From the VISN 8 Patient Safety Center of Inquiry, James A. Haley VA Hospital and Clinics.
Brains, Inc, San Antonio, Florida.
J Patient Saf. 2022 Jan 1;18(1):e205-e210. doi: 10.1097/PTS.0000000000000736.
The aims of the study were to evaluate and to compare protective properties of commercially available medical helmets for a set of standardized head injury risk measures.
Eleven helmet types were evaluated to represent the variety of commercially available medical helmet designs and manufacturers. A test mannequin and sensor apparatus were used to simulate a backward-standing fall. The head/neck size, mass, and "standing" height of the mannequin (5'9″) were representative of a 50th percentile male. A triaxial array was placed at the head center of mass to position 3 linear accelerometers and 3 angular rate sensors. Data were collected for 5 single trials for each helmet, as well as 5 repeated trials. Five trials were also collected with no helmet scenarios. Three head injury risk measures were examined (linear acceleration, angular acceleration, and head injury criterion). Data were analyzed by clinical cutoff thresholds and continuous values.
Helmets varied in their performance across head injury risk measures. All helmets provided higher levels of protection compared with no helmet scenarios. No helmets were protective for subdural hematoma (measured by angular acceleration). All helmets lost protective properties with repeated falls. Results for skull fracture risk were inconsistent between linear acceleration and head injury criterion injury risk measures.
No helmets were protective across all head injury risk measures. Medical helmets may reduce some fall injury severity but may not prevent all types of head injury. All helmets exhibited worsening of protective properties with repeated falls. We recommend medical helmets be replaced after each fall incident where the helmet impacts another surface.
本研究旨在评估和比较多种市售医用头盔对一系列标准化头部损伤风险指标的防护性能。
评估了 11 种头盔类型,以代表市售医用头盔设计和制造商的多样性。使用测试假人和传感器设备模拟向后站立的跌倒。假人的头/颈尺寸、质量和“站立”高度(5'9")代表 50 百分位男性。三轴阵列放置在头质量中心,以定位 3 个线性加速度计和 3 个角速率传感器。对于每种头盔,收集了 5 个单次试验和 5 个重复试验的数据。还收集了 5 个无头盔情况的试验数据。检查了 3 种头部损伤风险指标(线性加速度、角加速度和头部损伤准则)。数据通过临床截止阈值和连续值进行分析。
头盔在头部损伤风险指标方面的性能存在差异。与无头盔情况相比,所有头盔均提供更高水平的保护。无头盔对硬膜下血肿(通过角加速度测量)具有保护作用。所有头盔在重复跌倒后失去了保护性能。线性加速度和头部损伤准则损伤风险指标的颅骨骨折风险结果不一致。
没有头盔在所有头部损伤风险指标方面都具有保护作用。医用头盔可以降低某些跌倒损伤的严重程度,但可能无法预防所有类型的头部损伤。所有头盔在重复跌倒后保护性能均恶化。我们建议在头盔与其他表面碰撞的每次跌倒事件后更换医用头盔。