentage of quality ventilations compared with the helmet conditions ( P ≤ .003). Also, the percentage of quality ventilations differed, and the KA outperformed each of the other devices ( P ≤ .029).

Conclusions: The helmet chinstrap inhibited quality ventilation (rate and volume) in airway procedures that required the mask to be sealed on the face. However, the KA allowed quality ventilation in patients wearing a helmet with the chinstrap fastened. If a KA is not available, the helmet may need to be removed to provide quality ventilations.

Keywords: airway management; cardiopulmonary resuscitation; protective equipment.

MeSH terms

Adult
Airway Management* / instrumentation
Airway Management* / methods
Athletes
Cardiopulmonary Resuscitation* / instrumentation
Cardiopulmonary Resuscitation* / methods
Cross-Over Studies
Equipment Design
Female
Head Protective Devices*
Humans
Male
Manikins
Materials Testing
Protective Devices*
Racquet Sports*
Simulation Training