Comparison of Four Popular Tools for Number of Cuts Required, Correlated with Time, and Success in First Attempt to Remove a Football Facemask

In cases of suspected spinal injury in football players, the certified athletic trainer (ATC) is advised to remove the facemask to gain access to the athlete’s airway. Because of potential catastrophic sequelae related to prolonged anoxia, it is imperative that the tool chosen for this task is effective. Tools used for facemask removal include the Trainer’s Angel (TA), Face Mask Extractor (FME), Anvil Pruner (AP) and PVC Pipecutter (PVC). The purpose of this study was to compare these tools for number of cuts required, correlated to time, to fully remove the facemask, and first-removal-attempt success. A cut was defined as complete closure of the jaws of the cutting device. A removal attempt was successful when the facemask cleared all four clips holding the mask to the helmet. Time began when the ATC picked up the tool and ended when the facemask was placed on the floor. Twenty-nine ATCs (age 28.24 + 5.3, years of certification 5.5 + 4.4) used each tool in random order to remove the facemask from a supine model football player. Trials were recorded with a VHS camcorder and observed by three investigators to demonstrate inter-tester reliability. A repeated measures ANOVA was used to analyze the mean number of cuts by tool: TA 8.03 + 2.75; FME 8.18 + 3.07; AP 11.27 + 4.64 and PVC 11.69 + 4.65 (F=9.2, p=0.000). Post hoc analysis revealed significant differences between PVC and TA, PVC and FME, AP and FME, and AP and TA (p<.05). The time in seconds required to remove the facemask (FME=77.45 +26.6; AP=96.2 +41.6; TA=101.1 +39.9; PVC=155.9 +63.8) was analyzed as it correlated to number of cuts. Correlation between cuts and time was significant (p=.01), but relatively low (r =.370). The FME removed the facemask on the first attempt 72% of the time, more frequently than TA (55%), AP (45%) and PVC (43%). Success rates were compared using Cochran’s Q for repeated measures of the dependent variable across several conditions (Q=7.54, p=.056). In summary, the TA and FME required about the same number of cuts to remove the facemask, fewer than AP and PVC. Factors like time spent per cut and the effectiveness of each cut may be important considerations given the low correlation between time and number of cuts. The FME had greater first-removal-attempt success and required the shortest amount of time to complete the task, making it the most effective tool in this study.

2002 Hall MC, Decoster LC, Norkus SA, Swartz EE: Comparison of Four Popular Tools for Number of Cuts Required, Correlated with Time, and Success in First Attempt to Remove a Football Facemask (Abstract). J Athletic Training, Vol 37, Supp