EMT's and emergency release cheek pads

Discussion in 'Equipment' started by ElRod, Jun 7, 2019.

  1. Grinder

    Grinder Wrong way 'round

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    This x1000. If I need help, help. My insurance will cover my gear. I’d rather have to get a new lid rather than have been paralyzed because I tried to save a few bucks.
    #21
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  2. ClosetCaseNerd

    ClosetCaseNerd Adventurer

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    Former FF/EMT, former patient of a motorcycle accident too. There is a procedure taught for removing gear from patients, and it works near universally. Don't be surprised that the guys aren't receptive to a specialized method that works on a narrow margin of helmets. Frankly - if gear has been in an accident enough for EMS to be called and have to remove for you, insurance should be buying you new gear. Further - the gear you used should probably not be used again. Think about it, if EMS arrived and you haven't already peeled off your gear you're probably significantly inured.

    When I got into my accident I was wearing a $800 helmet and a $600 dollar jacket, $130 gloves, but my shoulder was so extensively injured from blunt for trauma I told the paramedic in no uncertain terms to CUT. IT. OFF. He was reluctant "I dunno man it all seems fine-" CUT IT OFF AND MOVE NOTHING.

    I've, as a firefighter, been cutting people out of cars and been assaulted by family members for "making the car worse" meanwhile the victim has flail chest and is nearly entirely stuffed into the footwell of the car from the impact without a seatbelt. The family member's concern is financial, about the object, my concern is removing the entirety of a vehicle from around a patient, something like a measly helmet's cost wouldn't even enter my mind. These guys at the fire house don't have time or energy for specialized gear. This isn't the race track.

    Don't mean to be negative, just being realistic.
    #22
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  3. ClosetCaseNerd

    ClosetCaseNerd Adventurer

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    #23
  4. Grreatdog

    Grreatdog Long timer Supporter

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    I can honestly say that when I was doing this the absolute last thing on my mind was your fucking riding gear except in terms of whether it was preventing us from doing something.

    If there was a reason for me to be there doing first aid, then I did not give the slightest shit about riding gear despite being a rider. That is not to say we always screwed it up.

    Sometimes there was no need to mess with gear and other times we deemed it best for ER nurses to the job. But literally the only thing I ever cared about was not making somebody worse.
    #24
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  5. phillyrube

    phillyrube Long timer

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    Forwarded the info on removable cheek pieces to my old EMS agency. They still use a couple helmets I dinged up for practice.

    Last fall off I had was wearing a Motoport kevlar mesh jacket. Medic on the box was a former student of mine, just left it on, was able access everything he needed for the ride in (including the back of the hand IV...OUCH). Once I was downgraded in the trauma bay and had some meds onboard (ankle fx plus 4 ribs) they were able to sit me up and help take the jacket off.
    #25
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  6. C-Stain

    C-Stain Long timer

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    How many helmet manufacturers are on the market? How many have removable cheek pads? How many hours does EMT school devout to helmet removal?

    I’ve been a Firefighter/Paramedic/Rescue Tech for 26 years. I’ve spent the last 20 years with the same service and get Clinical, Operational and Geographic Updates DAILY. It’s busy out there...

    If you think that I’ll be able to remember which helmet manufacturer and what helmet model has removable cheek pads - then I’m sorry. I don’t often remember what I had for breakfast or if I managed to pee the last time we stopped.

    It’s not about delivering “5 min of training to the guys”. There’s a lot of liability there too... does the medical director approve of removing cheek pads? How long will this training take to deliver to the entire department? How much will it cost? Who will oversee the development of the training? What risk factors are there with removing cheek pads before helmet removal?

    I do remember my training to take off a helmet. Hasn’t changed in 25 years. It’s worked, and still works.

    Until the industry in universal, stay with the tried and true techniques. We use them for a reason. Thanks for having an intelligent response. :thumb
    #26
  7. RonKZ650

    RonKZ650 Been here awhile

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    I wouldn't trust or expect anything from emt. Recently my dad fell and had major injuries, 7 broken ribs, punctured lung. We called 911, emt came out, 3 or 4 guys in ambulence, 2 or 3 in fire engine, and said nothing was wrong with him, all they cared or seemed to check was for a heart attack. He kept saying his heart was not the problem, his ribs were, but they had no clue he was even injured, made him walk to the ambulence with all these injuries, then took him to the hospital where he was then put in intensive care for injuries they did not even know how to check for.
    #27
  8. C-Stain

    C-Stain Long timer

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    I’m sorry your Dad did not receive the care you felt he deserved. I treat every one of my patient’s as if they were one of my own parents or grandparents, but it is called “practicing” medicine for a reason. We don’t always get it right. We also have Biases that, unfortunately, change the way we approach calls.

    I’m also sorry your father had injuries that required care not available on an ambulance.

    I’m guessing your father (since you’re 58) is probably in his mid to late 80s, and had a fall from standing height and fell against a piece of furniture? When the ambulance arrived, he was probably sitting in a chair, talking and complaining that his chest hurt? No initial bruising either I’d imagine.

    As long as he wasn’t complaining of shortness of breath, had diminished lung sounds on one side, exhibited subcutaneous emphysema or paradoxical movement of his chest, I’d have made him walk too. The stories we’re told go a long way to how a person is treated, or rather the stories go a long way to pique our senses.

    No one is perfect. We all make mistakes.
    #28
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  9. RonKZ650

    RonKZ650 Been here awhile

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    Right on all accounts. Thanks for more or less explaining how things work. I see your point and understand better now.
    #29
  10. Friz Freleng

    Friz Freleng Religious zealot Supporter

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    Since so many of you are EMTs, would you mind explaining how you remove a helmet? I wear a full face Schuberth and it's a snug fit to pull on and off, especially because the collar contains the electronics of my comm set. I'm not at all concerned about an EMT damaging the helmet but I am concerned about whether I might suffer additional injury caused by my helmet being removed improperly.

    Do you cut the shell or the chin bar? Do you leave it for the ER team to remove? Or do you just 'wiggle' it off? What exactly is the technique?
    #30
  11. playinatwork

    playinatwork Been here awhile

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    I'm 7 weeks post deer strike. I had 3 crushed cervical vertebrae and I am now dealing with Central Cord Syndrome. The EMT's on scene couldn't remove my helmet safely and I instructed them I had spinal cord damage. I was completely paralyzed from the neck down and I knew it as soon as I hit the ground. The helmet was a Nolan 104 and was somewhat damaged. They did a fine job of stabilizing me for the 3 hour ride to the hospital with my helmet on. The ER staff slowly cut away the cheek pads and part of the liner so they could remove the helmet.
    I am now typing this and will be walking in a few weeks because everyone of the dozen folks assisting me did their job. I'm ok with you being cocky, arrogant, or if you were pink bunny slipper pajamas. Thanks for knowing how to do what you do.
    #31
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  12. C-Stain

    C-Stain Long timer

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    It’s a 2 person technique. Best shown in this video.



    It’s not rocket surgery. There’s no magic. Nothing I can’t manage easier by removing the cheek pads. It does require practice.
    #32
  13. a2ronm

    a2ronm Ti-6Al-4V

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    Dang!

    Even though I went through the helmet removal thing at the scene of my accident (I was damaged below the waist-full face helmet, armored gloves and Badlands Jacket kept upper body injury free) I was expecting some cool "jaws-of-life" tools....

    The 1st responder team of Police, Fire Department and EMT's all were very helpful and professional I had/have no complaints.
    #33
  14. OGOBRacing

    OGOBRacing Been here awhile

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    On June 2, 2013 I was involved in a racing incident. I was unconscious, barely breathing from what I'm told and among other things had an arrhythmia. I'm damn glad the Medic was able to cut away enough of the suit to get a big line in. I do not know if they removed my helmet or that was done in the ER, and I don't know what was done to get it safely off. I'm told the Vanson gave them a rough time. It was sort of fileted. Bottom line is this, the field Paramedics knew what they were doing and so did the hospitals trauma team. And a large reason is they follow protocol. The point about the limited number (although growing) manufacturers using removable cheek pads is spot on. It is easiest to have one standardized procedure. My guess is cheek pads will be and probably already are being introduced in training, but in the field tried and true comes into play.
    A mistake by the medics might have meant I wouldn't be typing this. I'm willing to give them a lot of leeway in how they would react to me telling them I think there's a better way of doing things, even if I'm right
    For the record my son is a career firefighter/paramedic.
    #34
  15. C-Stain

    C-Stain Long timer

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    I’m not saying the responders did everything right. However, what causes an 80+ year old man to fall?

    1. Cardiac Arrhythmia
    2. Trip/Slip/Loss of Balance
    3. Hypotension
    4. Syncope
    5. CVA/TIA

    Rule out the arrhythmia with a 12 Lead ECG. Inquire about Chest Pain and discomfort. Check BP for hypotension. Syncope? Same thing. Cincinnati Stroke Scale. If you rule out everything else, the hoof beats are horses right?

    Now, the other factor is how many patients, on average do we see with multiple rib fractures after a fall? My experience? Very few.

    What tools do I have to assess for rib fractures? Palpating and visual cues (paradoxical movement). You Dad fell and hurt his side. The only definitive way to properly diagnose a rib fracture is an X-ray. Punctured Lung? Diminished breath sounds - but often that can take time given the patient’s breathing and honestly - the lung may not have been punctured until he arrived at the hospital. O2 Saturation as well - but if it was normal-ish, then it’s not a good rule out.

    I don’t know what the EMS Service is like where you live. I can tell you that I undertake upwards of 100 hours of Continuing Medical Education every year, and can be answerable to the employer’s
    Board of Inquiry and to the licensing body’s investigation committee.

    We do screw up. We’re human. We really try not to though.

    I’m glad your Dad ended up in the right place.
    #35
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  16. husky390

    husky390 Long timer

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    Because the Fire/EMS service hates change
    #36
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  17. husky390

    husky390 Long timer

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    So is it okay to assume you’re an idiot motorcyclist or 1%er since you ride a motorcycle? There are hacks in every profession and I’m sorry your Dad was treated by some but there are some damn good professional crews out there. If you’re upset by how they treated your father, I’d recommend talking with their Battalion Chief or Commander about it.
    #37
  18. KneeDrachen

    KneeDrachen Long timer

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    Shit, I just like using the siren!
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  19. Friz Freleng

    Friz Freleng Religious zealot Supporter

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    I'm surprised, too. I was expecting some sort of cutting tool or something to at least cut the chin bar. My helmet is truly a tight fit when pulled over my ears. I wish I knew some EMTs and have them practice on me to see what if it would be difficult to pull my Schuberth off.
    #39
  20. Grreatdog

    Grreatdog Long timer Supporter

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    You can spread a helmet wider than you think with both hands sitting where the EMT is located. So it will slip off.

    A close fitting Schuberth might hit your nose just like it did to the "victim" in that video. But it will still slip off.
    #40
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