Anyone who was watching I’m sure felt the immediate shock and devastation when Keven Everett failed to get up off the football field after a helmet-to-helmet collision during NFL opening weekend this past Sunday.
From an Emergency Medical Services Point of View, this is what we are there for. Doctors, trainers, paramedics and an ambulance on the sidelines of every high school, college and professional football game may be an unattainable goal.
But Kevin Everett needed us.
While I have no inside information on the injury other that what is reported in the media, I would guess that he had 1 of 2 types of cervical spine injuries.
First, an “unstable” cervical spine injury, as opposed to a stable one. The spinal bony vertebra are considered to be in three “columns”, Anterior, Middle and Posterior. If two of these three columns are intact, then the spinal cord is “stable” meaning that lateral bony movement and hence, spinal cord injury, is very unlikely. If two of the three columns are injured or fractured, an unstable injury exists.
Any movement could cause bruising or laceration of the spinal cord if it was not injured in the initial incident. With unstable spinal injuries, the technique involved in stabilizing the spine, immobilizing the patient on the backboard and moving the patient to the ambulance, ER, CT Scanner, OR and to the patient’s bed is vital. A wrong move can make a partial injury into a complete injury. This is one reason for trained medical personel at the sidelines.
The second type of injury that may have caused Kevin’s paralysis is what is described as a “burst” fracture. The body of the vertebra sustains a vertical compression causing the bone to shatter and sending small fragments in all directions…as if dropping a dinner plate on the floor. If fragments are sent backwards in to the spinal cord, immediate injury, not to mention swelling of the surrounding tissues can cause paralysis or a partial neurologic defecit. Immediate surgery is required to remove the pieces of bone from the spinal cord.
There are many additional types of spinal cord and vertebral injuries, but these are the two that are most likely to result in immediate surgery like Kevin had.
While time cannot be reversed and the initial injury eliminated, subsequent and secondary injuries can be minimized.
This article from MSNBC discusses infusing “ice cold saline” into Everett’s veins…
Green said the key was the quick action taken by Cappuccino to run an ice-cold saline solution through Everett’s system that put the player in a hypothermic state. Doctors at the Miami Project have demonstrated in their laboratories that such action significantly decreases the damage to the spinal cord due to swelling and movement.
While hypothermia treatment has been discussed frequently for both head injuries and cardiac arrest patients, this is the first I’ve heard of it for spinal cord injuries. They do not mention controversial steroid treatment, but I am curious if he was given that as well.
I obviously need to do my research on current treatment modalities for spinal cord injuries with a specific focus on hypothermia. By the way, there are other ways of inducing hypothermia besides infusing “ice water” into your veins…
In the meantime, Kevin Everett will be in my thoughts & prayers. With early movement after the surgery, the prognosis is much, much better. I predict he will be up and walking the sidelines before the end of the season.