Helmet Removal Periprocedural Care

Updated: Mar 21, 2016
  • Author: James Cipolla, MD; Chief Editor: Jonathan P Miller, MD  more...
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Periprocedural Care

Equipment

Providers: At least 2 providers (3-4 is ideal) should be present.

Facemask removal: Studies have been performed to determine the ideal tool to remove the facemask in prehospital and hospital settings. [11] The findings suggest that a cordless screwdriver is the superior tool to remove the screws securing the facemask. [12] However, a manual screwdriver can also be used.

Screwdrivers have been shown to minimize neck motion more than pipe cutters, anvil pruners, facemask extractors, or Trainer’s Angels. These 4 tools do reduce the time needed to remove a facemask; unfortunately, they also increase the amount of motion of the cervical spine.

Helmet removal: A pair of scissors is also necessary for helmet removal. [13] Scissors should be used to cut clothing and the laces holding the shoulder pads together, if present. [14, 15] Exposure is one of the basic tenets of trauma resuscitation.

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Patient Preparation

Anesthesia

No anesthesia is needed for helmet removal.

If airway instability occurs, rapid sequence intubation should be employed to secure the airway. For more information, see Tracheal Intubation, Rapid Sequence Intubation and Tracheal Intubation, Medications.

Positioning

The patient should be placed supine on a long cervical immobilization board if he or she is not already on one.

Minimization of cervical spine motion should be maintained prior to the initiation of helmet removal. [16]

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Monitoring & Follow-up

Helmet removal, when performed properly, does not carry inherent risks.

The major complication of helmet removal is worsening an extant cervical spine injury.

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