To the Editor:

Thank you to Dr. Usman for an excellent review of the sideline management of head and neck injuries.¹ In our experience at the Division I college football level, it is now the norm rather than the exception for medical and training staff to remove the injured player's helmet and shoulder pads on the field before transport. Often the medical and training staff and the game coverage emergency medical technicians have significant training, expertise, and practice in helmet and pad removal and are the ones most familiar with the specific equipment used. This also allows easier access to the airway for cardiopulmonary resuscitation should issues develop before or during transport. A discussion about the protocol to be used at any game generally occurs during a pregame medical huddle with the medical and training staff covering the game. As Dr. Usman points out, we agree that transportation with the helmet and shoulder pads left on is appropriate in many other settings.

Editor's Note: This letter was sent to the author of “Management of Head and Neck Injuries by the Sideline Physician,” who declined to reply.