Helmets for use on your arm?

This sub-forum all discussions about this "lively" subject. All topics that are substantially about helmets will be moved here, if not placed here correctly in the first place.
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Cunobelin
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Re: Helmets for use on your arm?

Postby Cunobelin » 27 Aug 2017, 6:35pm

softlips wrote:It's for statistical reasons they ask, same with seat belts or was.

Although after working in A&E myself and seeing deaths and worse which would have been avoided with a helmet I'd agree with the previous post.


As a health care professional, I would agree that in some cases with low speed impacts that helmets may prevent head injury , but with a proviso


I see far more pedestrians, car drivers and children than cyclists, with drunken falls and assaults being the main causes in adults ands simple falls in children

All the Cohort studies support the fact that Alcohol is the biggest single factor, cyclist rarely actually making the risk groups, and all would have demonstrably been suffering impacts far more in line with the specific performance envelop of helmets that cyclists

Many of these would also benefit form helmets, yet the narrow minded and blinkered unprofessional breach of evidence based practice simply chooses to stick their fingers in their ears and sing LALALALALALALALAL when presented with reality


Are you really stating that in your experience that cyclists are the majority of cases in your experience and that none of the pedestrians, drunks, or assault victims would not have benefitted from head protection?

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Cunobelin
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Re: Helmets for use on your arm?

Postby Cunobelin » 27 Aug 2017, 6:40pm

Tangled Metal wrote:He's a doctor, accept that word if God! S



Two professional medical jokes:

What is the difference between God and a Doctor:

1. God knows his limits
2, God doesn't write prescriptions

Tangled Metal
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Re: Helmets for use on your arm?

Postby Tangled Metal » 27 Aug 2017, 10:22pm

In my case I seriously have no idea why helmets are mentioned by the orthopedic specialist. A broken arm with no other injury. Question asked and answered about head injury to the negative. Not any contact between the head and anything hard. All made clear before the helmet question.

So whatever the reason for asking there is no justified reason for asking a head injury question when there is without doubt no head injury.

This leaves another reason for asking the question. What is that reason? To all those medics please can you answer that. There can be no value in asking that question. If no value then asking it is political or for ulterior motives.

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pjclinch
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Re: Helmets for use on your arm?

Postby pjclinch » 28 Aug 2017, 3:16pm

Tangled Metal wrote:In my case I seriously have no idea why helmets are mentioned by the orthopedic specialist. A broken arm with no other injury. Question asked and answered about head injury to the negative. Not any contact between the head and anything hard. All made clear before the helmet question.

So whatever the reason for asking there is no justified reason for asking a head injury question when there is without doubt no head injury.

This leaves another reason for asking the question. What is that reason? To all those medics please can you answer that. There can be no value in asking that question. If no value then asking it is political or for ulterior motives.


I'm not a medic, but I am a clinical scientist. However, my answer comes from anecdotal observation of general behaviour of quite a lot of people, quite a lot of the time, rather than any special insight I have as a clinical scientist.

And it boils down to if you've got a box to mark Yes/No (actual or virtual) it's easier to fill it than worry about whether it's relevant. Especially if it's a tick box concerning something which a lot of people have got a bee in their bonnet about.

The next question is why is that box there? I imagine the answer has a lot to do with claims of amazing injury prevention ability and the lack of realisation that those claims have had their veracity very seriously questioned.

Pete.
Often seen riding a bike around Dundee...

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Re: Helmets for use on your arm?

Postby pjclinch » 28 Aug 2017, 3:19pm

Cunobelin wrote:
Two professional medical jokes:

What is the difference between God and a Doctor:

1. God knows his limits
2, God doesn't write prescriptions


And the surgeon's corollary, "God doesn't think he's a surgeon"... (with apologies to my remarkably grounded colleagues in surgery!)
Often seen riding a bike around Dundee...

drossall
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Re: Helmets for use on your arm?

Postby drossall » 28 Aug 2017, 6:47pm

Tangled Metal wrote:What has a helmet to do with a broken arm? I can understand getting helmet use figures with cycling head injuries but not arm. If you present with a broken leg would a helmet being relevant? Data is only useful if related to the injury surely?

To be fair, one of the earliest studies showing massive benefits from helmets was later re-analysed and shown to prove that helmets are also massively effective at protecting limbs. This was, of course, because the crashes suffered by helmet wearers and non-wearers were different. So, the more useful hospital studies tend to use injuries to other parts of the body as controls; if the other injuries (or absences of them) are similar, then there's at least a reasonable chance that the potential for head injuries in the crashes was similar too.

So, if you start excluding all the accidents with other injuries only, you distort the figures. It's important to record all accidents requiring hospital treatment* if you want a data base to analyse. Don't forget that some analyses (a minority) even suggest that helmets make things worse on average; if you're not recording the accidents in which there was no head injury, how can you determine whether the wearing (or not) of a helmet was totally effective in preventing injury?

When I crashed without a helmet the other year and got quite a serious scalp injury without any long-term effects ("just" needed stitches), I was asked the helmet question too, possibly with a little more justification. Let to an interesting (but brief) discussion with the medical staff (who did after all have other patients to see!) Hopefully though it also was one more number in the data base showing that helmet-less riding does not necessarily mean instant death.

* Not "hospitalisation"; no crash actually turns you into a hospital :lol:

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Cunobelin
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Re: Helmets for use on your arm?

Postby Cunobelin » 28 Aug 2017, 7:45pm

drossall wrote:
Tangled Metal wrote:What has a helmet to do with a broken arm? I can understand getting helmet use figures with cycling head injuries but not arm. If you present with a broken leg would a helmet being relevant? Data is only useful if related to the injury surely?

To be fair, one of the earliest studies showing massive benefits from helmets was later re-analysed and shown to prove that helmets are also massively effective at protecting limbs. This was, of course, because the crashes suffered by helmet wearers and non-wearers were different. So, the more useful hospital studies tend to use injuries to other parts of the body as controls; if the other injuries (or absences of them) are similar, then there's at least a reasonable chance that the potential for head injuries in the crashes was similar too.

So, if you start excluding all the accidents with other injuries only, you distort the figures. It's important to record all accidents requiring hospital treatment* if you want a data base to analyse. Don't forget that some analyses (a minority) even suggest that helmets make things worse on average; if you're not recording the accidents in which there was no head injury, how can you determine whether the wearing (or not) of a helmet was totally effective in preventing injury?

When I crashed without a helmet the other year and got quite a serious scalp injury without any long-term effects ("just" needed stitches), I was asked the helmet question too, possibly with a little more justification. Let to an interesting (but brief) discussion with the medical staff (who did after all have other patients to see!) Hopefully though it also was one more number in the data base showing that helmet-less riding does not necessarily mean instant death.

* Not "hospitalisation"; no crash actually turns you into a hospital :lol:



The even more interesting aspect was that Rivara went on to "prove" that badly fitting helmets doubled the chance of head injury

Yet the fans of the pro-helmet lobby recognise the faulty "85% claim" yet refuse to recognise the same researcher when the outcome doesn't conform wit their biased agenda

nez
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Re: Helmets for use on your arm?

Postby nez » 29 Aug 2017, 6:45am

Tangled Metal wrote:A family member recently broke his arm falling off a bike. At A&E we got asked the helmet question to which our answer was no helmet. That got the usual response "must wear a helmet". Now I've never had that before from a doctor so I thought it a myth that they insist a helmet must be worn to save us from accidents unrelated to the head.

So out of devilment I thought of a small.helmet attached to the young child's arm in future rides.

Not serious but I was very good in not biting. It was very hard because I really wanted to show the guy how idiotic it is to bring up head injury risk for an arm injury. The child owns a helmet but it's a heavy child helmet so would guarantee head contact when helmet-less there would be none. I'm glad to say my boy gave the doctor a dirty look. A 4 year old with more common sense than a registrar!

Can medical professionals keep to what they know and leave risk analysis to the experts (one highly respected expert switched from wearing helmets to going bare after looking into it IIRC)? Fix his broken arm nothing else please.

Of course if he really wants to meddle in other fields can he do a service on my car. That would be useful.

i had it from a doctor oncewhen I had gone to hospital on a bicycle for something entirely non related. Sauce pot, as my mother would say.


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[XAP]Bob
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Re: Helmets for use on your arm?

Postby [XAP]Bob » 29 Aug 2017, 9:33am

How do the risk analysts get their data...

The medical professionals are at this point acting as data collection clerks.

Given that some accidents generate head injuries, some generate 'other' injuries and some generate both.
Given that some cyclists were wearing a lid and some were not...

Then I want the count of all 6 combinations to make my analysis (which also needs some non-hospital data, such as overall population spread between lids and no lids, and the number of miles ridden by each group).
But the question at that point has to be asked in the context of collecting statistical information, not as part of a medical history taking (which is how I get the impression it is often asked).
A shortcut has to be a challenge, otherwise it would just be the way. No situation is so dire that panic cannot make it worse.
There are two kinds of people in this world: those can extrapolate from incomplete data.

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Re: Helmets for use on your arm?

Postby bovlomov » 29 Aug 2017, 3:06pm

[XAP]Bob wrote:But the question at that point has to be asked in the context of collecting statistical information, not as part of a medical history taking (which is how I get the impression it is often asked).

It is often reported that the medical professional appeared to have a personal stake in the matter. Conversely, much of the information gathered by health professionals seems to be general data collection, unrelated to the patient's treatment. For instance, the dentist assured me that my smoking, drinking and drug habits and my ethnic identity are of no interest to him. They are on the form that he has to complete to retrieve the treatment costs.

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Re: Helmets for use on your arm?

Postby Tangled Metal » 29 Aug 2017, 3:26pm

Actually it was not data collection in that there were no notes being taken. This was one doctor dragged in by the A&E to cover their decision with a specialist's opinion. He looked at x rays and did very little just repeat what the other general doctor said. Then he asked the helmet question in a cocky way. He nearly got an angry response, but I turned away and took a deep breath.

Seriously this was nothing but a cocky registrar making an ignorant helmet comment. He walked straight out afterwards and didn't speak to the other doctor again or go anywhere near the desk where the computer was other than to walk around it and out the door. If it was recorded I'd be very much surprised.

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[XAP]Bob
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Re: Helmets for use on your arm?

Postby [XAP]Bob » 29 Aug 2017, 3:45pm

even worse.

I must rehearse the answer "No, I only wear one when doing something dangerous - like walking"
A shortcut has to be a challenge, otherwise it would just be the way. No situation is so dire that panic cannot make it worse.
There are two kinds of people in this world: those can extrapolate from incomplete data.

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Cunobelin
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Re: Helmets for use on your arm?

Postby Cunobelin » 29 Aug 2017, 6:00pm

[XAP]Bob wrote:How do the risk analysts get their data...

The medical professionals are at this point acting as data collection clerks.

Given that some accidents generate head injuries, some generate 'other' injuries and some generate both.
Given that some cyclists were wearing a lid and some were not...

Then I want the count of all 6 combinations to make my analysis (which also needs some non-hospital data, such as overall population spread between lids and no lids, and the number of miles ridden by each group).
But the question at that point has to be asked in the context of collecting statistical information, not as part of a medical history taking (which is how I get the impression it is often asked).



To me the question would be why only this minority group was selected, why not look at ALL admissions with head injuries?

There is a simple reason.... ALL cohort studies start proving that there are hundreds and thousands of head injuries that could be prevented by helmet use, yet they are excluded because it is outside the limited and narrow minded agenda.

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Re: Helmets for use on your arm?

Postby ian s » 29 Aug 2017, 9:44pm

You also overlook the fact that many medics are not accustomed to original thought; they just dole out the currently fashionable treatment for whatever the problem is that their victim has. They also tend to be risk averse even if the potential benefits of an action outweigh the potential risks. My father in law, who was a GP at the time, seeing me about to go for a short run said "oh dear"

If the current instruction at that A&E is to enquire about helmets, most likely they will, even if it makes them look stupid.

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Re: Helmets for use on your arm?

Postby Tangled Metal » 29 Aug 2017, 10:12pm

He enquired but not for any research reason. Purely to make his point no matter whether in depth researched or totally ignorant.