In which of the following cases, would you leave a helmet on your patient?
The correct answer and explanation is:
Correct Answer:
When the helmet fits snugly, does not obstruct the airway, and there is a suspicion of a spinal injury.
Explanation:
A helmet should be left on a patient when removing it could cause further harm, especially if there is a suspected spinal injury. The helmet provides support to the cervical spine and can act as a stabilizing device during initial assessment and transportation. If the helmet is properly fitted, does not interfere with the patient’s breathing or airway management, and there is no immediate need to access the head or airway, it is safer to leave it in place.
Removing a helmet in the field can be risky. It may cause movement of the cervical spine, leading to worsening of a spinal injury. Only trained personnel using proper techniques should attempt helmet removal if it becomes necessary. It should only be removed if the helmet is loose, obstructing the airway, or preventing access to vital treatment such as bleeding control or airway management.
When a helmet is left on, it is important to ensure that the patient’s head and neck remain in a neutral position and that the helmet does not obscure the face or hinder breathing. Additionally, padding behind the shoulders may be used to keep the spine aligned, especially if the back of the helmet is thick.
In trauma scenarios, such as motorcycle or contact sport accidents, the helmet’s condition and fit must be evaluated. Emergency responders are trained to assess whether the helmet should stay on or be removed. The guiding principle is to prioritize spinal protection and airway maintenance without causing additional injury.
In summary, a helmet should be left on when it provides cervical spine support, does not interfere with airway access or breathing, and when removing it could result in greater harm to the patient.