scenario question

[britt07]

Had this as a test question and Im trying to determine the correct answer:

You have a female patient involved in a motorcycle accident with a severe MOI, what is the best course of action to help the patient in the LONG run.
(may have been worded slightly different?)

The 2 possible choices were:

A rapid transport to the appropriate hospital
OR
Removing the helment and providing oxygen

 

[Veneficus]

Had this as a test question and Im trying to determine the correct answer:

You have a female patient involved in a motorcycle accident with a severe MOI, what is the best course of action to help the patient in the LONG run.
(may have been worded slightly different?)

The 2 possible choices were:

A rapid transport to the appropriate hospital
OR
Removing the helment and providing oxygen

I like option 1.

Removing the helmet has risk to it. Especially without the appropriate tools.

While adding oxygen is spouted like the cure for all ills. The problem in trauma isn't usually lack of oxygen, it is lack of blood to trade oxygen.

 

[Afflixion]

Rapid transport is going to be your best bet in my opinion, as the question stated "in the long run" Removing the helmet without proper extrication techniques can aggravate possible c-spine injuries, and O2 would probably not be overly beneficial, where as in the long run if you get the patient to the nearest appropriate medical facility quickly, they are more likely to have a higher survival rate and overall better quality of life during recovery.

 

[DesertMedic66]

option 1.
you can still give oxygen to a person wearing a helmet. depending on the shape of the helmet you can get a NRB or even a cannual in there. we spent 4 hours on the proper way to remove a helmet in the field.

 

[byoung57]

Option 1 is the best for the long run. This is a surgical problem and must be handled as such.

 

[Handsome Robb]

Option 1 with blow by O2 if your dead set on her getting O's

 

[EMTinNEPA]

Leave the helmet in place unless it makes inline cervical immobilization impossible or there is airway compromise.

 

[Handsome Robb]

We remove ski helmets to immobilize. Granted they are very different than motorcycle helmets. We have a couple the Eject Helmet Removal systems. Only used it once on a guy wearing a full face MX helmet on the hill, don't ask me why he elected to wear that instead of a regular ski helmet, but it worked like a charm.

It doesn't seem like you can provide neutral alignment very easily with a helmet on.

 

[the_negro_puppy]

Bit of a strange question.

Here we are trained in motorcycle helmet removal, and I have personally removed one from a rider involved in high mechanism trauma. How are you supposed to manage the airway properly in the case of a fully enclosed helmet? It would be difficult at best. What if you needed to insert an advanced airway or bag the pt?

Rapid transport is essential as well, but if you don't manage the basics, you could arrive at hospital with a rapidly transported body.

 

[calebsheltonmed23]

Bit of a strange question.

Here we are trained in motorcycle helmet removal, and I have personally removed one from a rider involved in high mechanism trauma. How are you supposed to manage the airway properly in the case of a fully enclosed helmet? It would be difficult at best. What if you needed to insert an advanced airway or bag the pt?

Rapid transport is essential as well, but if you don't manage the basics, you could arrive at hospital with a rapidly transported body.

In a patient with a helmet on, I would tape the NC to the helmet or if needed, face. I do the same on back board patients. When you put the foam head blocks on, just tape the NC to it.

Option 1.

 

[Handsome Robb]

If the airway needs managing remove the helmet and manage it. If its patent, leave it alone and use blow-by high flow or a NC if they need a little more FiO2

 

[Akulahawk]

Given ONLY the two options and the limited info available... Option 1.

 

[fast65]

Option 1 is the the one I would choose. Think about it, if she has a significant MOI then there's the risk for some sort of internal bleeding, is it going to be more beneficial for the patient to get oxygen, or is it going to benefit them more to get to the hospital quickly where they can be taken into surgery?