Was at the scene of a bike crash this evening

[anonymous-user]

So what special magic can a paramedic work that a mere mortal cannot?
There's no secret to removing a helmet, it's just a question of (a little) training/education/practise and confidence that c-spine injury can be ruled out.

[EP3vMk3RS]

SystemParanoia said:

I was at tye scene of one too not too long ago.
Car pulled out from its drive wwithout looking. Bike had no chance as traffic was comming the other way.



Lucky for the biker, the guy who hit him was a rretired a&e dr.

Unlucky for the biker, he had a broken femur

I really don't like people taking photos while a casualty is lying on the floor. Poor taste.

[EP3vMk3RS]

Crossflow Kid said:

So what special magic can a paramedic work that a mere mortal cannot?
There's no secret to removing a helmet, it's just a question of (a little) training/education/practise and confidence that c-spine injury can be ruled out.

You're unlikely to be able to rule out a spinal injury by the side of the road based on that mechanism of injury, and if he had a distraction injury such as a broken bone then he would need some sort of radiological imaging in hospital.

[SystemParanoia]

EP3vMk3RS said:

SystemParanoia said:

I was at tye scene of one too not too long ago.
Car pulled out from its drive wwithout looking. Bike had no chance as traffic was comming the other way.



Lucky for the biker, the guy who hit him was a rretired a&e dr.

Unlucky for the biker, he had a broken femur

I really don't like people taking photos while a casualty is lying on the floor. Poor taste.

I gave the photos to the rider to aid his insurance claim and to the police.

Also he was giving instructions to the woman that stopped first so I did what I could to help.

Note no pics of his face or the paramedics working on him. I see no reason to post those.

[s3fella]

EP3vMk3RS said:

You're unlikely to be able to rule out a spinal injury by the side of the road based on that mechanism of injury, and if he had a distraction injury such as a broken bone then he would need some sort of radiological imaging in hospital.

So you mean "he may have fked his back and he needs an xray".

[CAPP0]

Interesting that nobody has referred to the removable cheek pads which many helmets come with now (my past two have both had them) - I guess that highlights the lack of knowledge of what and how to do it.

[tom_e]

Helmets with removable cheek pads to aid removal after an accident are still relatively scarce, if they're fitted great it's going to make life easier with less chance of further injury during removal but for the most part they're probably not fitted so it's best just to assume they don't exist when it comes to general advice.

[anonymous-user]

s3fella said:

EP3vMk3RS said:

You're unlikely to be able to rule out a spinal injury by the side of the road based on that mechanism of injury, and if he had a distraction injury such as a broken bone then he would need some sort of radiological imaging in hospital.

So you mean "he may have fked his back and he needs an xray".

So he has an x-Ray, then what?
"Sorry mate, you've fked your back and will have to wear your helmet for the rest of your natural life"?
It's got to come off one way or another and something else to consider is that if a rider has fked their back or upper spine, toddling off to A&E with the additional weight of a helmet still on their head could be no less damaging.
Helmets can be removed in such a way that the neck and c-spine can still be supported/isolated if injured, but like I said it's a question of training and knowledge. I guess the underlying factor is people will be more trusting of someone in uniform.

[EagleMoto4-2]

EP3vMk3RS said:

Crossflow Kid said:

So what special magic can a paramedic work that a mere mortal cannot?
There's no secret to removing a helmet, it's just a question of (a little) training/education/practise and confidence that c-spine injury can be ruled out.

You're unlikely to be able to rule out a spinal injury by the side of the road based on that mechanism of injury, and if he had a distraction injury such as a broken bone then he would need some sort of radiological imaging in hospital.

Even paramedics don't remove the helmet until they have a neck brace and scoop stretcher on the scene. At least that is what happened at the crash I was at.
Not sure though why a car based paramedic doesn't carry this kit.

[anonymous-user]

EagleMoto4-2 said:

EP3vMk3RS said:

Crossflow Kid said:

So what special magic can a paramedic work that a mere mortal cannot?
There's no secret to removing a helmet, it's just a question of (a little) training/education/practise and confidence that c-spine injury can be ruled out.

You're unlikely to be able to rule out a spinal injury by the side of the road based on that mechanism of injury, and if he had a distraction injury such as a broken bone then he would need some sort of radiological imaging in hospital.

Even paramedics don't remove the helmet until they have a neck brace and scoop stretcher on the scene. At least that is what happened at the crash I was at.
Not sure though why a car based paramedic doesn't carry this kit.

Because it needs more than one person to use it properly?
Incidentally, did they use the collar and board to get your helmet off, or just to treat you once it was off?
I suspect it was the latter.

Edited by anonymous-user on Saturday 8th October 10:12

[EP3vMk3RS]

Crossflow Kid said:

So he has an x-Ray, then what?
"Sorry mate, you've fked your back and will have to wear your helmet for the rest of your natural life"?
It's got to come off one way or another and something else to consider is that if a rider has fked their back or upper spine, toddling off to A&E with the additional weight of a helmet still on their head could be no less damaging.
Helmets can be removed in such a way that the neck and c-spine can still be supported/isolated if injured, but like I said it's a question of training and knowledge. I guess the underlying factor is people will be more trusting of someone in uniform.

The comment referred to "ruling out" a c spine injury. Not removal of helmet. Helmets should be removed while the c spine is protected by someone who is trained to provide manual in line stabilisation. It is a two person job. If the airway is threatened then the helmet should be removed straight away.

[EP3vMk3RS]

s3fella said:

So you mean "he may have fked his back and he needs an xray".

Or CT.

[anonymous-user]

EP3vMk3RS said:

Crossflow Kid said:

So he has an x-Ray, then what?
"Sorry mate, you've fked your back and will have to wear your helmet for the rest of your natural life"?
It's got to come off one way or another and something else to consider is that if a rider has fked their back or upper spine, toddling off to A&E with the additional weight of a helmet still on their head could be no less damaging.
Helmets can be removed in such a way that the neck and c-spine can still be supported/isolated if injured, but like I said it's a question of training and knowledge. I guess the underlying factor is people will be more trusting of someone in uniform.

The comment referred to "ruling out" a c spine injury. Not removal of helmet. Helmets should be removed while the c spine is protected by someone who is trained to provide manual in line stabilisation. It is a two person job. If the airway is threatened then the helmet should be removed straight away.

The latter part of your reply is kinda what I was getting at.
Removing a lid doesn't involve any special equipment of drug therapy, just a bit of knowledge.

[ruggedscotty]

You leave the helmet on unless there is immediate risk to life. ie a need to remove sickness or breathing pulse has stopped.

A spinal injury will and can cause a rapid deterioration if it is disturbed, if you do not have training or the required equipment help etc to remove the helmet then you leave well alone.

All the research and information out there tells you to leave it alone.

A paramadic will have the training and equipment and even a second pair of hands to stabilise the neck while the helmet is removed and the equipment there to assist if the condition of the patient deteriorates.

i attended an accident a while back when a biker collided with a car at the end of the M8. twice a woman tried to remove the helmet of the biker as he was laying on the road. I asked her to stop. third time she went to do it I had to ask her to stay away from the patient, When the paramedics arrived they said that it was the right thing to do to leave the helmet on. and that they prefer if it the helmet is left on.

[anonymous-user]

Ok, so I'll ask again........what is this "special equipment" for removing lids?
Clearly I'm stupid and know nothing compared to the masses of PHBB but it seems this "Nooooo! Leave their helmet alone!" thing is as much an extention of the general lack of hands-on assistance bystanders are willing to give in any medical emergency as anything else...."Don't touch their helmet, in fact...don't touch them at all....anywhere, don't even look at them"
It's telling that a lot of the posts talk about what might happen after a helmet has been removed as a reason not to remove one in the first place.

Edited by anonymous-user on Saturday 8th October 11:23

[WinstonWolf]

Crossflow Kid said:

Ok, so I'll ask again........what is this "special equipment" for removing lids?

Would you trust me to remove your lid if your spine was potentially compromised? I've had no training, never done it before but I've read an article on the Internet...

[anonymous-user]

WinstonWolf said:

Crossflow Kid said:

Ok, so I'll ask again........what is this "special equipment" for removing lids?

Would you trust me to remove your lid if your spine was potentially compromised? I've had no training, never done it before but I've read an article on the Internet...

Did you deliberately miss the bit where I said it requires (some) training and knowledge?

Anyhow, since the discussion has, as is so often the way on PH with anything regarding collisions, injury and immediate actions, descended in to people shouting "I admit to knowing nothing, but my recognition of that lack of knowledge is sufficientliy robust that I consider that authority to tell you that you know nothing too", I'm off.

Edited by anonymous-user on Saturday 8th October 11:34

[WinstonWolf]

Crossflow Kid said:

WinstonWolf said:

Crossflow Kid said:

Ok, so I'll ask again........what is this "special equipment" for removing lids?

Would you trust me to remove your lid if your spine was potentially compromised? I've had no training, never done it before but I've read an article on the Internet...

Did you deliberately miss the bit where I said it requires (some) training and knowledge?

Anyhow, since the discussion has, as is so often the way on PH with anything regarding collisions, injury and immediate actions, descended in to people shouting "I admit to knowing nothing, but my recognition of that lack of knowledge is sufficientliy robust that I consider that authority to tell you that you know nothing too", I'm off.

Edited by Crossflow Kid on Saturday 8th October 11:34

You said "just some knowledge "

If there isn't a compelling reason to remove the lid just leave it on till the pro's arrive. With spinal injuries a little caution is the best course of action. It could make the difference between full recovery or a wheelchair.

I'm only interested in discouraging armchair paramedics from doing more harm than good.

"First do no harm".

[tom_e]

It's really as simple as can they breathe without issue/are they currently breathing. If the answer is yes don't touch the lid. If the answer is no then trained or not get the lid off as best you can or else they're dead anyway.

I have the training, I would not go popping lids off at an accident for sh*ts and giggles just because I can.

[ruggedscotty]

exactly - leave the lid on....

its all out there - those that have the training and knowledge etc all tell you to leave as is unless there is an immediate issue.

THAT IS THE OFFICIAL LINE.

why oh why do we get folks that say they can remove that there is no issue in doing so ?

THERE IS A REAL RISK YOU WILL DO MORE DAMAGE THAN GOOD.

Yes there is no special equipment needed to remove a lid, but there is a need for special equipment if the casualties condition deteriorates. defib drugs all that the paramedic has with them.

leave it to the pros if they are on their way, they know what to do and will have the training and skills to minimise the risk to any fractures or neck compression that may exist.