First aid question - full face helmet

[Ron 10]

And this is one of the problems.

We now have several people who now "know" how to remove a helmet in case of an emergency.

And they will try it without training, and possibly really screw up the situation.

I have yet to EVER be on a DZ that didn't have some type of medical trained person on it.

The best bet?

1. Know who the really trained people are, and get them.
2. Have the DZ staff attend first responder training.
3. When in doubt....If you are not trained, don't do anything.

Edit to add....You folks really want to learn how to respond in an emergency?...Take a class. Don't read stuff on here and assume you know what to do.
Even if the advice is good....You may not be able to perform it with out PRACTICE and TRAINING.

"No free man shall ever be debarred the use of arms." -- Thomas Jefferson, Thomas Jefferson Papers, 334

[Shotgun 1]

I am currently taking a First Aid/CPR course, and using this site to think of and discuss the various situations that might arise in skydiving. It's unlikely I'll ever use the training at the dz because I jump at Perris and there are usually people around with a much higher level of training. But you never know...

I don't know if the dz staff are required to take first responder training, but I think that they should be. I think it would be a good idea for all skydivers to take at least a basic First Aid/CPR course. There is always the possibility of landing off and being the only person immediately available to an injured person.

[mjosparky 4]

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I don't know if the dz staff are required to take first responder training, but I think that they should be. I think it would be a good idea for all skydivers to take at least a basic First Aid/CPR course.

I think every kid should have to take a basic first aid/CPR class in high school.
Sparky

My idea of a fair fight is clubbing baby seals

[Shotgun 1]

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I think every kid should have to take a basic first aid/CPR class in high school.

Absolutely.

For me, it is one of those things that "I keep meaning to do but never get around to." What finally got me motivated was a recent trip to North Carolina... Hiking with my young nieces and nephews in somewhat remote locations. I just had this helpless feeling that if one of them got hurt I wouldn't really know what to do. So as soon as I got home, I enrolled in this 4-month First Aid course.

[cvfd1399 0]

I am in my 3rd refresher since I got my EMT years ago(10 years in field) we just had this discusssion. the thinking was that air is what keeps you alive, stopping c-spine integrity might parailize you, but you will still be alive. Now the thinking is "what if compression of the nerve that controlls all breathing and heart regulation that exits your spine at C3-C4 is causing the breathing problem". Do you risk further compressing/shearing that nerve that goes straight to the diaphram that might paralize that muscle and kill you only to remove a helmet? I say if the rate, and quality(tidal volume) is enough, leave it. If you are a non-medical responder, and are wondering how to judge adequate breathing, breath like the patient. Take in the amount of air at the same time and rate that they do, if you feel that you are being deprived the patient probbaly is also. Air we breathe is approx. 21% oxygen, and on each breath we only use about 20% of that 21% available, so if you can get 100% oxygen to the patient via a non-rebreather(if you can take the sheild off) or even by placing it near their mouth and nose(blow by method) that right there increased the amount of air that they can get in each shallow,labored, or irregular breath. I think that if there is NO breathing would be one of the only reasons to take it off until advanced life support arrives to intubate, and apply other life saving interventions. If the patient is not breathing take off the helmet slowley, and with as much care as possible and use the modified jaw thrust manuver to open the airway as it is the only reccommended method to use on a neck injury.

[sunshine 2]

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I think it would be a good idea for all skydivers to take at least a basic First Aid/CPR course. There is always the possibility of landing off and being the only person immediately available to an injured person.

I'm a CPR/First Aid instructor and have always offered to train anybody free of charge. (They would just have to pay the paperwork processing fee which is like $8). Sad part is only ONE person has ever taken me up on the offer. People say they wanna learn, but never get around to actually scheduling anything.

___________________________________________
meow

I get a Mike hug! I get a Mike hug!

[kelpdiver 2]

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I don't know if the dz staff are required to take first responder training, but I think that they should be. I think it would be a good idea for all skydivers to take at least a basic First Aid/CPR course.

I think every kid should have to take a basic first aid/CPR class in high school.
Sparky

It's a start, but for the purposes of this discussion, people need to be more current, and they need more specific training that the Basic provides. It may need to be DZ specific based on the likely response time for EMT types.

It seems like every time I do CPR, they've dumbed it down some more. Taking the slightly more professional one feels a bit better. I've read that now they have removed the breathing for 1 person CPR?!

[freefalle 0]

Ive been an EMT for about 12 years, now I'm a Nursing Student. I have a pretty hard and fast line of thought about removing a helmet from an injured person. Unless you know what you are doing, or unless the patient has a compromised airway, leave the helmet alone. Even if you know what your doing, if you dont have a second person there who knows what they are doing, unless the patient has a compromised airway, leave the helmet alone, to be done properly it takes 2 people to remove a helmet. That being said if the patient has a compromised airway AND you are willing to attempt rescue breathing if necessary then by all and any means remove the helmet.

my .02

[mr2mk1g 10]

Someone should go down your local hardware shop and buy a set of tin snips (or like). They would make short work of the chin guard on any helmet on the market today with the absolute minimum of movement to the patient. Now you've cut the chin guard straight off, it's as if they're wearing an open face.

[sunshine 2]

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It seems like every time I do CPR, they've dumbed it down some more. Taking the slightly more professional one feels a bit better. I've read that now they have removed the breathing for 1 person CPR?!

That would be a big negative. The combination of chest compressions and breathing into the victims airway is still taught.

___________________________________________
meow

I get a Mike hug! I get a Mike hug!

[billvon 2,989]

>tin snips (or like). They would make short work of the chin guard
>on any helmet on the market today.

We tried it; they don't work well on a Factory Diver. The fiberglass is just too smooth to get a purchase on; the jaws slide off.

[mnealtx 0]

The big change in my last CPR recurrency was that they changed 2 person CPR from 1 breath/5 compressions to 2 breaths / 15 compressions.

That didn't make any sense to me - I had originally learned that the reason for the 2 breaths/15 compressions was that single person CPR is less efficient than two person CPR.

Was it really that difficult for people to remember the difference?

Mike
I love you, Shannon and Jim.
POPS 9708 , SCR 14706

[Stumpy 284]

As far as i can make out, they seem to change it almost every time i do a new ticket. Did NARS beach lifeguard last year and guess what, different again.
(But i did learn how to use the defib machine!

Never try to eat more than you can lift

[mr2mk1g 10]

Try secateurs then - the more pronounced the curve the better. The curved bar should hold the helmet in towards the centre of the leaver action and the one blade should be enough to do the cutting.... I figure anyway... someone would have to test it I guess.

(as below in case they're called something different over there)
http://www.ormistonrenwick.co.uk/images/large/secateurs.jpg

[Squeak 17]

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As far as i can make out, they seem to change it almost every time i do a new ticket. Did NARS beach lifeguard last year and guess what, different again.
(But i did learn how to use the defib machine!

I'm a Senior 1st Adie Instructor here in oz, for The St Johns Ambulance Service (our national service) and we still teach BOTH 2-15 and 1-5

You are not now, nor will you ever be, good enough to not die in this sport (Sparky)
My Life ROCKS!
How's yours doing?

[kelpdiver 2]

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That would be a big negative. The combination of chest compressions and breathing into the victims airway is still taught.

I would hope so. But I heard something on the radio to the opposite, and this article is as close a stab at it.

http://www.defrance.org/artman/publish/article_670.shtml

[SeaKev 0]

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It seems like every time I do CPR, they've dumbed it down some more. Taking the slightly more professional one feels a bit better. I've read that now they have removed the breathing for 1 person CPR?!

That would be a big negative. The combination of chest compressions and breathing into the victims airway is still taught.

The change is on its way. AHA will be changing their standard shortly. There are changes on the way in the next year or two for the professional as well. EMS Protocols have been modified in the region where I work with regards to CPR as studies are showing that survivability is higher when more emphasis is placed on CPR vs. de-fib. There is data suggesting that compression-only CPR is also more effective than the combo of compressions/ breathing, at least for the lay responder.

[Ruffles 0]

Actually the evidence that brought about this change is that most people refuse to lip-lock a dead person that they don't know and subsequently fail to do chest compressions too if they're already in the "Not me" mode. The chest-compressions-only model was brought about so that those people would at least to CC without feeling guilty about mouth-2-mouth.
Where did you find that study that shows CPR is better than Defib for survivability, I would love to read it.

[sunshine 2]

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Actually the evidence that brought about this change is that most people refuse to lip-lock a dead person that they don't know and subsequently fail to do chest compressions too if they're already in the "Not me" mode. The chest-compressions-only model was brought about so that those people would at least to CC without feeling guilty about mouth-2-mouth.
Where did you find that study that shows CPR is better than Defib for survivability, I would love to read it.

I personally don't keep up on studies/statistics etc. When i teach according to my instructor manual, i do teach to do "something rather than nothing." So in the case of not having a breathing barrier with you and not knowing the victim, i do tell my students to at least do chest compressions. Of course what they do once i'm done teaching them is their own decision. But i know they are told to at least do the compressions. I'm proud to say i have the reputation of being a hardass instructor too.

___________________________________________
meow

I get a Mike hug! I get a Mike hug!

[SeaKev 0]

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Actually the evidence that brought about this change is that most people refuse to lip-lock a dead person that they don't know and subsequently fail to do chest compressions too if they're already in the "Not me" mode. The chest-compressions-only model was brought about so that those people would at least to CC without feeling guilty about mouth-2-mouth.
Where did you find that study that shows CPR is better than Defib for survivability, I would love to read it.

As well as the inability of the general public to properly open and maintain an airway, and effectively ventilate the patient.

As far as my other comment, I'm not saying CPR is better than defib. We're still going to use defib, but, the emphasis is on effective and continuous CPR before, between, and after shocking.

I'm looking up the info on the study for you. If nothing else, you can reference Dr. Mickey Eisenberg, King County EMS Medical Program Director

[Ruffles 0]

No that sounds about right. I just try to keep up on things. Thought that might be some new revelation I missed out on. Hey Sunny, I'm not faulting the general public, I would not mouth to mouth someone either, especially given the fact that their going to puke up all that air+stomach contents in about 2 minutes. You sound like my kinda CPR instructor, but after seeing your rendition of the"good morning song" I can't see you as a hard ass.

[Casquito 0]

Here's my 2 cents for what it's worth.
Keep it simple. Ask yourself what you're really trying to do out there. You're not a mobile trauma center, your job is to keep someone as stable as possible until help arrives. There is most likely nothing you're going to fix right there so just concentrate on preventing bad things from happening or getting worse.
On the subject of the removing the helmet, what is the goal there? There is no benefit from removing the helmet unless to establish control over the airway itself. So go back to the ABC's first like someone previously mentioned: Airway takes priority, then Breathing, then Circulation. The first two have to do with the getting air in, so if that is a problem, then the helmet goes. Ideally someone with knowledge on how to do so will be there, but if not, the you may have to make do without them. Be sure though that you are ready to follow through with controlling the airway once the helmet if off. Removing it alone will do little. Are you ready to do mouth to mouth on someone you may not know? Are you willing to stick your fingers in someone's bloody mouth? If not, don't bother removing the helmet in the first place.
Like so many things though, this is not black and white. People want protocols and step by step instructions everyone can apply to all situations, so by necessity, the guidelines are often nonspecific and ambiguous. There are too many variables to think about to expect a lay person to be able to consider them all before acting. As one's level of training and experience increases, you realize that there are few "correct" pathways; some are just better than others (there are many bad ones though). The ideal response takes into account each of many variables in each individual situation and tailors a unique response. There can be no clear, categorical answer to the question of helmet removal. The answer depends on the needs of the patient and the resources of the responder.
But as a good rule of thumb, ask yourself what your goals are here. There is much you can do without removing the helmet, and if you do remove it, be prepared to follow through with what you started, otherwise you expose them to the risk without the benefit.

J

[WeakMindedFool 0]

Bill, Penny cutters (Trauma Shears) Should do the trick on just about anything you would come up against...but if they are breathing, leave them for EMS. If they arent breathing they are dead already.
Peace!

Faith in a holy cause is to a considerable extent a substitute for lost faith in ourselves.
-Eric Hoffer -
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[billvon 2,989]

>Penny cutters (Trauma Shears) Should do the trick on just
>about anything you would come up against...

First thing we tried; no dice.

>but if they are breathing, leave them for EMS. If they aren't
>breathing they are dead already.

Of course; but that's basic first aid. One problem with full face helmets is that if you can't determine if they are breathing (i.e. no perceptible chest movement, spasmodic chest movements) often you can't even ensure they have an airway, especially if their nose or mouth is occluded by the helmet. You can remove their helmet to ensure their airway, thus putting their CV spine at risk, or you can assume they are breathing and risk brain death.

Of the injuries I've assisted with, the only one where a helmet was removed (before I got there) was in a case where Cheyne-Stokes breathing led the first responder to believe that they did not have an airway. It didn't matter much anyway; they stopped breathing soon afterwards and died a few hours later.

[kelpdiver 2]

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Bill, Penny cutters (Trauma Shears) Should do the trick on just about anything you would come up against...but if they are breathing, leave them for EMS. If they arent breathing they are dead already.
Peace!

Are you sure about part 2? Given the nature of skydiving - healthy young people, no water, that seems likely to be true. But what if instead it was someone suffering a coronary, which lead to the crash landing? They've been without oxygen for at least a couple minutes, and only have a few more before things start dying. Wouldn't CPR/rescue breathing give them the lifeline until the EMS arrives?

How often are the coronaries? It's a pretty big chunk for scuba, though some debate how many have the cause and effect backwards.