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2 piece may be safer than a 1 piece? ... hmmm ...

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Nixon
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PostPosted: 14:28 - 25 Jun 2009    Post subject: 2 piece may be safer than a 1 piece? ... hmmm ... Reply with quote

Here is an interesting point to ponder! While doing some research about motorcycle rider injuries and the way they are managed in a pre hospital setting, i came across a lot of interesting information regarding the risks and the potentials for injurys for us all.

It is a well known fact that riders can suffer an open book fracture to the pelvis from direct impact on the tank. This has the potential to cause massive internal bleeding which could lead to death - very quickly!
Modern, well fitted leathers do a very effective job at immobilising the hip and stop it from further displacing - reducing the risk of blood loss so it is not advised to remove the lower section of leathers in a case of a pelvic injury.

However chest injuries are also common and bleeding into the lung can kill you just as quick, a paramedics/doctor needs to expose your chest in order to assess and ensure you have no serious injuries.

Now imagine if you are wearing a 1 piece and a para cuts off your top half, but leaves the bottom in place. This leaves no structural support arround the waist as in a 1 piece there is no need for it as the support is coming from the shape of the entire article, you cut that you will lose rigidity.

Now in the same situation if you are wearing a 2 piece and the para removes the top they don't even have to touch the bottom half, it is still offering the best possible support it can, which as it has a waist belt and is designed to support itself will offer greater protection to the hip than a dissected 1 piece.

And to be honest i can't find any real reason to chose a 1 piece over a 2 piece apart from the distrust of the zip middle (and the tart factor Wink ). and if i distrusted the zip i would certianly distrust the rest of the seams in the suit, so that kind of flaws that argument.

What do you guys think about this? .....
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UnknownStuntm...
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PostPosted: 14:42 - 25 Jun 2009    Post subject: Reply with quote

you think too much. Thumbs Up
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Wafer_Thin_Ham
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PostPosted: 14:58 - 25 Jun 2009    Post subject: Reply with quote

If what you say is true then why can you only race in a one piece suit?

Although racing injuries tend to be different from road ones.
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Luke_Retrofly
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PostPosted: 15:02 - 25 Jun 2009    Post subject: Reply with quote

I believe if they are cutting off your jacket they will more than likely cut off the the bottom half to check for injuries too.
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multijoy
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PostPosted: 15:13 - 25 Jun 2009    Post subject: Reply with quote

It's worth considering that if you're at the point of cutting the leathers open, you've probably got sufficient trauma managment in place to deal with the consequences of easing the pressure, including immobilisation.

Also, there's no point protecting the pelvis if the casualty is going to suffocate instead!
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Nixon
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PostPosted: 16:30 - 25 Jun 2009    Post subject: Reply with quote

Quote:
If what you say is true then why can you only race in a one piece suit?


Exactly the point i am trying to raise, Why is this the case? What evidence or theory was the original decision made upon? And is this the safest and most efficient method? look at advances in leather design even from the 80s to todays, huge differences.
Is it time for a review?

Quote:
Although racing injuries tend to be different from road ones.

Granted they can be but anatomy and physiology doesn't.
A broken pelvis on track is exactly the same as on the road, your just more likely to have multiple injuries and more at risk of sustaining them on the road. There is no evidence i have found that says track sustained injuries are any different to road sustained injuries.

Quote:
I believe if they are cutting off your jacket they will more than likely cut off the the bottom half to check for injuries too.

What makes you think that? I need to expose your chest because most thoracic injuries cannot be assessed or diagnosed through clothing, whereas serious lower limb injuries are going to be pelvis, neck of femur, midshaft of femur, or other bony injuries, all of which can be diagnosed without exposure, removing leathers to assess for injury on scene will cause undue risk, they need immobilisation and support. removal of leather just to have a look is not acceptable practice.

Quote:
It's worth considering that if you're at the point of cutting the leathers open, you've probably got sufficient trauma managment in place to deal with the consequences of easing the pressure, including immobilisation.


This is the point, pre hospital we shouldn't be exposing the lower limbs or pelvis. I don't have a theater in the back of my ambulance to deal with a ruptured femoral artery. Fluid replacement only goes so far. and unfortunately its not far enough.

as for immobilisation the patient should already be boarded but if anyone can show me a way of exposing lower limbs while still maintaining sufficient pelvic immobilisation i'm willing to learn....#

Quote:
Also, there's no point protecting the pelvis if the casualty is going to suffocate instead

Would never happen as ACBC are the priorities, but in the overall picture, securing a compromised airway if the patient is hypovalaemic isn't going to provide that much benefit them because the o2 or (lack of) in the blood stream will not perfuse the tissues as its bleeding out of the rupture.
But i agree Airway is always the first thing to be secured.
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D O G
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PostPosted: 16:53 - 25 Jun 2009    Post subject: Reply with quote

nixon wrote:
There is no evidence i have found that says track sustained injuries are any different to road sustained injuries.


Oh I don't know, I've never seen a racer run into the side of a car on the track, or be crushed against a fencepost by a car either.

Come to that I've never seen anyone on the road highside at 120mph then skid into a massive gravel trap, tumbling end over end over end.

I would have thought that the types of injuries racers incur are significantly different to those sustained on the road.

I mean I haven't actually looked at any hard facts, but then again, have you, and if so, what?
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The999Kid
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PostPosted: 17:23 - 25 Jun 2009    Post subject: Reply with quote

Luke wrote:
I believe if they are cutting off your jacket they will more than likely cut off the the bottom half to check for injuries too.


Secondary survey of the pelvis, legs and feet can be performed through leathers are they are thin enough to transmit any artefacts through to the paramedics hands... what we cant see though is bruising and incisions from the collision.
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Pete.
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PostPosted: 17:37 - 25 Jun 2009    Post subject: Reply with quote

nixon wrote:
Quote:
If what you say is true then why can you only race in a one piece suit?


Exactly the point i am trying to raise, Why is this the case? What evidence or theory was the original decision made upon? And is this the safest and most efficient method? look at advances in leather design even from the 80s to todays, huge differences.
Is it time for a review?


Zippers are crap, that's why.

One piece leathers are mandatory because two-piece leathers can and do split at the weakest point which is the zip (not the stitching to the zip or seams) and expose the rider's back to the tarmac. Ever had a zipper with one knackered link? They constantly keep undoing themselves with very little force. Stitched seams don't do that, in fact when did you last see any leathers where the stitching had failed alone? Never I bet, yet zippers can and do. I have an old & battered one-piece and the only reason I can't wear it is the zipper won't stay done up.
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The999Kid
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PostPosted: 17:42 - 25 Jun 2009    Post subject: Reply with quote

Geri wrote:

Zippers are crap, that's why.

One piece leathers are mandatory because two-piece leathers can and do split at the weakest point which is the zip (not the stitching to the zip or seams) and expose the rider's back to the tarmac. Ever had a zipper with one knackered link? They constantly keep undoing themselves with very little force. Stitched seams don't do that, in fact when did you last see any leathers where the stitching had failed alone? Never I bet, yet zippers can and do. I have an old & battered one-piece and the only reason I can't wear it is the zipper won't stay done up.


And in place of zippers to secure the 2 'halves' together, you would suggest.....?
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Nixon
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PostPosted: 18:25 - 25 Jun 2009    Post subject: Reply with quote

Damofo D.O.G. wrote:

Oh I don't know, I've never seen a racer run into the side of a car on the track, or be crushed against a fencepost by a car either.

Come to that I've never seen anyone on the road highside at 120mph then skid into a massive gravel trap, tumbling end over end over end.

I would have thought that the types of injuries racers incur are significantly different to those sustained on the road.


Every incident is unique, with different factors and variables, every injury is also different and every patient should be treated as an individual patient, however in most pre hospital situations the treatment stays the same. If i feel it is an unstable pelvis i am going to treat it with the best care pathway for the presenting injury, regardless of how it is caused.
An unstable pelvis is an unstable pelvis, that is all i will know on scene, i don't have xray, i dont have an orthopedic consultant, all i know is that its unstable and an unstable pelvis has the potential to cause serious blood loss potentially leading to death = bad! Sad

Quote:
I mean I haven't actually looked at any hard facts, but then again, have you, and if so, what?

I have looked at quite a lot, and i have written quite a lot on the subject too, and have spoken with a lot of people who have lots of experience in the field of both biking incidents and major trauma management. and then found any research or articles that do or don't support what they are saying.
And this is also a filed i am considering doing a full blown publishable research piece on, so just testing the water with ideas at the min.

Do you have access to athens? If you do i can forward you quite a few really good articles as a place to start and you can do your own research
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carlperkins00...
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PostPosted: 18:26 - 25 Jun 2009    Post subject: Reply with quote

I change between 1 and 2 piece.
1 piece is comfier on the bike and looks awesome.
2 piece isnt so comfy but i can walk around better, dont look as good though.
both offer good protection.

look at it this way... no matter if its a 2 piece or a 1 piece, if you break your pelvis your gonna have a little trouble. best thing is to not move and wait for an ambulance to arrive. im sure the paramedics will thoroughly assess the situation before they go tearing your leathers off, the same thing they do with your helmet.

if they dont.. well at least they will get sued.
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carlperkins00...
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PostPosted: 18:28 - 25 Jun 2009    Post subject: Reply with quote

Quote:
I mean I haven't actually looked at any hard facts, but then again, have you, and if so, what?


im about 95% sure that was sarcasm...
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Nixon
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PostPosted: 18:38 - 25 Jun 2009    Post subject: Reply with quote

Geri wrote:


Zippers are crap, that's why.

One piece leathers are mandatory because two-piece leathers can and do split at the weakest point which is the zip (not the stitching to the zip or seams) and expose the rider's back to the tarmac. Ever had a zipper with one knackered link? They constantly keep undoing themselves with very little force. Stitched seams don't do that, in fact when did you last see any leathers where the stitching had failed alone? Never I bet, yet zippers can and do. I have an old & battered one-piece and the only reason I can't wear it is the zipper won't stay done up.


Its a good point, and definitely a factor that should be addressed, but don't really think its an acceptable reason to just say that they are crap, i need real evidence and references for why they are crap, is it just a manufacturing compromise between cost and quality, or is it that zips are not an adequate method and other items should be explored? its an area that needs to be researched and addressed (or found if its already been published)


This is a really good thing going here, getting loads of good ideas and ways to take this... keep it up
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Dr. DaveJPS
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PostPosted: 18:52 - 25 Jun 2009    Post subject: Reply with quote

well surely you are still getting support from the lower half of the leathers, unless they are massivly baggy. and also something i'm surprised hasn't been mentioned is the support your waist gets from teh kidney belt of a (good) backprotecter.

just a few ideas
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fra-zzr
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PostPosted: 19:09 - 25 Jun 2009    Post subject: Reply with quote

hey nixon, i just recently came of in 2 piece leathers breaking my pelvis a few times among other things, have athens access and would really be interested in the articles you mentioned,

cheers
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multijoy
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PostPosted: 19:24 - 25 Jun 2009    Post subject: Reply with quote

If belted trousers are effective, why not carry the-yet-to-be-invented-but-I'm-claiming-the-royalties-if-it-is TrouserSecurer?

A wide webbing-type belt with non-slip/adhesive/friction thing on the inside. Secure around your patient to maintain the outfit, start chopping away merrily above it...

Granted, it seems like it's a solution waiting for a problem, but that's what the internet is for Wink

In all seriousness, though, how much pressure is needed to keep things in place? Is the effect of leathers an actual design feature, or just one of those happy coincidences?

Is there not some sort of inflatable hip splint/box thing that could be used, or am I just imaging things again?
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Nixon
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PostPosted: 19:43 - 25 Jun 2009    Post subject: Reply with quote

multijoy wrote:
If belted trousers are effective, why not carry the-yet-to-be-invented-but-I'm-claiming-the-royalties-if-it-is TrouserSecurer?

A wide webbing-type belt with non-slip/adhesive/friction thing on the inside. Secure around your patient to maintain the outfit, start chopping away merrily above it...

Granted, it seems like it's a solution waiting for a problem, but that's what the internet is for Wink

In all seriousness, though, how much pressure is needed to keep things in place? Is the effect of leathers an actual design feature, or just one of those happy coincidences?

Is there not some sort of inflatable hip splint/box thing that could be used, or am I just imaging things again?


There is a device salled a SAM Splint designed to be used to support pelvic fractures, as well as act as a manual handling aid
https://www.spservices.co.uk/images/sp101-description.jpg However not many UK trusts have these as standard on all road vehicles. Another issue with this product is once its attached it is essentially only doing the same job as the leathers anyway. We also carry a set of various sized webbing straps that are used to imobilise.

but the method of imobilisation is not what i am trying to examine, that has been done and decided. Its the dangers of a unstable pelvic fractires specifically to bikers and it seems that cutting of leathers for examination could potentially cause an issue, My article im currently writing is to highlight this to other pre hospital health professionals.

I am just fishing for ideas and arguments that could counter what i am trying to say.
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Pete.
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PostPosted: 20:33 - 25 Jun 2009    Post subject: Reply with quote

ProvectusIncurro wrote:
Geri wrote:

Zippers are crap, that's why.

One piece leathers are mandatory because two-piece leathers can and do split at the weakest point which is the zip (not the stitching to the zip or seams) and expose the rider's back to the tarmac. Ever had a zipper with one knackered link? They constantly keep undoing themselves with very little force. Stitched seams don't do that, in fact when did you last see any leathers where the stitching had failed alone? Never I bet, yet zippers can and do. I have an old & battered one-piece and the only reason I can't wear it is the zipper won't stay done up.


And in place of zippers to secure the 2 'halves' together, you would suggest.....?


Stitching the top half to the bottom half to make a one-piece Wink
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chris-red
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PostPosted: 20:50 - 25 Jun 2009    Post subject: Reply with quote

Do you actually ride a bike or are you a just a student nurse?



Of course track accidents are way different from road incidents.


https://www.focusedevents.com/images/pics/BCE_r6portimao.web.jpg

Notice the large grass/gravel run offs? and how you could easily be doing 160 as you approach a corner.

https://www.goodguyswearblue.com/_photos/big/London-Road-Where-I-Crashed-into-the-Drunk-Driver.jpg

Now notice the railings parked cars and side roads.


You will probably not be doing more than 60 around town on a bike, a track you could be doing 160.

There are ar more things you can hit and that can hit you on the road, there is usually very little run off and the hings you hit will be solid. On a track you have loads of run off and anything you will likely hit (apart from the ground) will probably have some kind of cushioning.
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Wafer_Thin_Ham
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PostPosted: 20:53 - 25 Jun 2009    Post subject: Reply with quote

As Geri says 1 pieces are specified on track because from an abrasion and burst point of view they are stronger. At all points during the actual crash they are safer.

I'm not even sure the pelvis example is true on the track. It's certainly not hugely common.

Correct me if I'm wrong, but the broken pelvis occurs when you fly over the front of the bike, but your legs are restrained by the tank. The most common way for this to happen would be in a head on with a car, as there are no cars on track it's rather a moot point.

Perhaps one piece leathers need an internal belt that could be fastened before riding and thus providing the support you need.
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T.C
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PostPosted: 20:58 - 25 Jun 2009    Post subject: Reply with quote

I covered this subject some considerable time ago (the original is in the history files somewhere) where, based on 25 years and 20,000+ motorcycle accident investigations, and working with SATRA and other bodies, I wrote about why two piece is safer on the road over a 1 piece which is a requirement for racing.

I still stand by this observation, and since I wrote the original paper, I have looked atr a further 7,500 bike accidents, and riders in two piece suits in ROAD accidents usually come out of it better than those in 1 piece.

But regardless of whether it is 1 piece or 2 piece, the biggest problem or causation of injury after the impact is the poor fit, poor quality of the garment (despite some big brand name claims) and a lack of understanding of what leather (or any other type of protective clothing) is meant to behave like in an accident.

In some areas because of some of the gimmicks, the level of protection has actually decreased, but riders are too easily brainwashed by the brand name or the salesman Shocked Embarassed

So to answer the original question, for the road, 2 piece is safer than a 1 piece for all the reasons you mention, although it looks like someone has copied my original article which appeared in a number of magazines about 6 years ago.
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Pete.
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PostPosted: 20:58 - 25 Jun 2009    Post subject: Reply with quote

Busted pelvis isn't a terrifically common biking injury - and just as well because it's probably ythe most life-threatening bone to break. I don't really see the argument for 2-piece giving pelvic support anyway, as the typical 2-piece leather trousers belt-line is higher than normal trousers/jeans and around your waist not your pelvis anyway.

Unless you're going for 'anti-fit' like you see in the adverts that is Smile
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Wafer_Thin_Ham
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PostPosted: 21:00 - 25 Jun 2009    Post subject: Reply with quote

Do these anti-fit leathers come with a flap so you can show off your boxers too? Laughing
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sickpup
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PostPosted: 00:30 - 26 Jun 2009    Post subject: Reply with quote

Geri wrote:
Busted pelvis isn't a terrifically common biking injury -


Supposedly becoming more common due to higher tanks on modern bikes according to the student Dr's who lived a few doors up from mine.
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