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Lesson

Helmet Removal for Airway

10 min Trauma Skip to quiz

Objective: Take the helmet off when you need the airway or you cannot ventilate. Use two people so the neck does not flex. If the helmet stays on, pad the space so the neck stays nearer to neutral.

Why this matters

A full-face helmet hides the mouth, and the oxygen saturation is falling. One person pulling the helmet off can flex or twist the neck. Use two rescuers. One holds the head in line. The other spreads the helmet and slides it off. Then use a collar only if your protocol uses one. The airway still comes before the helmet.

Key points
  • If you cannot ventilate or see the mouth, the helmet is in the way. It comes off.
  • Use two people. One holds in-line stabilization. One removes the helmet. Do not twist the neck.
  • Football helmet plus shoulder pads: if the helmet comes off, plan the pads too. Otherwise the neck extends and the head hangs back.
Verbalize
  • If we cannot ventilate, the helmet comes off.
  • Two people. One holds the head. One removes the helmet.
  • Helmet off means the shoulder pads need a plan.

Clinical sequence

  1. If you cannot ventilate or see the airway, remove the helmet. The airway comes first.
  2. Use two people. One holds the head in line. The other cuts the chin strap, spreads the helmet, and slides it off. Do not twist the neck. Do not pull it off alone.
  3. If this is a football helmet with shoulder pads, plan the pads when the helmet comes off so the neck does not extend. Use a board for the move, then take the patient off the board.

Teaching points

  • Remove the helmet when there is an airway or ventilation problem, the helmet is loose, or you cannot stabilize the head with it on.
  • Use a two-person technique from your training. Cut the chin strap. Do not twist. This lesson does not replace that skill practice.
  • If the helmet stays on, pad under the shoulders or the helmet so the neck does not flex on a flat surface. Use a board for the move, then take the patient off it.
  • Motorcycle helmets and sports helmets are different shapes. Train both.

Common errors

  • One person pulling the helmet off and moving the neck with it.
  • Leaving a full-face helmet on a patient who is not breathing, so you cannot ventilate.
  • Taking the helmet off and leaving the shoulder pads on, so the neck hangs in extension.

Practice

One-minute check

A motorcyclist is not breathing and is wearing a full-face helmet. Say how many people you need, who holds the head, and when the helmet comes off.

Related: Spinal motion restriction, BVM.

Sources & Further Study

Named guidelines for further study. They are not clinical orders and do not replace your protocol or medical direction.

Education only. Apply learning within your protocols and medical direction. This is not clinical care guidance.

Check Your Understanding

Questions drawn only from this lesson. After you check, the key is highlighted. Education practice — not a certification exam.

1. Apneic rider, full-face helmet hiding the mouth. What do you do?
2. The person at the head during helmet removal should:
3. Football helmet is off, shoulder pads are still on. Next thought is:
4. If the helmet stays on for the move, you should:
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