Helmet Removal and C-Collar Placement

What are the three steps of helmet removal?

1. remove all removable padding and sections

2. while one person holds manual stabilization underneath the head and jaw, another pulls the helmet straight off (minimizes C-spine movement)

3. place a folded blanket underneath the head to replace the elevation that was provided by the helmet

Why are two people required for helmet removal?

one person must manually stabilize underneath the head and jaw, while the other pulls the helmet straight off, to minimize c-spine movement

What should be done/said at the end of the helmet removal?

airway assessment

“I am now going to check the airway for any obstructions or contaminants”

What comes after the helmet removed (and airway is assessed)?

neck assessment

What are you looking for within the neck assessment?

• contusions

• contamination

• lacerations

• abrasions

• penetrations

• punctures

• protrusions

• swelling

• deformity

• dried blood

• diaphoresis

• sucking wounds

• sub-Q emphysema

What are you feeling for during the neck assessment?

• tenderness

• instability

• crepitus

• swelling

• “step-off” deformity

• sub-Q emphysema

What is the last step of the neck assessment?

assessing for:

• jugular venous distention (JVD)

• tracheal deviation for pneumothorax

What is JVD?

What is tracheal deviation?

How can points be lost during the feeling portion of the neck assessment?

forgot to palpate the posterior neck

How can points be lost during the looking portion of the neck assessment?

forgot to examine the posterior neck

What is sub-Q emphysema?

What are the three steps of the neck assessment?

1. looking assessment

2. feeling assessment

3. assessment for JVD and/or tracheal deviation (pneumothorax)

What are the four steps of cervical collar placement?

1. size collar using fingers for proper width measurement

2. places fingers under black line of collar and adjusts shoulder rest mechanism so it’s the same width measurement found via finger placement

3. chin support mechanism is flipped out and placed under patient’s chin securely

4. slides Velcro strap under the small of the neck until collar is centered; wraps front around and makes sure fit under chin is snug and secured down

How can points be lost during the placement of the cervical collar?

• skill is performed roughly

• skill is performed in reverse order

• partner does not stabilize the head

• collar is misaligned on first attempt (but is fixed)

  • no room for initial error if you want perfect

How will the mannequin be set up for the helmet removal and c-collar placement assessment?

• ECG 120/min

• SPO2 98%

• BP 140/60 (no auto cycle running)

What equipment will be made available during the helmet removal and c-collar placement assessment?

• blanket

• cervical collar

How much time is given for the helmet removal and c-collar placement assessment to be completed?

• 2 minutes of coaching

• 5 minutes to complete skill