Airway Management of a Motorcyclist with a Full-Face Helmet Following a Crash
A 34-year-old male motorcyclist was involved in a single-vehicle crash and died of his injuries following extrication from the vehicle. The patient’s helmet could not be removed during transport and he was intubated and on mechanical ventilation.
The patient was hemodynamically stable at the scene and was placed on an airway-only team due to the current lack of resources for an airway team. A bottle mask was placed over the endotracheal tube and suctioned manually by a rescuer who stood behind him with one hand on the patient’s forehead and one on his chin, while another rescuer held his head in place with an arm across his neck (Figure 1). The endotracheal tube was then replaced with an LMA which allowed for more effective ventilation (Figure 2). Additionally, as indicated by the video documentation, there were no signs of significant airway compromise at this time so it was felt that immediate intubation would not be necessary.
A 35-year-old male was involved in a motorcycle collision. The helmet he was wearing was not designed to be removed and he suffered a head injury. He was treated at an emergency department and then transferred to another hospital for further treatment.
The patient had no known allergies, previous head injuries, or neurological disorders. He had no known medical problems that could have caused him to lose consciousness prior to the crash, including alcohol or drug use, diabetes mellitus, thyroid disease, or seizure disorder. There were no other patients in the department at the time of his arrival but there were others waiting outside on stretchers who could have been brought into contact with him during transport between hospitals.
Airway management of a motorcyclist with a full-face helmet following a crash may be challenging. A number of factors are at play, including the patient’s position, the type of injury, and the amount of time that has elapsed since the crash.
A 37-year-old female with no past medical history was riding her motorcycle when she crashed into an open manhole cover on a residential street in New York City. The woman was wearing a full-face helmet with no eye protection. She sustained head trauma and was transported to an area hospital where she was treated for her injuries. The patient subsequently required endotracheal intubation for airway compromise secondary to swelling around her neck.
The dynamics of this case are based on the assumption that in a crash with face protection, airway management can occur through both direct laryngoscopy from the front and indirect laryngoscopy from behind
- In addition, because there is little contact between upper airway structures such as the pharynx and tongue, it is possible to visualize these structures during laryngoscopy without difficulty When performing indirect laryngoscopy from behind, care should be
The full-face helmet is a popular item of protective gear for motorcyclists. It provides excellent protection against impacts to the head but can be difficult to remove in a life-threatening situation. The airway management of a patient with a full-face helmet following a crash must be carefully evaluated and planned.
The case presentation will include an assessment of the patient’s airway status after they have been injured in a motorcycle accident. The patient may require endotracheal intubation or supraglottic airway insertion prior to extrication from the motorcycle.
Patient considerations include age, pre-existing medical conditions, underlying diseases, medications, and allergies that may impact their ability to tolerate mechanical ventilation.
Airway considerations range from trauma patients who have sustained injuries to those who have suffered from traumatic brain injury (TBI). In addition to identifying potential airway complications such as laryngeal edema or cervical spine injuries, trauma patients may exhibit cervical spine deformity (subluxation) which may prevent the helmet from being removed easily. In addition, patients with TBI often present with altered mental status which can make it difficult for them to understand instructions regarding their airway management. Lastly, some patients may have difficulty speaking due