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When a football player goes down and doesn’t get up, the next five minutes decide the rest of his life. Emergency c spine management, the way it has to go: 1. Assume the spine. Head down contact with a down athlete is a cervical spine injury until proven otherwise. Nobody moves him. 2. Hands on the helmet. First person in takes manual in line stabilization of the head and neck. That hold stays on until he’s packaged. 3. ABCs without motion. Airway and breathing checked with the neck neutral. If you need airway access, the facemask comes off with the right tools. The helmet and shoulder pads stay on. 4. Leave the equipment. Helmet and pads together hold the neck neutral. Pulling one without the other forces an injured spine to move. Removal happens at the hospital, not on the field. 5. Move as one. A trained team gets him onto the board in a single coordinated motion, strapped, head secured, and into the ambulance. 6. Have the plan before you need it. Every venue needs a written emerg...

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