Recommended protocols for helmet extraction in first aid: practices and precautions

In the event of a road accident, every second counts, especially when the victim is wearing a helmet. Knowing how to properly remove a motorbike or bicycle helmet can be crucial and save lives. This article explores the best practices and precautions to take when removing a helmet in an emergency situation, an essential skill for first responders as well as witnesses at the scene of an accident.

Context and importance of safe helmet extraction

In an accident involving a cyclist or motorcyclist, helmet removal must be carried out carefully to avoid aggravating possible collar injuries or cranial trauma. Inappropriate removal can cause irreversible damage to the spine. It is crucial to know the appropriate actions: stabilise the head and neck, intervene with two people if possible, and slowly remove the helmet while maintaining the alignment of the cervical spine. Only proper training can guarantee a safe operation.

Situation assessment and preparation

Before any intervention, it is essential to assess the safety of the scene to avoid exposing the victim and first aiders to new dangers (traffic, fire, electrical cables). Once the area is safe, check the state of consciousness of the victim by talking to them and gently stimulating them. If the victim is conscious, explain clearly your intentions before acting to reassure them and limit stress. This encourages cooperation and avoids sudden movements that could aggravate injuries.

Safe helmet extraction techniques

Removal of a helmet must be carried out with extreme caution to avoid aggravating any neck injuries. This procedure is ideal when carried out by two trained people.

1. Head and neck stabilization:
   • The first person positions herself behind the victim’s head and firmly stabilises the head and neck by placing her hands on either side of the helmet. She maintains the alignment of the cervical spine throughout the procedure.
2. Jugular release:
   • The second person gently undoes the jugular or cuts it if it is difficult to remove, to release the helmet without creating additional tension.
3. Phased helmet removal:
   • In perfect coordination, the second person grabs the sides of the helmet and removes it slowly using a backwards and then upwards motion.
   • The person at the head adjusts their grip to continue supporting the head as soon as the helmet starts to come off.
4. Maintaining cervical stabilization:
   • Once the helmet has been removed, the head must remain immobile. Use lateral wedges (such as cushions or rolls of cloth) to keep the head aligned until help arrives.

⚠️ If you are not trained, only remove the helmet if the casualty is not breathing and cardio-pulmonary resuscitation (CPR) is required.

Precautions and contraindications

There are situations where the helmet should not be removed immediately. If the victim is showing signs of respiratory distress, or if removing the helmet seems likely to cause further damage, it is preferable to wait for professional medical services to arrive. Rescuers should also be alert to the possibility of cervical fractures and avoid any movement that could exacerbate such injuries.

Prospects and training

Although this article provides an introduction to helmet extraction protocols, formal training is essential. These techniques are an integral part of the IAS 1 course and IAS 2 training programme but are not included in the BLS AED SRC training programme. For those who frequently witness road accidents, such as cyclists and motorcyclists themselves, training is highly recommended so that they can intervene effectively when needed.

To develop these skills further, discover our specialised training courses:

• BLS AED in Geneva
• BLS AED SRC Complete in Lausanne
• BLS AED course in Fribourg