Remove Motorcycle Helmet?

[FourLoko]

We practiced it in our EMT course so I'm voting with the "remove it" crowd

 

[Aprz]

I should've turned this into a poll. I asked this at the station, and the majority said no, don't remove it. I asked this on an online facebook group composed of CPR-certified, EMTs, Paramedics, RNs, etc... that volunteer at concerts their opinion, and the majority said yes. It looks like on this forum, the majority is yes so far.

I think it's 9 yes and 1 no so far on this forum. On the facebook group, 4 yes, 2 no. At my station, I only asked 3 people, all 3 said no. A total of 13 yes and 6 no.

 

[Handsome Robb]

It's comin' off. Some said it earlier about why we leave football helmets on and keeping a neutral position.

 

[Tigger]

It's comin' off. Some said it earlier about why we leave football helmets on and keeping a neutral position.

And hockey helmets as well. For those of you with a lacrosse presence in your area, those helmets are better just taken off because of how difficult a mask removal is. Furthermore, lacrosse shoulder pads are very thin, so leaving the helmet on will not allow for neutral alignment. Motorcycle helmet type removal seems to be the best practice for these helmets.

Not muck access to mask attachment points.
http://www.cascadehelmets.com/CPV

 

[the_negro_puppy]

Remove it. We are trained to remove helmets properly and its one of the first things we do. Once the helmet is removed you immediately apply a c-collar if possible after doing your usual checks.

 

[Akulahawk]

And hockey helmets as well. For those of you with a lacrosse presence in your area, those helmets are better just taken off because of how difficult a mask removal is. Furthermore, lacrosse shoulder pads are very thin, so leaving the helmet on will not allow for neutral alignment. Motorcycle helmet type removal seems to be the best practice for these helmets.

Not muck access to mask attachment points.
http://www.cascadehelmets.com/CPV

Football helmets can stay on. Hockey helmets can stay on if they're properly fitted and will provide a good in-line stabilization in conjunction with the pads. Lacrosse helmets should come off because of the facemask and airway problems. Tigger is correct, the pads are very thin, but you should take those off too if you take the helmet off. Anytime you take a helmet off, be prepared to also remove shoulder pads. If you can show that Lacrosse pads do, in fact, keep the player in neutral spine with the helmet off, then you can leave them on and you will have a valid point as to why you elected to leave them on.

 

[adamjh3]

Had a pt. This weekend at a football game we c-spined. Because of his ALOC we removed the helmet in anticipation of possible airway issues. In all you have to look at how the spine is, if the head is elevated remove the helmet. With football players get rid of the shoulder pads when you get rid of the helmet. Helmet first, support the head while pulling the pads.

Sent from my DROIDX using Tapatalk

 

[epipusher]

What the PHTLS stance on this? I'm curious and lazy.

 

[Tigger]

Football helmets can stay on. Hockey helmets can stay on if they're properly fitted and will provide a good in-line stabilization in conjunction with the pads. Lacrosse helmets should come off because of the facemask and airway problems. Tigger is correct, the pads are very thin, but you should take those off too if you take the helmet off. Anytime you take a helmet off, be prepared to also remove shoulder pads. If you can show that Lacrosse pads do, in fact, keep the player in neutral spine with the helmet off, then you can leave them on and you will have a valid point as to why you elected to leave them on.

Our experiences have shown that the vast majority of lacrosse pads will not effect neutral alignment. If it can be avoided, we try not to remove pads since that process might cause more movement than needed.

For our hockey players, we try to keep the helmet on so long as it is not absurdly loose. If we have to take it off, we keep a special pad on hand from an old head wedge set that is the right height to ensure neutral alignment. Their pads generally do not allow the use of a c-collar wither, though lacrosse pads do not pose this problem.

We're also trialing using a vacuum splint to mold around the neck and head, early indications look like this could be a better way to go. I know the local FD and ambulance are already doing it too.

 

[Fish]

I was taught to leave the helmet in place, unless it obstructs your care of the Pt's Airway. Removing it may compromise C-Spine.

If done right and carefully it does not compromise Cspine, and unless the persons clothing.protective gear makes the spine in a nuetral line it will cause curveature of the spine to leave it on.

 

[guttruck]

IMO if the pt. was in a MVA/MVC there is probably going to be some type of trauma, but on the other hand I have been on scene of a motorcycle MVA/MVC and the motorcycle driver walked away w/o a scratch. No I have been taught that if you don’t have a airway you don’t have a pt. So I am in favor of taking the helmet off carefully. I am totally in favor of calling medical direction/or the local trauma center for further guidance.

 

[BrushBunny91]

For polling purposes I was recently instructed to remove motorcycle helmets.

 

[EMT11KDL]

here is my two cents, and no i did not read all the comments.. It depends on the helmet. If I can manage the airway without removing it, than NO i will not remove the helmet. But If I cannot manage the airway, yes i am going to remove it. Best way to get practice on this, is go get a few different styles and have your agency practice helmet removal and find out what works best with the different styles..

 

[ksmith3604]

The theme of this seems to be remove the helmet and airway management is priority. This is how I think of it...the helmet is going to come off at some point bottom line. Whether you pull it off in the field or the ER pulls it off....the patient isn't going to wear that helmet until they are discharged....may as well pull it off, if they decompensate and airway becomes compromised, you don't have to jack with the helmet because its already removed. I can see both sides of this argument.

 

[Tigger]

here is my two cents, and no i did not read all the comments.. It depends on the helmet. If I can manage the airway without removing it, than NO i will not remove the helmet. But If I cannot manage the airway, yes i am going to remove it. Best way to get practice on this, is go get a few different styles and have your agency practice helmet removal and find out what works best with the different styles..

What if you can manage the airway but the helmet interferes with the neutral alignment of the spine?

Sent from my out of area communications device.

 

[EMT2B]

Here's my two cents. In my EMT-B class, we have been instructed to consider manual C-spine, and to do a DCAPBLSTIC check starting at the top of the head.

I was in an MVA in 2009. I put my motorscooter into the back of a car. The EMTs on-scene did NOT remove my helmet. I had a 3/4 or "open-face" helmet on. The EMTs just duct-taped my helmet to the backboard. They did not even try to take it off. As a matter of fact, my helmet stayed on until I was taken in to X-ray almost an hour after arriving at the hospital.

I think (since I'm still in the class portion of EMS, not the field work portion) that I would probably remove the helmet if possible. Especially considering the fact that the patient could have injuries to the head that are hidden by the helmet.

 

[Shishkabob]

The EMTs just duct-taped my helmet to the backboard. They did not even try to take it off. As a matter of fact, my helmet stayed on until I was taken in to X-ray almost an hour after arriving at the hospital.

For a 3/4 helmet, yes, it tends to stay on. The 'issue' with full-face non-modular helmets is that it can impede the airway, assessment of the airways, and control of the airway, which is why full-face get removed.

 

[usalsfyre]

It's still gonna be very difficult to achieve neutral alignment with a helmet.

 

[Shishkabob]

It's still gonna be very difficult to achieve neutral alignment with a helmet.

Agreed. Didn't say I LIKED the idea, but alas that's what happens a lot.

 

[usalsfyre]

Agreed. Didn't say I LIKED the idea, but alas that's what happens a lot.

So is it wrong to point our here that the same people who jump up and down to defend immobilization are the same ones who seem to to counterproductive stuff like this ?