A tight-fitting motorcycle helmet should be left in place unless:

A tight-fitting motorcycle helmet is designed to protect the head and brain during impact, making it essential to leave it in place when possible. However, if it interferes with assessing the airway, it becomes crucial to remove the helmet. An obstructed airway can lead to inadequate oxygenation and respiratory failure, which requires immediate attention.

In situations where the helmet hinders your ability to clear or secure the airway, removal becomes necessary to ensure the patient's survival. The other options, while they may present considerations for the patient's condition, do not take precedence over the potential need to maintain an open airway. Maintaining airway integrity is a critical component of emergency care, thereby justifying the removal of the helmet in such circumstances.