Spinal on the Ice – A Second Year Story

Rachel is an athletic therapy student and has her placement with a womens hockey team. Here is something she wrote after a fairly bad on-ice injury. The injured girl will recover complete but is out for the season.

Going down on the ice, head down, direct impact, contact and player face down. It’s as easy as that. A hockey game I will never forget for the rest of my life. For player confidentially purposes, the locations and names and locations will not be used so this may be a little hard to follow.

Friday night, second period, an away game, player of the opposite team takes a hit minimal from my player, trips on the puck and goes head into the ice. I wait patiently trying to withstand the urge to run out on the ice. The hockey trainer from the opposition goes out onto the ice and is there blocking her head for almost a full minute with no help.

I looked at my watch counting down from 60 seconds in my head then go out onto the ice hoping to help the other trainer. My heart is pounding, the ice slippery and cold on the bottom of my runners. I am first approached the ref and told to get off the ice. I assure her that “I am here to help” and I reach the player and the trainer. As I get onto my knees, I intro introduce myself as Rachel and that I am a student in the athletic therapy program at Sheridan, and that I am there to assist her in anything she needs help with. The trainer introduces herself and says “she is a nurse”, and is talking to the player trying to get some sort of clarity.

The ref approaches me while I am on my knees beside the nurse and player. She tells me that if I do not get off the ice I will be suspended and that “I should not try to be stating a fight with the opposing team in such a situation”. I reassure the ref that “I am there to help” and she gets quite verbal with me, so I reaffirm to her that this “player is in dire need of medical attention and unless she is there to help, I am here to help”. The ref relaxes.

I ask the nurse what her status is and she says that “she is seeing colors and that she wants to move”. I tell the nurse that we have been sitting here just “under three minutes” and suggest that we call 911. She ignores me and gets a little verbal with me than says “just wait”.

I ask the ref for blankets as I believe she is going into shock from the hit to the ice. I ask the nurse again, “she is not completely conscious and aware, we should call 911″. The nurse replies “just wait”. I tell the nurse I am simply going to take her pulse. Her pulse is rapid and she is breathing and then I start palpation on the player from T spine to C spine and she has pain at the C spine. The player cries out in pain.

I ask the nurse again. “I understand that you are the trainer and make the decision to call EMS but your player is in and out of level of consciousness. Her pulse is weak. She is in severe pain and she went straight head down into the ice. Let’s call 911!” The nurse ignores me, so I prompt my EAP (emergency action plan) with my sign to call EMS.

The player is talking about swirling colors and gardens and then back to the game. The nurse is still talking to her about her colors she is seeing. I ask the player, do you know where you are? She is babbling about colors. I ask the player what the score is and she says she is on the ice. I know she has some awareness.

I ask the nurse to continue to block the head and I tell the player that “I am going to play a game” with her. “Sometimes I will touch you and sometimes I won’t. I need you to tell me where I am touching you or if I am not touching you at all, ok? “. I touch her shoulder and she replies “my shoulder”. I touch her lower back and she replies “my back”. I touch her left leg and she say “you are not touching me”. I am thinking it’s her pants, so I firmly grip her thigh, and ask her “am I touching you”. She replies “you are not touching me”. I ask her to remember three little words “three purple pigs” and then tell her that I will ask her them again later.

At this point she has the following signs and symptoms:
– in and out of level of consciousness
– severe pain in her tp’s and sp’s of her c spine
– rapid pulse
– loss of sensation in her left leg

I saw the mechanism of injury of how she hit the ice. I am treating her for shock as I ask the nurse to keep blocking the head to keep her calm. I am also aware this is probably a true spinal, and that all we can do is wait and all I can do is monitor her vitals, and treat for shock as we wait for EMS. I ask the player “what were those three words asked you to remember?” She is babbling about colors incoherently and no longer even aware that both the nurse and I are there.

The father of the player hurt is screaming at my player from across the ice and telling her he is going to hurt her. He is told to stay calm by the ref. I look at my watch and just under 6 minutes. I pull out my stethoscope and my blood pressure cuff and get a reading; it is normal 115/76. I write it down on my tape that is stuck to my leg. I get her pulse and breathing rate again and her pulse and breathing rate are a little escalated and write them down. I ask the nurse to try and look at her pupils although the player would rather keep her eyes closed and “look at the colors”. The player is no longer aware that both the nurse and I are even there or even where she is. Her skin is warm.

The father tries to come out onto the ice although the ref tries to stop him and he is crying” help my little girl, what is wrong with her”. He is told by the ref he is allowed to come onto the ice as long as he keeps his distance and just stays calm. I talk to the nurse for a second and she tells me that when the paramedics get there that she is “in charge”, and I reaffirm that she is and that I am just there to help. I take a second set of vitals, check her blankets and feel down her body for anything I may have missed in the initial assessment.

The paramedics arrive and I glance at my watch just over 12 minutes. They talk to the nurse and the nurse tells the paramedics what happened and that the player is seeing colour. I take the tape off of my knee then hand it to the male paramedic and tell him that there is a baseline they can start with. I tell the paramedic “my name is Rachel and I am an Athletic Therapy Student from Sheridan and that I am trained to remove the helmet pads and skates.” He smiles, takes my tape and says “thank you, we can use you”.

The spinal board is place onto the ice and with both paramedics one at the head, one at the feet, and the nurse and I at the hip, we log roll the player onto the spinal board. The male paramedic looks at me and says do you thing. At this point the nurse starts to yell at me and says what are you doing, so I reassure her that I am trained and that with her help, I can do this even better. I ask the paramedic to stabilize the head while I take the helmet off, and pads. I ask the nurse to help me take off the skates. I remove the left and she removes the right. The ambulance attendants thank us and pick up the spinal board and carry her off the ice to the ambulance. The nurse follows.

I go back to my team’s bench and the players return to the ice and we restart the clock to finish the period as though it never happened. The end of the game, we line up to shake hands, and the nurse skips me and I walk away from the ice with my head down in silence.