Dr. Troy Madsen shares some of his first-hand experiences with helmet safety from the ER. He reminds listeners to still play it smart when it comes to safety, even if you're wearing a helmet.">

May 19, 2017 — Helmets are a vital piece of safety equipment for many activities and may save your life. But we may be depending on helmets a little too much. Emergency room physician Dr. Troy Madsen shares some of his first-hand experiences with helmet safety from the ER. He reminds listeners to still play it smart when it comes to safety, even if you're wearing a helmet.

Interview

Interviewer: Don't let that helmet make you think you're invincible. We'll talk about that next on The Scope.

Announcer: This is from The Frontlines with emergency room physician Dr. Troy Madsen on The Scope.

Interviewer: Dr. Troy Madsen's an emergency room physician at University of Utah Health and helmets are good. They can definitely protect you from a lot of injuries, but don't let them make you think you're invincible because there's a lot of other injuries helmets can't protect against that Dr. Madsen will see in the emergency room. Let's talk about that. Whether you're riding a bike or on a four-wheeler what are some of the not helmet related things that you see?

Dr. Madsen: Well, first of all, to address the myth with helmets because I've heard someone say this and this was a police officer who came in to the ER after an accident on his motorcycle, not while he was in his role as a police officer, he wasn't wearing a helmet and people are saying to him, "Why weren't you wearing your helmet? You've got bleeding in your head?"

Interviewer: Yeah, like of all people, you would think this guy . . .

Dr. Madsen: Of all people, yeah. And he said, "Well, the reason I didn't wear a helmet," he said, "because I figured the difference between wearing a helmet and not wearing a helmet on a motorcycle was the difference between an open casket funeral and a closed casket funeral" So first of all, that's a myth. Helmets are not going to just, you know, you're not going to die regardless. Helmets are going to make a huge difference for this guy. He could have avoided bleeding in his head.

Interviewer: A lot of times it can make the difference between whether you walk out of the ER that day or . . .

Dr. Madsen: Oh, absolutely.

Interviewer: Or not that day.

Dr. Madsen: With the helmet on, he would have walked out of the ER. As it was, he was admitted for several days, things turn out okay. So that's probably the first thing to address but it is absolutely true that helmets, on the other hand, do not make you invincible. People with helmets on can still have severe head injuries. You figure it's just some plastic and some cushion around your head, some padding, you can still have severe head injuries. You can absolutely have severe injuries. It's not covering your face so we'd absolutely see those things.

Interviewer: So the important thing is to not think, "Well, I've got my helmet so I'm okay. So I can try some crazy stuff."

Dr. Madsen: Exactly.

Interviewer: It's really, "I should still be careful and prudent." Plus also other injuries, right? That helmet's not going to protect your neck.

Dr. Madsen: Oh, no. Helmet's not going to do anything at all for your neck and cervical spine injuries, neck injuries are one of the also much more serious things we see along with severe head injuries but a helmet will do absolutely nothing to protect your neck. If you come down on your head, you're still going to have that same impact potentially fracturing vertebrae in there, causing spinal cord injury so you're not protected there at all.

Interviewer: What are some other injuries that you see, you know, from helmet related activities that helmets don't protect against?

Dr. Madsen: Well, they're the orthopedic injuries and that's, again, probably the most common thing we see in the ER from bicycles, motorcycles, four-wheelers, horses, you know, all these things where people have helmets on. People will come down and they'll catch themselves. They're not landing on their head. Maybe that's the secondary impact as their head hits the ground but they'll have a forearm fracture, ankle fractures, and knee injuries, ligament injuries.

And then of course, cuts, scrapes, all those sorts of things that happen as well. Helmets do absolutely nothing for that besides, like you said, maybe they make you feel a little more invincible, maybe you'd take some risks that makes you more prone to those things.

Interviewer: And it sounds like what you're saying is you should wear other safety gear other than just the helmet. The helmet has been the thing that's been promoted a lot but like if you're on a motorcycle, wear other stuff.

Dr. Madsen: Exactly. Yeah, I think most motorcyclists . . . I'm not a motorcyclist, but most of them talk to me about wearing their leathers and it seems like that makes a difference. Some guys have come saying they slid for 60 feet, separated from their bike, they'll come in with some road rash but otherwise, okay. And they said it scraped all the way through the leather but obviously, without that, they would have been in much worse shape. So there's definitely other stuff you can wear but definitely don't make that helmet feel like other stuff is not going to happen.

Interviewer: What's your advice to anybody that's participating in activity where a helmet is required along with maybe some other safety equipment?

Dr. Madsen: I mean, my advice and it's maybe wear the helmet to protect yourself from the bad stuff but also don't take risks you won't take without a helmet. It's there if you need it. But you don't want to have that helmet then raising your threshold for what you're willing to do simply thinking, "Hey, this helmet is going to protect me if I go at a higher speed or if I take this jump on my bike," or whatever it might be. If you won't do it without a helmet, don't do it with the helmet.

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