helmet removal (ppt)

Drill of the MonthDrill of the Month Drill of the Month Drill of the Month

Drill of the MonthDrill of the MonthDeveloped by Gloria BizjakDeveloped by Gloria Bizjak

Helmet RemovalHelmet Removal

22Drill of the MonthDrill of the Month

Helmet RemovalHelmet RemovalStudent Performance Objective:Student Performance Objective:Given information, resources, and opportunity Given information, resources, and opportunity for discussion and practice, EMTs will be able for discussion and practice, EMTs will be able to:to:• List helmet types, features, and purposeList helmet types, features, and purpose• List the standards that cover helmetsList the standards that cover helmets• Explain what types of helmets are removed or left in Explain what types of helmets are removed or left in place place after a trauma incident and whyafter a trauma incident and why• Demonstrate assessment steps and emergency care Demonstrate assessment steps and emergency care EMTs will follow acceptable Maryland medical EMTs will follow acceptable Maryland medical practice and Maryland Medical Protocols for practice and Maryland Medical Protocols for Emergency Medical Providers.Emergency Medical Providers.


Altered Mental Status: Altered Mental Status: Assessing and Managing Assessing and Managing

Seizure PatientsSeizure Patients OverviewOverview Helmets: Types, Features, PurposeHelmets: Types, Features, Purpose Helmet standardsHelmet standards Helmets: Remove or Leave in PlaceHelmets: Remove or Leave in Place Assessment and Care ProceduresAssessment and Care Procedures PracticePractice


Helmets: Types, Features, Helmets: Types, Features, PurposePurpose

Types: Non-motor or sports helmetsTypes: Non-motor or sports helmets– Typically open in frontTypically open in front– Some may have chin guardsSome may have chin guards– Have easy access to ABCsHave easy access to ABCs



Types: Non-motor sports helmetsTypes: Non-motor sports helmets– Horseback riding, poloHorseback riding, polo– Bicycle riding, mountain bikingBicycle riding, mountain biking– Inline skating, skateboardingInline skating, skateboarding– Skiing, snowboardingSkiing, snowboarding– Hockey, football, lacrosse (high-impact Hockey, football, lacrosse (high-impact

contact sports)contact sports)– BaseballBaseball



Types: Motor sports helmetsTypes: Motor sports helmets– Have different protection features than Have different protection features than

non-motor sports helmetsnon-motor sports helmets– IncludeInclude

Motorcycle ridingMotorcycle riding Motocross racingMotocross racing



Features and PurposeFeatures and Purpose– Outer shell: hard plastic (polystyrene)—Outer shell: hard plastic (polystyrene)—

protects head from impact of fall, crash, protects head from impact of fall, crash, collisioncollision

– Padding: a Styrofoam-type lining—Padding: a Styrofoam-type lining—cushions impactcushions impact

– Other lining: inflatable lining, cloth Other lining: inflatable lining, cloth comfort lining—for better fit, snugness, comfort lining—for better fit, snugness, comfortcomfort



Features and PurposeFeatures and Purpose– Face shield, chin guard: depending on Face shield, chin guard: depending on

sport and position played (football); sport and position played (football); preference (motorcycle)—offers further preference (motorcycle)—offers further protection to facial areas, e.g., jaw, protection to facial areas, e.g., jaw, mouth, eyesmouth, eyes

– Chin strap: retention system—holds Chin strap: retention system—holds helmet in placehelmet in place



Features and PurposeFeatures and Purpose– Other safety features: Motocross racing Other safety features: Motocross racing

requires Eject Removal System—inflatable requires Eject Removal System—inflatable bladder to remove helmet, requires tools, bladder to remove helmet, requires tools, training; helmets must have chin bartraining; helmets must have chin bar

– Label: Must show DOT, Snell, ANSI, ASTM, Label: Must show DOT, Snell, ANSI, ASTM, Eject system, or other standard labelEject system, or other standard label

– Size and types: Size and types: Sized for children in some sports (bicycling)Sized for children in some sports (bicycling) Three types of motorcycle helmetsThree types of motorcycle helmets

– Full size; three-quarter size, half sizeFull size; three-quarter size, half size


StandardsStandards All helmets must meet one or more of All helmets must meet one or more of

many rigid standardsmany rigid standards Some standards are written specifically to Some standards are written specifically to

a particular helmet and its usea particular helmet and its use All helmets meet standards for:All helmets meet standards for:

– Impact and penetrationImpact and penetration– RetentionRetention– Surface contourSurface contour– LiningLining

May have requirements for:May have requirements for:– Peripheral vision (motorcycles specifically)Peripheral vision (motorcycles specifically)– Labeling (e.g., DOT, Snell, Eject equipped, Labeling (e.g., DOT, Snell, Eject equipped,

etc.)etc.)


StandardsStandards U.S. Consumer Product Safety U.S. Consumer Product Safety

Commission (CPSC)—benchmark for Commission (CPSC)—benchmark for bicycle helmetsbicycle helmets

American Standard for Testing American Standard for Testing Materials (ASTM)Materials (ASTM)

Snell Helmet testing standardsSnell Helmet testing standards American National Standards American National Standards

Institute (ANSI)Institute (ANSI)


StandardsStandards Central European Norm (CEN)—Central European Norm (CEN)—

easiest standard to meet for skiing, easiest standard to meet for skiing, snowboarding (better helmets meet snowboarding (better helmets meet Snell, ASTM)Snell, ASTM)

National Operating Committee National Operating Committee Standards (NOCS) for athletic Standards (NOCS) for athletic equipment—industry accepted equipment—industry accepted standard (football)standard (football)

Safety Equipment Institute (football)Safety Equipment Institute (football)


StandardsStandards Department of Transportation (DOT)Department of Transportation (DOT)

—required for all motorcycle helmets—required for all motorcycle helmets American Motorcyclist Association American Motorcyclist Association

(AMA)—requires Eject Helmet (AMA)—requires Eject Helmet Removal System (motocross racing)Removal System (motocross racing)


Helmets: Remove or Leave In Helmets: Remove or Leave In Place?Place?

Leave the helmet on Leave the helmet on IFIF : :– The patient is consciousThe patient is conscious– It does not interfere with assessing or It does not interfere with assessing or

reassessing ABCsreassessing ABCs– There are no airway or breathing There are no airway or breathing

problemsproblems– The helmet fits snugly and does not The helmet fits snugly and does not

move around on patient’s headmove around on patient’s head



Leave the helmet on Leave the helmet on IFIF::– The patient is wearing shoulder padsThe patient is wearing shoulder pads– Removal will cause further injuryRemoval will cause further injury– The patient’s head can remain in a The patient’s head can remain in a

neutral, in-line position during neutral, in-line position during transport on a spine boardtransport on a spine board



Remove the helmetRemove the helmet– Generally Generally IF:IF:

It is easy to removeIt is easy to remove It has a removable chin bar and/or It has a removable chin bar and/or

face shield or just a chin strapface shield or just a chin strap One other person is available to One other person is available to

maintain head stabilization until maintain head stabilization until immobilization is completeimmobilization is complete



Remove the helmetRemove the helmet– Specifically Specifically IF:IF:

You cannot assess ABCsYou cannot assess ABCs It interferes with providing oxygen It interferes with providing oxygen Removing face shield still interferes with Removing face shield still interferes with

providing oxygenproviding oxygen The patient is in respiratory or cardiac arrestThe patient is in respiratory or cardiac arrest The helmet does not fit snugly and allows The helmet does not fit snugly and allows

head movement inside helmethead movement inside helmet You cannot immobilize patient on a spine You cannot immobilize patient on a spine

board in a neutral, in-line positionboard in a neutral, in-line position– If you remove helmet, remove shoulder If you remove helmet, remove shoulder

padspads


Assessment and Care Assessment and Care ProceduresProcedures

Assessment: Perform General Assessment: Perform General Patient Care Patient Care (Maryland Protocols, pp 25-34, 124, (Maryland Protocols, pp 25-34, 124, 126, 128, 132)126, 128, 132)– Size up scene, gather informationSize up scene, gather information– Stabilize head with helmet onStabilize head with helmet on

Perform initial assessmentPerform initial assessment ABCs, oxygen as necessaryABCs, oxygen as necessary



Assessment: Perform General Assessment: Perform General Patient Care Patient Care (Maryland Protocols, pp 25-34, 124, (Maryland Protocols, pp 25-34, 124, 126, 128, 132)126, 128, 132)– Determine disability and whether Determine disability and whether

to remove or leave on helmetto remove or leave on helmet Check distal pulses and sensory Check distal pulses and sensory

motor functionmotor function



Assessment: Perform General Patient Assessment: Perform General Patient Care Care (Maryland Protocols, pp 25-34, 124, 126, 128, 132)(Maryland Protocols, pp 25-34, 124, 126, 128, 132)

– Provide cervical spine immobilization if:Provide cervical spine immobilization if: Patient was or is unconsciousPatient was or is unconscious Patient is disoriented or shows change in Patient is disoriented or shows change in

mental status (person, place, time)mental status (person, place, time) You suspect patient of substance You suspect patient of substance

abuse/useabuse/use Patient has midline cervical Patient has midline cervical

pain/tendernesspain/tenderness



Assessment: Perform General Assessment: Perform General Patient Care Patient Care (Maryland Protocols, pp 25-34, 124, (Maryland Protocols, pp 25-34, 124, 126, 128, 132)126, 128, 132)– Provide cervical spine Provide cervical spine

immobilization if:immobilization if: Patient shows decrease of or no Patient shows decrease of or no

function in a part of the body (focal function in a part of the body (focal neurological deficit)neurological deficit)

Patient has other major painful traumaPatient has other major painful trauma Patient is less than 8 years of agePatient is less than 8 years of age



Assessment: Perform General Assessment: Perform General Patient Care Patient Care (Maryland Protocols, pp 25-34, 124, (Maryland Protocols, pp 25-34, 124, 126, 128, 132)126, 128, 132)– Expose patient to assess injuriesExpose patient to assess injuries– Perform focused history and physical Perform focused history and physical

examexam– Follow treatment protocolsFollow treatment protocols– Communicate with hospital or other Communicate with hospital or other

response personnelresponse personnel– Determine priority and mode of Determine priority and mode of

transport and where (trauma center)transport and where (trauma center)



Emergency care: Helmet removed Emergency care: Helmet removed (Brady Emergency Care 10th ed., pp 713-714, Brady First (Brady Emergency Care 10th ed., pp 713-714, Brady First Responder 7th ed. pp 410-411)Responder 7th ed. pp 410-411)– First rescuer stabilizes helmet and head; First rescuer stabilizes helmet and head;

second rescuer cuts chin strapsecond rescuer cuts chin strap– Second rescuer grasps and stabilizes Second rescuer grasps and stabilizes

mandible with one hand and occipital mandible with one hand and occipital area with other handarea with other hand

– Second rescuer grasps lower edges of Second rescuer grasps lower edges of helmet, pulls sides away from ears, helmet, pulls sides away from ears, slowly slides helmet upward over slowly slides helmet upward over patient’s headpatient’s head



Emergency care: Helmet removedEmergency care: Helmet removed– First rescuer resumes head stabilization First rescuer resumes head stabilization

until immobilization is completeuntil immobilization is complete– Second rescuer measures and applies Second rescuer measures and applies

collar; with assistance moves patient to collar; with assistance moves patient to spine board; secures patientspine board; secures patient If you remove helmet, remove shoulder If you remove helmet, remove shoulder

pads pads OROR If you do not remove pads, place padding If you do not remove pads, place padding

to maintain neutral, in-line spine positionto maintain neutral, in-line spine position



Emergency care: Helmet Emergency care: Helmet removedremoved– Rescuers reassess patientRescuers reassess patient

Retake vital signsRetake vital signs Recheck injury treatmentsRecheck injury treatments Recheck medical statusRecheck medical status

– Rescuers Rescuers transport/transfer/transition transport/transfer/transition patient and informationpatient and information



Emergency care: Helmet left in placeEmergency care: Helmet left in place– First rescuer stabilizes helmet and headFirst rescuer stabilizes helmet and head– Second rescuer measures and applies Second rescuer measures and applies

collar; with assistance moves patient to collar; with assistance moves patient to spine board; secures patientspine board; secures patient

– Rescuers reassess patientRescuers reassess patient Retake vital signsRetake vital signs Recheck injury treatmentsRecheck injury treatments Recheck medical statusRecheck medical status

– Rescuers transport/transfer/transition Rescuers transport/transfer/transition patient and informationpatient and information


Helmet RemovalHelmet RemovalStudent Performance Objective:Student Performance Objective:Given information, resources, and opportunity Given information, resources, and opportunity for discussion and practice, EMTs will be able for discussion and practice, EMTs will be able to:to:• List helmet types, features, and purposeList helmet types, features, and purpose• List the standards that cover helmetsList the standards that cover helmets• Explain what types of helmets are removed or left in Explain what types of helmets are removed or left in place place after a trauma incident and whyafter a trauma incident and why• Demonstrate assessment steps and emergency care Demonstrate assessment steps and emergency care EMTs will follow acceptable Maryland medical EMTs will follow acceptable Maryland medical practice and Maryland Medical Protocols for practice and Maryland Medical Protocols for Emergency Medical Providers.Emergency Medical Providers.


Helmet RemovalHelmet Removal Practice . . .Practice . . . Review:Review: Helmets: Types, Features, PurposeHelmets: Types, Features, Purpose

– List several types of helmetsList several types of helmets– Name several features of helmets in generalName several features of helmets in general– State the purpose of helmetsState the purpose of helmets

Helmet StandardsHelmet Standards– List several of the well-known standards for List several of the well-known standards for

helmetshelmets– Explain why you think standards were Explain why you think standards were

developed for the variety of activities for which developed for the variety of activities for which helmets should be wornhelmets should be worn


Helmet RemovalHelmet Removal Review:Review: Helmets: Remove or Leave in PlaceHelmets: Remove or Leave in Place

– Explain when helmets should be left in placeExplain when helmets should be left in place– Explain when helmets should be removedExplain when helmets should be removed

Assessment and Care ProceduresAssessment and Care Procedures– Describe the steps of assessmentDescribe the steps of assessment– Describe the steps for care when the helmet is Describe the steps for care when the helmet is

removedremoved– Describe the steps for care when the helmet is Describe the steps for care when the helmet is

left in placeleft in place

helmet removal (ppt)

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