Remove Motorcycle Helmet?

[guttruck]

Most departments have sog's about this and if they don't ide ask your medical director what he wants done

 

[usalsfyre]

And if your SOP or medical director is making a poor recommendation?

 

[Shishkabob]

Honestly, at the 3 agencies I've worked at (2 with progressive protocols), none have ever said a word about motorcycle helmets.


Guess that comes with trusting your field crews to use their judgment over having set rules for every situation.

 

[Handsome Robb]

My protocols are to remove any helmet that could potentially interfere with patient care.

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

Difficult but possible. I know your way smarter than I am, just making a statement.


Personally I'm gonna remove the helmet whether it's full faced, 3/4 or a brain bucket.

When it comes to full face helmets, I'd rather get it off and dealt with than leave it on and accommodate it during immobilization. I don't want to be stuck behind the 8-ball and have to chase my tail and remove it en-route without proper assistance.

 

[Thriceknight]

The way I learned it, only football helmets are to stay on the patient. The front of the helmet (the grill) should be removed.

As to removing a motorcycle helmet, one person should grab the mandible and the back of the neck, and the other should slide the helmet off the patient's head. Obviously, one EMT should hold manual stabilization until the patient is fully immobilized.

A motorcycle helmet that covers the face would make it difficult at best to maintain the patient's airway should they need it, or assist their breathing should they need it. You can't even assess the head if the helmet is still on. I agree that the helmet should come off.

EDIT: I might also add that a helmet compromises the neutral, in-line position of the spine during immobilization.

I would do the same thing. Life over Limb. Simple.

 

[spike91]

Very glad this topic came up. Had a motorcycle MVA a few weeks ago, off duty call where I ended up being one of two EMTs on scene for two patients (both in decent shape, all things considered) awaiting ambulances. In this instance I didn't remove the motorcycle helmet. The damage to the helmet was limited to scratches and a missing eye mask. The pt had adequate, unlabored respirations and medical complaints limited to multiple abrasions and back pain. I took a minute to look over the helmet, and being the only assistance I had was a bystander I didn't care to **** around with it; I backboarded him with the helmet on (it wasn't interfering with the neutral position) and allowed them to take it off at the ER. No one questioned the decision; it was appropriate given the pt.

In the future, I'll probably lean more towards removing the helmet given some of the discussion here; however, I don't think leaving a helmet on is indefensible under certain circumstances.

 

[Tigger]

Difficult but possible. I know your way smarter than I am, just making a statement.

Eh I am not even sure it is possible. The helmet is lifting the head higher than neutral, so to correct this the head would have lower than the surface of the backboard and I am not sure how I would go about doing that in any sort of useful of efficient way.

 

[Tigger]

Very glad this topic came up. Had a motorcycle MVA a few weeks ago, off duty call where I ended up being one of two EMTs on scene for two patients (both in decent shape, all things considered) awaiting ambulances. In this instance I didn't remove the motorcycle helmet. The damage to the helmet was limited to scratches and a missing eye mask. The pt had adequate, unlabored respirations and medical complaints limited to multiple abrasions and back pain. I took a minute to look over the helmet, and being the only assistance I had was a bystander I didn't care to **** around with it; I backboarded him with the helmet on (it wasn't interfering with the neutral position) and allowed them to take it off at the ER. No one questioned the decision; it was appropriate given the pt.

In the future, I'll probably lean more towards removing the helmet given some of the discussion here; however, I don't think leaving a helmet on is indefensible under certain circumstances.

Removing the helmet is not a one person task so it makes sense for the lone provider to not attempt it.

That said I don't think there is a helmet out there will not effect neutral alignment. There is a reason that pads we place under the patient's head are so thin, most people are in neutral alignment when lying supine with proper head positioning.

Also, while the patient was not showing any signs of airway issues at the time, that could easily change. Riding supine and backwards while strapped down in an ambulance could easily induce vomiting, and the helmet could be an issue if suction is needed.

At least with athletic helmets one has shoulder pads providing neutral alignment and a removable face piece.