Use your head: Is it time for helmets in EMS?

Statistics suggest we need better head protection


Have you heard? More than 4200 retired players are suing the NFL over concussions and head injury. The suit alleges the league didn't do enough to warn players that they risked permanent brain damage if they played too soon after a concussion and that it hid evidence about the risks for decades.

The players all wear helmets and the defense argues that the players all knew the risks.

For years, many in EMS have been aware that a leading cause of death and injury among medics following a collision is from a head injury. This is not really surprising as medics, while in the patient compartment, admittedly are often unrestrained and in a completely vulnerable state. Note the following quote:

The B2 helmet allows the user to use a stethoscope and has a face shield for splash protection.
The B2 helmet allows the user to use a stethoscope and has a face shield for splash protection.

"NIOSH crash tests also revealed the possibility of head injury if a worker's head strikes the cabinets immediately above or behind them, and noted that vehicle structural failures can be a contributing factor in adverse outcomes of EMS crashes."

Its an unfortunate truth that's been around way too long. Years ago I had the opportunity to watch several safety presentations. Prior to the presentation the presenter would ask the question, who among you would consider wearing a helmet while caring for a patient in the back of a moving ambulance. Very few hands went up.

Following the presentation wherein gruesome EMS collision images were presented the same question was asked. Following the presentation, the response was almost perfectly reversed; a very high number stated they would wear a helmet. I often wondered was this just a short-term response to an emotional event or did this represent a real desire? I have seen other safety-related items like safety vests embraced immediately, only to be later cast aside.

Following the presentation, I would also sometimes hear the question, "Where can I buy a suitable helmet?" From what I know, helmets are specialized based upon their intended use or the activity of the wearer. The needs of a firefighter inside a burning building and a rock climber are different, so the helmet, shape and function needs to be different. At the time there was no EMS intended helmet.

I was recently sent a model EMT-1 Paramedic Helmet made by B2 Helmets to evaluate. It is intended for use in a moving ambulance, as the ears are free so a stethoscope may be used. The B2 also has a half face shield to help protect against blood or other potentially infectious materials from getting into the eyes. The design allows the face shield to be worn over prescription glasses. There is also an optional lightweight LED light to help light up the rescuers field of vision.

The helmet is FMVSS 218 (Federal Motor Vehicle Safety Standards) certified. This safety standard covers wheeled large motor vehicle applications. 

I wore the B2 for a couple of days while typing, walking and riding in a vehicle just to see how it felt. I definitely knew I was wearing it but it was not uncomfortable. I wore the helmet on a very mild weather day so was not exposed to extreme temperature or humidity.

From rock climbing, bike riding, car racing to motorcycle riding there is a growing body of evidence that helmets make a difference. To be fair, the literature also points out that improperly worn or fitted helmets reduce the ability to decrease the risk of head injury. Even when properly worn, helmets do not prevent all head injury and are not intended to reduce neck injury risk. 

To get helmets into the mainstream a change in culture is needed. When I was a kid I would never have considered wearing a helmet while riding a bike. Times have changed. The culture has changed. The media has driven a lot of the change, by providing the statistics and by the desire to save those we love.

I began my EMS career in the early/mid 70s and would not have given any thought to wearing a helmet then either. Back then we barely had seatbelts, let alone complete shoulder restraints or helmets. We did not have gloves back then or know of AIDS. We did many things back then that by todays standards would be considered wrong. We didn't have the choices then that we have today. 

Again, times and the culture have changed. Whether riding bikes, playing football or riding in the back of an ambulance, the media and the statistics suggest we need better head protection. The lives we need to save are our own, both for ourselves and for the ones who love us.

Until something else or better comes along, industry designed helmets may offer the best protection. Until something better comes along use your noggin to lead change within your organization not to just be another statistic on a chart- consider head protection, consider a helmet. Watch the video about Shoal Ambulance's decision to require helmets. A truly industry leading move.

For more information on the B2 helmet, visit www.arasan.us.

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