"Oh, bollocks, he's not breathing", my colleague says. That's my cue to swear, drop my radio in the passenger seat, and come running to help him. This particular motorcyclist is wearing a full-face helmet, and he needs a solid dose of CPR to keep him from popping his clogs.

Usually, we find out about traffic incidents over the radio. Someone dials 999, or CCTV spot that something weird is going on with the traffic, and discover that two finely engineered boxes of iron and plastic have reduced each other to a set of insurance claims, and the driver and passengers to 'casualties'.

This time was different.

We drove past the scene of the accident just as it happened. The motorcyclist, in fact, came skidding past the police car as we pulled out of a junction where we had just finished with an incredibly griefy case of a sudden death caused by a drugs overdose.

"I think he's forgotten something", my operator remarked, and we both laughed* as we span the car around to block the road to find out what had happened.

In order to be able to do any type of CPR, you need to be able to give rescue breaths. To do that, you need access to the patient's mouth. You'll be unsurprised to learn that a full-face motorcycle helmet doesn't really help us in that respect, so we have to remove the helmet in order to start CPR.

"Hey", I hear you say. "I heard somewhere that you should never remove a motorcyclist's helmet if he's been in an accident". That is true; motorcycle accidents have a high rate of spinal and head injuries, and removing the helmet could cause further injury to the spinal column. However, in our job, we don't have much of a choice: If someone stops breathing, they have, at most, 4 minutes before they suffer serious brain damage. They need CPR, and to do that, the helmet has to come off, pronto.

So, my colleague and I start the painfully slow process of taking his helmet off: Undo the chin strap (goddamn double-D clasps...), one of us sticks our hands into the helmet to steady his head, whilst the other rocks the helmet back and forth very carefully to get it off them. All he while, the motorcyclist doesn't move a muscle It feels like an eternity, but we finally get it off. My colleague starts mouth-to-mouth as I zip the motorcyclist's jacket down in order to be able to do do CPR properly.

After he gets his rescue breaths, I start chest compressions. The first compression gives a horrible crunching sound. Here's one thing they don't really tell you in the CPR course: If you're doing it right, you're rather likely to break their sternum and ribs in the process. The first time it happened to me, I was so sickened that I ended up dry heaving, trying my damnedest not to throw up all over my own arms and my victim. I didn't stop giving CPR, though, to my credit. That guy didn't make it, sadly.

With this particular motorcyclist, we only get through two CPR cycles before the ambulance arrive. They have an AED on them, and start hooking the man up right away.

Almost immediately after the ambulance crew open up their bag of tricks on the man, he wakes back to life. His pale face suddenly turns bright red, his lips regain their colour, he gasps for air, and starts groaning nearly immediately. I feel a rush of blood run to my ears, my face, and my fingertips: It happens quite rarely that we manage to bring someone back from the dead, but it's an indescribable feeling when we do.

That, ladies and gentlemen, is one of the reasons why I absolutely love my job.

His chances looking a little bit better and I'm taking the liberty to let my mind wander for a moment. I'm puzzled to what may have happened to the motorcyclist; the road was clear and dry, the visibility was good, it was early afternoon, there wasn't a lot of traffic around, there wasn't anybody else involved in the accident, and I can't really see anything wrong with the bike. The paramedics pipe up with a possible answer after the man has been hooked up to one of their machines. I'm not a paramedic, you'll have to forgive the technical terms; It's a machine that goes 'beep' a lot. "This guy has just had a heart attack. We'll take him with us. I think he'll be fine."

The traffic guys show up to do an investigation; they always do, if there's a risk the collision is "life changing or life threatening". They concur with my initial assessment; nothing wrong with the road or the bike. No sign that he even tried to hit the brakes; he just tumbled off the side of the motorcycle at about 30 mph, went skating along the road straight past our police car, and came to a halt against a piece of road furniture. "Seems like the LAS guys were right", the traffic copper says. "Heart attack makes sense".

The man is conveyed to hospital at full speed, and we give the ambulance a bit of an escort on the way. He had a broken shin, a metric tonne of bruises, and his very first heart attack, but he did walk (well, hobble) out a few days later.

Epilogue: A note about helmets

When we first did our ELS course, one of the things we did was to remove a motorcycle helmet from a motorcyclist. That was the moment that I decided that full-face helmets weren't for me, and I swapped my Arai out in favour of a lovely Schuberth flip-front instead.

I'm not here to go into a discussion about what the safest helmets are; by and large, full-face helmets are safer. However, if you've been in an accident in traffic the benefits of a full-face are completely eradicated if the EMT's have to take your helmet off to save your life. Done too quickly, this can cause spinal column damage. Done too slowly, you run a serious risk of brain damage, because you're delaying the time between stopping breathing and getting crucial CPR.

You may have noticed that most motorcycle helmets have coloured bits on them; fasteners, buttons, etc: The bits that take your helmet off are usually red. That's not for the rider's benefit: They can't see it, after all. It's there for the emergency personnel. They don't know every single helmet ever created, but they know to look for 'red bits'. On flip-front helmets, the buttons that flip up the helmet are bright, red, and in places the ambulance guys know where to look for them.

If there is already an ambulance team on the scene, and they are looking after you, they'll leave your helmet on until you're safely in A&E. If you stop breathing, and you're wearing a full-face helmet, you've just given yourself a 30 to 45-second delay between needing help and getting it. If you're wearing a flip-front, the ambulance guys will flip your helmet open, and will be able to start resuscitation without delay.

The choice is up to you, of course. Personally, I'll only wear a full-face helmet if I'm on a race track. In traffic? Flip-fronts, all the way.

Stay out of trouble,

Matt Delito

*) You'll have to forgive the laughing; It's not that I don't feel bad for the guy or his family, but it's an auto-pilot response for emergency responders.

About Matt Delito

Matt Delito is the pseudonym for a police constable in the London Metropolitan Police. His blog is usually published on Wordpress, but is posted to E2 to get some additional feedback on the writing. For more posts in this series, see Matt Delito.

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