title: The combined tool approach for face mask removal during on-field conditions.
abstract: BACKGROUND
  An effective approach to emergency removal of the face mask (FM) from a football helmet should include successful removal of the FM and limitation of both the time required and the movement created during the process. Current recommendations and practice are to use a cutting tool to remove the FM. Researchers recently have suggested an alternate approach that combines the use of a cordless screwdriver and a cutting tool. This combined tool approach has not been studied, and FM removal has not been studied in a practical setting.
  
  
  OBJECTIVE
  To investigate the effectiveness and speed of using a combined tool approach to remove the FMs from football helmets during on-field conditions throughout the course of a football season.
  
  
  METHODS
  Randomized multigroup design.
  
  
  METHODS
  Practice field of 1 National Collegiate Athletic Association Division II football college.
  
  
  METHODS
  Eighty-four members of 1 football team.
  
  
  METHODS
  We used a battery-operated screwdriver for FM removal and resorted to using a cutting tool as needed.
  
  
  METHODS
  We tracked FM removal success and failure and trial time and compared results based on helmet characteristics, weather variables, and the seasonal timing of the removal trial.
  
  
  RESULTS
  Of the 84 players, 76 were available for data-collection trials. Overall, 98.6% (75/76) of FM removal trials were successful and resulted in a mean removal time of 40.09 +/- 15.1 seconds. We found no differences in FM removal time throughout the course of the season. No differences in effectiveness or trial time were found among helmet characteristics, weather variables, or the timing of the trial.
  
  
  CONCLUSIONS
  Combining the cordless screwdriver and cutting tool provided a fast and reliable means of on-field FM removal in this Division II setting. Despite the excellent overall result, 1 FM was not removed in a timely manner. Therefore, we recommend that athletic trainers practice helmet removal to be prepared should FM removal fail.
authors.affiliation: New Hampshire Musculoskeletal Institute, Manchester, NH 03101, USA. sdgale
authors.forename: Stephanie D
authors.initials: SD
authors.lastname: Gale
authors.forename: Laura C
authors.initials: LC
authors.lastname: Decoster
authors.forename: Erik E
authors.initials: EE
authors.lastname: Swartz
mesh_terms: D000328:Adult; D000402:Airway Obstruction; D002574:Cervical Vertebrae / Q000293:injuries*; D004632:Emergency Medical Services; D005538:Football / Q000293:injuries*; D006260:Head Protective Devices; D006801:Humans; D008297:Male; D013124:Spinal Injuries / Q000517:prevention & control*; D019876:Sports Equipment; D013178:Sports Medicine