RALEIGH — Three times Wednesday, Adam Hager, a 6-foot-4, 230-pound graduate assistant athletic trainer, was lifted to a stretcher and wheeled off the field at Carter-Finley Stadium. But Hager, dressed in full football gear and appearing unconscious, was perfectly fine despite the repeated medical attention.

The treatment for Hager, 23, was part of a joint drill between the N.C. State athletic training staff and Wake County Emergency Medical Services, part of the preparation for the football season. The goal was to review procedures on how to safely handle injured players with possible spinal cord injuries.

"Since the players are usually bigger than the average person and have all their equipment on, it makes sense to come out and address this ahead of time with the N.C. State staff," said Jeffrey Hammerstein, the Wake County EMS district chief. "In the event of a spinal injury, it's important to calculate every move we make and be careful when we move things that could aggravate the injury. Training is important; training always matters in getting everything right."

Along with N.C. State's training staff, which includes a neurosurgeon and multiple orthopedic surgeons, there were nine paramedics from the EMS, two of whom will be present at each Wolfpack home game.

N.C. State first asked the paramedics to help them conduct the preseason drill three years ago.

"This is our third year running that we've done this, and we basically have a small group of paramedics assigned to our end zone at football games in the case of something catastrophic, and before we came out on the field, we sat down and talked because each practitioner has a different take on it," said Charlie Rozanski, director of sports medicine at N.C. State. "Our hope is that we can get everyone - the EMS, the athletic trainers, the physicians - on the same page and not discussing procedures on the field. We just want to make sure the Wake County EMS comes out and knows the equipment."

Rozanski said in the three years since the drill was implemented, there have been no spinal cord injuries at Carter-Finley Stadium that required the emergency procedures practiced Wednesday. According to the American Association of Neurological Surgeons, 295 football players at various levels of play have had incomplete neurological recovery after spinal injuries in the past 32 years.

North Carolina will hold a seminar on spinal injuries at its Kenan Football Center on Tuesday, according to Scott Trulock, head athletic trainer for football. The seminar will include a video, class sessions and training on procedures.

UNC athletic trainers meet with EMS workers before each football season, Trulock said.

Hap Zarzour, Duke's director of athletic training, said his school also holds training before the season and has a session planned for Aug. 4. He said the sports medicine clinic holds similar sessions.

Though the National Athletic Trainers' Association does not have specific rules requiring colleges to run these types of preseason drills, NATA vice president Jim Thornton said N.C. State is a great example of schools taking precautionary safety measures.

"They're doing what we hope other facilities or other athletic training staffs in the country are doing," Thornton said. "It's important that the emergency services and the school's athletic training staff understand each other and understand what the duties of both staffs are.

"Without doing these types of practices, you're winging it, and in the case of an emergency where an athlete is in distress of some kind that needs serious medical attention, that's not the time to figure out what to do."

patricia.lee@newsobserver.com or 919-829-4567