In what scenario should an athletic helmet be removed during transport?

Removing an athletic helmet during transport is warranted when airway access is obstructed. In emergency situations, maintaining a clear airway is the highest priority. If the helmet impedes the ability to ventilate or intubate the patient effectively, it needs to be removed, despite the potential risks associated with movement of the head and neck. Ensuring that the patient can breathe is essential, and if the helmet interferes with that, it must be taken off to provide adequate airway management.

Having a responsive patient does not justify helmet removal if there are no complications with airway access. Tight helmets may pose discomfort but do not necessarily compel removal unless they also cause airway issues. Additionally, comfort is subjective and not a valid reason for removal in emergencies where the threat to airway integrity exists. Therefore, the priority in emergency care is always to secure the airway first, making the scenario of obstructed airway access the correct context for helmet removal.