Lacrosse Helmet Facemask Removal

Context Facemask removal (FMR) is required to access the airway of a catastrophically injured football or ice hockey athlete. However, the best method of caring for the helmeted lacrosse athlete with suspected catastrophic injury remains unclear. Objective To evaluate the effects of sex and grip strength on the speed and ease of use of various FMR methods across different lacrosse helmet types. Design Cross-sectional study. Setting Athletic training laboratory. Patients or Other Participants Fourteen athletic trainers (7 men, 7 women). Intervention(s) Removal method (cordless screwdriver [CSD], Face Mask Extractor 2 [FMX], pruner, Trainer's Angel [TA]), helmet type (Cascade CPX, Cascade Pro7, Riddell Revolution, Brine Triumph, Warrior Venom), and sex. Main Outcome Measure(s) Facemask removal time and participant-reported ease of use of the removal method (6-point Likert scale). Results We found a 2-way interaction for removal method and sex only for the ease-of-use scores (F3,246 = 4.67, P = .01). A main effect for removal method for time (F3,200 = 19.41, P < .001) and ease of use (F3,200 = 53.78, P < .001) was seen. The fastest times (32.32 ± 11.70 seconds) and highest ease-of-use scores (4.94 ± 0.30) were recorded for the CSD. We noted a main effect for helmet type only for time (F4,200 = 5.34, P < .001), with the fastest removal times (72.75 ± 74.67 seconds) recorded for the CPX. We discovered a main effect for sex only for time (F1,200 = 17.57, P < .001), with slower times recorded for women (115.51 ± 110.80 seconds) than men (75.71 ± 83.87 seconds). We found correlations between FMR time and grip strength only when using the FMX (r = −0.40, P = .001), pruner (r = −0.26, P = .04), and TA (r = −0.26, P = .047). Conclusions Based on our results, FMR of lacrosse helmets should be attempted with a CSD. We recommend carrying a pruner as a backup cutting tool in case the CSD fails, practicing FMR regularly, and inspecting helmets for faulty hardware to reduce the chance of CSD failure.