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