Drill of the Month
Developed by Gloria Bizjak
Helmet Removal
Drill of the Month
Drill of the Month
Helmet Removal
Student
Performance Objective:
Given information, resources, and opportunity for
discussion and practice, EMTs will be able to:
• List helmet types, features, and purpose
•
List the standards that cover helmets
•
Explain what types of helmets are removed or left in place
after a trauma incident and why
•
Demonstrate assessment steps and emergency care
EMTs
will follow acceptable Maryland medical
practice and Maryland Medical Protocols for
Emergency Medical Providers.
Drill of the Month
2
Altered Mental Status: Assessing
and Managing Seizure Patients
Overview
 Helmets: Types, Features, Purpose
 Helmet standards
 Helmets: Remove or Leave in Place
 Assessment and Care Procedures
 Practice

Drill of the Month
3
Helmets: Types, Features, Purpose

Types: Non-motor or sports helmets
– Typically open in front
– Some may have chin guards
– Have easy access to ABCs
Drill of the Month
4
Helmets: Types, Features, Purpose

Types: Non-motor sports helmets
– Horseback riding, polo
– Bicycle riding, mountain biking
– Inline skating, skateboarding
– Skiing, snowboarding
– Hockey, football, lacrosse (high-impact
contact sports)
– Baseball
Drill of the Month
5
Helmets: Types, Features, Purpose

Types: Motor sports helmets
– Have different protection features than nonmotor sports helmets
– Include
 Motorcycle riding
 Motocross racing
Drill of the Month
6
Helmets: Types, Features, Purpose

Features and Purpose
– Outer shell: hard plastic (polystyrene)—
protects head from impact of fall, crash,
collision
– Padding: a Styrofoam-type lining—cushions
impact
– Other lining: inflatable lining, cloth comfort
lining—for better fit, snugness, comfort
Drill of the Month
7
Helmets: Types, Features, Purpose

Features and Purpose
– Face shield, chin guard: depending on sport
and position played (football); preference
(motorcycle)—offers further protection to
facial areas, e.g., jaw, mouth, eyes
– Chin strap: retention system—holds helmet in
place
Drill of the Month
8
Helmets: Types, Features, Purpose

Features and Purpose
– Other safety features: Motocross racing
requires Eject Removal System—inflatable
bladder to remove helmet, requires tools,
training; helmets must have chin bar
– Label: Must show DOT, Snell, ANSI, ASTM,
Eject system, or other standard label
– Size and types:
 Sized for children in some sports (bicycling)
 Three types of motorcycle helmets
– Full size; three-quarter size, half size
Drill of the Month
9
Standards
All helmets must meet one or more of many
rigid standards
 Some standards are written specifically to a
particular helmet and its use
 All helmets meet standards for:

–
–
–
–

Impact and penetration
Retention
Surface contour
Lining
May have requirements for:
–
–
Peripheral vision (motorcycles specifically)
Labeling (e.g., DOT, Snell, Eject equipped,
etc.)
Drill of the Month
10
Standards




U.S. Consumer Product Safety Commission
(CPSC)—benchmark for bicycle helmets
American Standard for Testing Materials
(ASTM)
Snell Helmet testing standards
American National Standards Institute
(ANSI)
Drill of the Month
11
Standards



Central European Norm (CEN)—easiest
standard to meet for skiing, snowboarding
(better helmets meet Snell, ASTM)
National Operating Committee Standards
(NOCS) for athletic equipment—industry
accepted standard (football)
Safety Equipment Institute (football)
Drill of the Month
12
Standards


Department of Transportation (DOT)—
required for all motorcycle helmets
American Motorcyclist Association (AMA)—
requires Eject Helmet Removal System
(motocross racing)
Drill of the Month
13
Helmets: Remove or Leave In Place?

Leave the helmet on IF :
– The patient is conscious
– It does not interfere with assessing or
reassessing ABCs
– There are no airway or breathing problems
– The helmet fits snugly and does not move
around on patient’s head
Drill of the Month
14
Helmets: Remove or Leave In Place?

Leave the helmet on IF:
– The patient is wearing shoulder pads
– Removal will cause further injury
– The patient’s head can remain in a neutral,
in-line position during transport on a spine
board
Drill of the Month
15
Helmets: Remove or Leave In Place?

Remove the helmet
– Generally IF:



It is easy to remove
It has a removable chin bar and/or face
shield or just a chin strap
One other person is available to maintain
head stabilization until immobilization is
complete
Drill of the Month
16
Helmets: Remove or Leave In Place?

Remove the helmet
– Specifically IF:
 You cannot assess ABCs
 It interferes with providing oxygen
 Removing face shield still interferes with providing
oxygen
 The patient is in respiratory or cardiac arrest
 The helmet does not fit snugly and allows head
movement inside helmet
 You cannot immobilize patient on a spine board in
a neutral, in-line position
– If you remove helmet, remove shoulder pads
Drill of the Month
17
Assessment and Care Procedures

Assessment: Perform General Patient
Care (Maryland Protocols, pp 25-34, 124, 126, 128, 132)
– Size up scene, gather information
– Stabilize head with helmet on
 Perform initial assessment
 ABCs, oxygen as necessary
Drill of the Month
18
Assessment and Care Procedures

Assessment: Perform General Patient
Care (Maryland Protocols, pp 25-34, 124, 126, 128, 132)
– Determine disability and whether to
remove or leave on helmet
 Check distal pulses and sensory motor
function
Drill of the Month
19
Assessment and Care Procedures

Assessment: Perform General Patient
Care (Maryland Protocols, pp 25-34, 124, 126, 128, 132)
– Provide cervical spine immobilization if:
 Patient was or is unconscious
 Patient is disoriented or shows change in
mental status (person, place, time)
 You suspect patient of substance
abuse/use
 Patient has midline cervical
pain/tenderness
Drill of the Month
20
Assessment and Care Procedures

Assessment: Perform General Patient
Care (Maryland Protocols, pp 25-34, 124, 126, 128, 132)
– Provide cervical spine immobilization if:
 Patient shows decrease of or no function
in a part of the body (focal neurological
deficit)
 Patient has other major painful trauma
 Patient is less than 8 years of age
Drill of the Month
21
Assessment and Care Procedures

Assessment: Perform General Patient
Care (Maryland Protocols, pp 25-34, 124, 126, 128, 132)
– Expose patient to assess injuries
– Perform focused history and physical
exam
– Follow treatment protocols
– Communicate with hospital or other
response personnel
– Determine priority and mode of
transport and where (trauma center)
Drill of the Month
22
Assessment and Care Procedures

Emergency care: Helmet removed
(Brady
Emergency Care 10th ed., pp 713-714, Brady First Responder 7th
ed. pp 410-411)
– First rescuer stabilizes helmet and head;
second rescuer cuts chin strap
– Second rescuer grasps and stabilizes
mandible with one hand and occipital area
with other hand
– Second rescuer grasps lower edges of
helmet, pulls sides away from ears, slowly
slides helmet upward over patient’s head
Drill of the Month
23
Assessment and Care Procedures

Emergency care: Helmet removed
– First rescuer resumes head
stabilization until immobilization is
complete
– Second rescuer measures and applies
collar; with assistance moves patient
to spine board; secures patient
 If you remove helmet, remove shoulder
pads OR
 If you do not remove pads, place
Drill of the Month
padding to maintain
neutral, in-line 24spine
Assessment and Care Procedures

Emergency care: Helmet removed
– Rescuers reassess patient
 Retake vital signs
 Recheck injury treatments
 Recheck medical status
– Rescuers transport/transfer/transition
patient and information
Drill of the Month
25
Assessment and Care Procedures

Emergency care: Helmet left in place
– First rescuer stabilizes helmet and head
– Second rescuer measures and applies collar;
with assistance moves patient to spine
board; secures patient
– Rescuers reassess patient



Retake vital signs
Recheck injury treatments
Recheck medical status
– Rescuers transport/transfer/transition
patient and information
Drill of the Month
26
Helmet Removal
Student Performance Objective:
Given information, resources, and opportunity for
discussion and practice, EMTs will be able to:
• List helmet types, features, and purpose
•
•
•
List the standards that cover helmets
Explain what types of helmets are removed or left in place
after a trauma incident and why
Demonstrate assessment steps and emergency care
EMTs will follow acceptable Maryland medical practice
and Maryland Medical Protocols for Emergency
Medical Providers.
Drill of the Month
27
Helmet Removal
Practice . . .
 Review:
 Helmets: Types, Features, Purpose

– List several types of helmets
– Name several features of helmets in general
– State the purpose of helmets

Helmet Standards
– List several of the well-known standards for helmets
– Explain why you think standards were developed for
the variety of activities for which helmets should be
worn
Drill of the Month
28
Helmet Removal
Review:
 Helmets: Remove or Leave in Place

– Explain when helmets should be left in place
– Explain when helmets should be removed

Assessment and Care Procedures
– Describe the steps of assessment
– Describe the steps for care when the helmet is
removed
– Describe the steps for care when the helmet is left in
place
Drill of the Month
29