Helimeds.

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.
Mike Sales
Posts: 4418
Joined: 7 Mar 2009, 3:31pm

Helimeds.

Postby Mike Sales » 27 Dec 2019, 1:43pm

I've just been watching a helimed show on the box.
A cyclist has (for unexplained reasons) fallen off and banged his head.
The paramed, as usual, comments that he was not wearing (or was) wearing a helmet.
I suppose that it can be assumed that motorists were not wearing one and that motorcyclists were, but surely these people notice that in spite of belts, air bags and crumple zones, or hefty helmets, many of their motorised patients have significant head injuries. Of course the pedestrian victims too can be assumed to be lidless, and quite often have head injuries.
I guess that medics are subject to confirmation bias like everyone else, or they might draw the conclusion that helmets are not that crucial in an RTC, and stop exhorting only cyclists to wear one, or even recommend them for all road users, if they really believe that they might make a difference for us.

User avatar
Syd
Posts: 375
Joined: 23 Sep 2018, 2:27pm

Re: Helimeds.

Postby Syd » 27 Dec 2019, 1:57pm

I got taken to hospital by ambulance after a cycling mishap and the first question I got asked was ‘were you wearing a helmet?’ I responded that ‘I did not hit my head’ to which they said ‘that is not what I asked. We’re you wearing a helmet?’

I failed to see the relevance and stated so. I was not complaining of any upper body injuries or pain. They then asked the same question for the third time. I ignored it and carried on telling my recollection of the incident.

For the record, I was wearing a helmet but wanted to make a point that the question asked simply was not relevant to that incident.

Steady rider
Posts: 2187
Joined: 4 Jan 2009, 4:31pm

Re: Helimeds.

Postby Steady rider » 27 Dec 2019, 6:26pm

'Wearing a cycle helmet may increase risk of injury, says new research'
https://www.researchgate.net/publicatio ... jury_rates

Research shows wearing a helmet increases the accident rate.

User avatar
Syd
Posts: 375
Joined: 23 Sep 2018, 2:27pm

Re: Helimeds.

Postby Syd » 27 Dec 2019, 6:56pm

Steady rider wrote:'Wearing a cycle helmet may increase risk of injury, says new research'
https://www.researchgate.net/publicatio ... jury_rates

Research shows wearing a helmet increases the accident rate.

I’m sure this was discussed elsewhere and IIRC, like most studies pro or con, was criticised for its statistical analysis.

Steady rider
Posts: 2187
Joined: 4 Jan 2009, 4:31pm

Re: Helimeds.

Postby Steady rider » 27 Dec 2019, 7:11pm

I do not recall any specific statistical analysis detailing parts to seriously question the findings. Doctors may well ask about helmets for general information or to see if the person can discuss the accident and is showing any signs of concussion. The important part is knowing why the accident happened and how it could have been avoided.

Mike Sales
Posts: 4418
Joined: 7 Mar 2009, 3:31pm

Re: Helimeds.

Postby Mike Sales » 27 Dec 2019, 7:30pm

Steady rider wrote:I do not recall any specific statistical analysis detailing parts to seriously question the findings. Doctors may well ask about helmets for general information or to see if the person can discuss the accident and is showing any signs of concussion. The important part is knowing why the accident happened and how it could have been avoided.


How the accident can be avoided is of course important. Doctors do not ask any questions that might help with that. That is not their job, repair is.
Concussion is best diagnosed by observation, I would have thought. Certainly helmeted and helmetless alike can be concussed. Of course, like Syd, I would hope to show my alertness by telling them the foam hat was irrelevant. My reaction might reassure them!
Many doctors are free with advice on how to mitigate the consequence of impact, but not from any knowledge of helmet efficacy. They presumably have not read Siegelhalter's and Goldacre's BMJ editorial.
We are often told by helmeteers that doctors are an authority on helmets who should be heeded.

User avatar
Syd
Posts: 375
Joined: 23 Sep 2018, 2:27pm

Re: Helimeds.

Postby Syd » 27 Dec 2019, 7:32pm

Steady rider wrote:....Doctors may well ask about helmets for general information or to see if the person can discuss the accident and is showing any signs of concussion. The important part is knowing why the accident happened and how it could have been avoided.

I don’t have a problem with them asking once but pressing the point and asking three times is going to far especially as the patient (me in this case) has already been assessed by a risk response paramedic and an ambulance crew and, during handover, a GCS of 15 was mentioned and head injury/ possibility of concussion ruled out.

User avatar
Syd
Posts: 375
Joined: 23 Sep 2018, 2:27pm

Helimeds.

Postby Syd » 27 Dec 2019, 7:34pm

Mike Sales wrote:
Steady rider wrote:I do not recall any specific statistical analysis detailing parts to seriously question the findings. Doctors may well ask about helmets for general information or to see if the person can discuss the accident and is showing any signs of concussion. The important part is knowing why the accident happened and how it could have been avoided.


How the accident can be avoided is of course important. Doctors do not ask any questions that might help with that. That is not their job, repair is.
Concussion is best diagnosed by observation, I would have thought. Certainly helmeted and helmetless alike can be concussed. Of course, like Syd, I would hope to show my alertness by telling them the foam hat was irrelevant. My reaction might reassure them!
Many doctors are free with advice on how to mitigate the consequence of impact, but not from any knowledge of helmet efficacy. They presumably have not read Siegelhalter's and Goldacre's BMJ editorial.
We are often told by helmeteers that doctors are an authority on helmets who should be heeded.

I work at the hospital I was taken to and discussed that for a few minutes prior to being questioned on injuries. I would have thought that, and the handover would have been enough to demonstrate the lack on head injury/ concussion.

Marcus Aurelius
Posts: 1004
Joined: 1 Feb 2018, 10:20am

Re: Helimeds.

Postby Marcus Aurelius » 27 Dec 2019, 7:50pm

The risks are totally different. Stop comparing apples with dishcloths. Cycle helmets reduce the risk of head injuries whilst cycling, anyone who thinks differently really needs to think about it a bit harder

Mike Sales
Posts: 4418
Joined: 7 Mar 2009, 3:31pm

Re: Helimeds.

Postby Mike Sales » 27 Dec 2019, 8:03pm

Marcus Aurelius wrote:The risks are totally different. Stop comparing apples with dishcloths. Cycle helmets reduce the risk of head injuries whilst cycling, anyone who thinks differently really needs to think about it a bit harder


Ben Goldacre, Wellcome research fellow in epidemiology, David Spiegelhalter, Winton professor for the public understanding of risk.

In any case, the current uncertainty about any benefit from helmet wearing or promotion is unlikely to be substantially reduced by further research. Equally, we can be certain that helmets will continue to be debated, and at length. The enduring popularity of helmets as a proposed major intervention for increased road safety may therefore lie not with their direct benefits—which seem too modest to capture compared with other strategies—but more with the cultural, psychological, and political aspects of popular debate around risk.


https://www.badscience.net/2013/12/bicycle-helmets-and-the-law-a-perfect-teaching-case-for-epidemiology/

"Too modest to capture", if helmets really reduce the risks, you should be able to capture the benefits statistically,, don't you think?

I am not clear on which are dishcloths and which are apples!

Marcus Aurelius
Posts: 1004
Joined: 1 Feb 2018, 10:20am

Re: Helimeds.

Postby Marcus Aurelius » 27 Dec 2019, 8:24pm

Mike Sales wrote:
Marcus Aurelius wrote:The risks are totally different. Stop comparing apples with dishcloths. Cycle helmets reduce the risk of head injuries whilst cycling, anyone who thinks differently really needs to think about it a bit harder


Ben Goldacre, Wellcome research fellow in epidemiology, David Spiegelhalter, Winton professor for the public understanding of risk.

In any case, the current uncertainty about any benefit from helmet wearing or promotion is unlikely to be substantially reduced by further research. Equally, we can be certain that helmets will continue to be debated, and at length. The enduring popularity of helmets as a proposed major intervention for increased road safety may therefore lie not with their direct benefits—which seem too modest to capture compared with other strategies—but more with the cultural, psychological, and political aspects of popular debate around risk.


https://www.badscience.net/2013/12/bicycle-helmets-and-the-law-a-perfect-teaching-case-for-epidemiology/

"Too modest to capture", if helmets really reduce the risks, you should be able to capture the benefits statistically,, don't you think?

I am not clear on which are dishcloths and which are apples!


The problem comes when you have to say a helmet saved a life. Corpses tend not to be able to talk too much.

Mike Sales
Posts: 4418
Joined: 7 Mar 2009, 3:31pm

Re: Helimeds.

Postby Mike Sales » 27 Dec 2019, 8:32pm

Marcus Aurelius wrote:The problem comes when you have to say a helmet saved a life. Corpses tend not to be able to talk too much.


I really can't imagine how you think this means anything.

When helmet wearing by cyclists in Australia went from about a third to nearly 100%, overnight, because of a new law, the drop in head injury rate ought to have been unmistakeable, if there was any benefit. However, the rate barely changed, but for the worse.

User avatar
Syd
Posts: 375
Joined: 23 Sep 2018, 2:27pm

Helimeds.

Postby Syd » 27 Dec 2019, 8:44pm

Mike Sales wrote:
Marcus Aurelius wrote:The problem comes when you have to say a helmet saved a life. Corpses tend not to be able to talk too much.


I really can't imagine how you think this means anything.

When helmet wearing by cyclists in Australia went from about a third to nearly 100%, overnight, because of a new law, the drop in head injury rate ought to have been unmistakeable, if there was any benefit. However, the rate barely changed, but for the worse.

The problem using Australia as an example is that cyclists numbers dropped and a raft of new laws have come in making cyclists lives harder in what already appeared to be a cyclist hating nation.

Don’t get me wrong, I am pro choice and my experience in the ER annoying me as much as I’m sure it annoys the anti-helmet lobbyists.

Mike Sales
Posts: 4418
Joined: 7 Mar 2009, 3:31pm

Re: Helimeds.

Postby Mike Sales » 27 Dec 2019, 8:47pm

Syd wrote:The problem using Australia as an example is that cyclists numbers dropped and a raft of new laws have come in making cyclists lives harder in what already appeared to be a cyclist hating nation.


The point about using Australia is that a sudden, large jump in wearing by a whole population should have produced an immediate and obvious improvement in injury rate. The laws came later. The drop in numbers did not.

User avatar
Syd
Posts: 375
Joined: 23 Sep 2018, 2:27pm

Helimeds.

Postby Syd » 27 Dec 2019, 8:57pm

Mike Sales wrote:
Syd wrote:The problem using Australia as an example is that cyclists numbers dropped and a raft of new laws have come in making cyclists lives harder in what already appeared to be a cyclist hating nation.


The point about using Australia is that a sudden, large jump in wearing by a whole population should have produced an immediate and obvious improvement in injury rate. The laws came later. The drop in numbers did not.

Change the law to enforce helmet wearing and you potentially change the mindset of the motorists which brings unintended outcomes. Changes seldom happen in isolation.
Last edited by Syd on 27 Dec 2019, 8:57pm, edited 1 time in total.