This used to be an old feature that was long forgotten before we did the switch to baycode. It was shortlived as the organ printer and didn't see a lot of attention.
What I'm suggesting is that you can't reach your radio when you're in paincrit on the ground or if you're handcuffed. It doesn't automatically activate. Ergo, in cases where you cannot fathomably activate your headset like that, you shouldn't be able to yelp into comms in the event you get floored due to weakening or by being restrained.
What this does, both with positive and negative consequences:
1.) Gives antagonists an added edge of being able to stun someone with one measure or another without too much risk of the person being targeted yelping into their headset like a whinybaby player rather than an actual character that would avoid being killed faster because they ratted out the guy attacking them. This specifically allows certain drugs to be used effectively to sedate targets, unlike now in which people can yell to everyone who's killing them at X, Y, Z coordinates!
2.) Inadvertently gives security much of the same edge.
3.) Changes up the meta a bit for people to communicate in different manners before they give chase to a confirmed antag lest they get stun-cheesed and dragged off into maintenance, allowing for more tense rounds in which people stop mysteriously responding.
4.) Will probably end up in people keying up ;HELP! as a macro whenever they have a spidey sense of an antag about to sneeze in their general direction.
This was an old bit of code so I don't recall exactly how Scopes did it from years back to make this feature work, but it was pretty robust.
Praise the sun, and pray that it shine forever!