helmet in ems

[spenac]

Thank you AK, well said.

(Still waiting for an answer from spenac about why they stop the ambulance to do CPR)

I did not say stop the ambulance. I said you do not transport an active code. Yes I would transport a patient with ROSC but if they coded yes I would stop so that they get quality CPR.

Not restricting myself to the last model year of the Caddylance in 1980, I don't believe I have seen any roof hangers in any ambulances after 1980. That does not mean they no longer make them, just that I have not seen any. Outside the United States and Canada, does anybody use them for multiple patient transport or transfer on one trip?

Almost every ambulance in my area has them. But we are very rural and help is not available in a timely fashion. If you don't find a way to transport them you have an hour or more wait for the next ambulance to get there. Pretty much every Type 1 or Type 3 has them available as an option from the manufacture.

[Siffaliss]

I did not say stop the ambulance. I said you do not transport an active code. Yes I would transport a patient with ROSC but if they coded yes I would stop so that they get quality CPR.

Thanks for the clarification, it sounded different.

I have however seen and myself performed quality CPR while the ambulance is in motion, even in an urban setting with retarded traffic all over the place. It's not difficult.

[spenac]

Thanks for the clarification, it sounded different.

I have however seen and myself performed quality CPR while the ambulance is in motion, even in an urban setting with retarded traffic all over the place. It's not difficult.

I guess the experts that determined it was a bad idea are wrong then? There was a reason for the changes in guidelines besides the book company wanting us to buy new books.

Every bump you hit that causes even a small pause disrupts circulation. Then it takes 10+ compressions to reestablish circulation so your quality can be hurting that extremely small chance of getting ROSC that the patient has. Plus in the field we do everything that the ER doc is going to do so why risk disrupting circulation. Work them where they are at then call them in the field if no ROSC. If ROSC start you medications as you now travel to the hospital.

[Siffaliss]

I guess the experts that determined it was a bad idea are wrong then? There was a reason for the changes in guidelines besides the book company wanting us to buy new books.

Who are these 'experts' you talk of? Where are the studies behind what you're talking about? What book and what book company? What reason?

You can sit in the middle of a busy intersection doing chest compressions 3 minutes away from hospital. I'll continue on as originally planned with perfectly good CPR and meds

[Dustdevil]

I don't give a flying fuck what the statistics are. All I know is that I AM one of those statistics, and I damn sure wish I had been wearing a helmet. Skull fractures are no fun. And I was already ugly enough without this scar over my eye.

So yes, I am all for REQUIRED headgear in the ambulance. I was pleasantly surprised to see it being worn in Japan (where you can't go ten minutes without seeing an ambulance flying by). But no, I do not know of any agency that currently requires them, nor have I ever been with such an agency.

We had a very thorough discussion of this issue here a few years back:

http://www.emtcity.com/index.php/topic/3679-would-you-wear-a-helmet-during-transports/page__hl__helmet

I'll repeat my initial (among many) response to that thread:

Not only would I wear one, but I have been a proponent of helmet usage. Have a little imagination, folks. I have in the past researched what is available commercially that might fit this need. Indeed, there are plenty of readily available helmets that would work in this application while not restricting mobility or the ability to use a stethoscope. Bicycle and sk8er helmets do not block the ears, and do not have big rims (like fire helmets) that limit mobility in the cab. Same thing with climbing and rafting helmets.

Anybody who hasn't seen the need hasn't been in the field long enough. Come to Texas and I'll show you the scar across my head from crashing into the front bulkhead at 70 mph, which resulted in a skull fracture.

Whining about ambulance design is a cop out. YOU are primarily responsible for YOUR safety. If you know anything about safety, you know that the number one factor is the human factor. Environmental engineering is only part of the equation. The choices YOU make are the greatest contribution to your safety. Nobody else can do that for you. Nobody should have to.

As for compliance, I am unconcerned. Violations of safety regulations are ground for immediate termination. No second chances. No questions asked. If you knowingly, willingly, and intentionally jeopardize my assets, you are unemployed. There is your choice. Play by the rules or starve.

A quarter of respondents to that thread said they would voluntarily wear a helmet. A quarter said they would not, and would even defy any policy requiring them to do so. The other half were somewhere in the middle. I'm curious if the numbers have changed as the makeup of the board has changed.

[akflightmedic]

Emotion in an argument is not a win, even if you are one of the statistics.

I am disappointed in you as you have always championed logic, facts and statistics (evidence based medicine anyone) to make most of your arguments. You have had some great ones over the years and changed my mind on a few things as well. However, simply cause you are one of the statistics, it makes the point no more valid.

Hell, we should have ALL drivers wear helmets..scratch that..we should have ANYONE in a motorized vehicle wear a helmet. I am sure the numbers for those incidents far surpass the ones specifically covering ambulance personnel.

I said motorized cause bikes, skateboards and skates already have mandatory helmet laws for under age 14 here...but we should expand it to ALL ages.

[Dustdevil]

The evidence is clear, regardless of the numbers.

They always help. They never hurt. So what does it matter how often it happens? Regardless of how often or how many times it happens, those numbers do not change those two basic facts. The facts remain constant regardless of numbers.

There's your evidence. What numbers do you need to convince you that it's not worth thirty bucks worth of prevention to save an employee's life?

Edited March 14, 2010 by Dustdevil

[Just Plain Ruff]

I don't give a flying fuck what the statistics are. All I know is that I AM one of those statistics, and I damn sure wish I had been wearing a helmet. Skull fractures are no fun. And I was already ugly enough without this scar over my eye.

So yes, I am all for REQUIRED headgear in the ambulance. I was pleasantly surprised to see it being worn in Japan (where you can't go ten minutes without seeing an ambulance flying by). But no, I do not know of any agency that currently requires them, nor have I ever been with such an agency.

We had a very thorough discussion of this issue here a few years back:

http://www.emtcity.com/index.php/topic/3679-would-you-wear-a-helmet-during-transports/page__hl__helmet

I'll repeat my initial (among many) response to that thread:

A quarter of respondents to that thread said they would voluntarily wear a helmet. A quarter said they would not, and would even defy any policy requiring them to do so. The other half were somewhere in the middle. I'm curious if the numbers have changed as the makeup of the board has changed.

I'll bite dust. So what happens when that quarter who would openly defy policy gets injured and workmen's comp refuses to pay? I'll bet they would come here and vent. If you openly defy policy and it states the consequences then can you truly claim victim status that so many of us like to claim?

[akflightmedic]

The evidence is clear, regardless of the numbers.

They always help. They never hurt. So what does it matter how often it happens? Regardless of how often or how many times it happens, those numbers do not change those two basic facts. The facts remain constant regardless of numbers.

There's your evidence. What numbers do you need to convince you that it's not worth thirty bucks worth of prevention to save an employee's life?

I need a study to see if they ALWAYS help. I also need a study to show me they never hurt as I have treated patients with injuries due to improper wearing or ill fitting helmets...yes we have to consider that even though we are adults...it will happen. If we are wearing one, shouldn't everyone wear one?

I see no display of constant fact yet.

I see no evidence other than your words.

Please show me a helmet that fits well and offers premium protection for $30. After finding that unicorn, show me an employer that will purchase one for every employee...if they can even afford it. And since these will need to be custom fitted to prevent further lawsuits when someone gets injured wearing one and they will have to meet rigorous safety standards to even be implemented, I think the price tag just went up.

In short, ain't happening during this lifetime due to the statistically small odds this will ever be of use on the grand scale and the fact we have much bigger fish to fry in the EMS world before worrying about this.

[spenac]

Who are these 'experts' you talk of? Where are the studies behind what you're talking about? What book and what book company? What reason?

You can sit in the middle of a busy intersection doing chest compressions 3 minutes away from hospital. I'll continue on as originally planned with perfectly good CPR and meds

I will not give you all the answer just part then the research will be easy for you. Take a look at the current ACLS guidelines and you shall shall see rolling codes are not acceptable.

As to proof you can not provide proof that every compression while rolling is quality. In fact I am positive if it were monitored you will have some shifts where you barely compress or even completely stop when your partner takes a corner, hits a pot hole etc. Just because you feel you do not miss does not make it so. Seriously start at the ACLS guidelines then follow it for the research.