Helmet use in preventing acute concussive symptoms in recreational vehicle related head trauma

BACKGROUND Helmet use is now viewed as an essential safety measure in almost all sports involving a high risk of impact and head trauma, from horseback riding to mountain biking, rock climbing and winter sports such as skiing and snowboarding. For young skiers and snowboarders under the age of 14, the use of certified helmets is compulsory in Italian law, although no defined regulations exist for recreational sledding OBJECTIVE To review past and current regulations covering winter sports, to explore potential legal discrepancies in appraising factors related to helmet use in recreational activities by children under the age of 14, and to identify hazards connected with various types of sledding accidents METHODS Descriptive data of the cases of 16-year-old or younger adolescents injured while sledding without helmets were gathered from injury reports collected by ski patrols, pre-hospital emergency services and emergency departments, and compared with 53 cases of adolescents and children who went skiing and snowboarding wearing certified helmets, over two winter seasons (December to April, 2011-12 and 2012-13). Sledges were grouped into three categories:1) traditional wooden toboggans (hereafter called ‘traditional sleds’); 2) plastic sleds; 3) newly designed sleds (with inner tubes, plastic and hard foam sleds, snowskates, boardslides, runslides, snowblades, foam slides, etc.) RESULTS Descriptive data of the cases of 16-year-old or younger adolescents injured while sledding without helmets were gathered from injury reports collected by ski patrols, pre-hospital emergency services and emergency departments, and compared with 53 cases of adolescents and children who went skiing and snowboarding wearing certified helmets, over two winter seasons (December to April, 2011-12 and 2012-13). Sledges were grouped into three categories:1) traditional wooden toboggans (hereafter called ‘traditional sleds’); 2) plastic sleds; 3) newly designed sleds (with inner tubes, plastic and hard foam sleds, snowskates, boardslides, runslides, snowblades, foam slides, etc.) CONCLUSIONS Additional investigation of the actual dynamics of the accident, together with information on the sitting position and sled speed are required. Regulations should compel ski slope operators to improve the current level of control on sledding slopes.

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Alcohol consumption, helmet use and head trauma in cycling collisions in Germany

Accident Analysis & Prevention ◽

10.1016/j.aap.2013.12.019 ◽

2014 ◽

Vol 65 ◽

pp. 97-104 ◽

Cited By ~ 25

Author(s):

Chiara Orsi ◽

Ottavia E. Ferraro ◽

Cristina Montomoli ◽

Dietmar Otte ◽

Anna Morandi

Keyword(s):

Alcohol Consumption ◽

Head Trauma ◽

Helmet Use

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Impact of Helmet Use in Traumatic Brain Injuries Associated with Recreational Vehicles

Advances in Preventive Medicine ◽

10.1155/2013/450195 ◽

2013 ◽

Vol 2013 ◽

pp. 1-6 ◽

Cited By ~ 12

Author(s):

Latha Ganti ◽

Aakash N. Bodhit ◽

Yasamin Daneshvar ◽

Pratik Shashikant Patel ◽

Christa Pulvino ◽

...

Keyword(s):

Brain Injuries ◽

Hospital Length ◽

Hospital Length Of Stay ◽

Safety Education ◽

Helmet Use ◽

Vehicle Accidents ◽

Recreational Vehicles ◽

Observational Cohort ◽

The Impact ◽

Recreational Vehicle

Objective. To study the impact of helmet use on outcomes after recreational vehicle accidents.Methods. This is an observational cohort of adult and pediatric patients who sustained a TBI while riding a recreational vehicle. Recreational vehicles included bicycles, motorcycles, and all-terrain vehicles (ATVs), as well as a category for other vehicles such as skateboards and scooters.Results. Lack of helmet use was significantly associated with having a more severe traumatic brain injury and being admitted to the hospital. Similarly, 25% of those who did wearing a helmet were admitted to the ICU versus 36% of those who did not (P=0.0489). The hospital length of stay was significantly greater for patients who did not use helmets.Conclusion. Lack of helmet use is significantly correlated with abnormal neuroimaging and admission to the hospital and ICU; these data support a call for action to implement more widespread injury prevention and helmet safety education and advocacy.

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48. Age, Sex, Ethanol Levels, and Helmet Use Among Injured Motorcyclists

Prehospital and Disaster Medicine ◽

10.1017/s1049023x00045696 ◽

1996 ◽

Vol 11 (S2) ◽

pp. S32-S32

Author(s):

William B. Lober ◽

Daniel G. Judkins

Keyword(s):

Head Trauma ◽

Case Series ◽

Regional Level ◽

Trauma Centers ◽

Prevention Strategies ◽

Helmet Use ◽

Ethanol Level ◽

The Mean ◽

Level I ◽

Motorcycle Injuries

Introduction: Previous studies of motorcycle injuries show that helmet use is associated with a decrease in head trauma. Understanding patterns of helmet use is important in selecting and assessing injury prevention strategies.Methods: All 470 motorcyclists presenting to either of two regional Level I trauma centers from 7/93 through 12/95 comprise this case series. Thirty-three patients were excluded due to unknown helmet use or outcome, and 50 due to age under 18 years (for whom helmet use was required by state law).Results: Of 386 patients, 42% wore helmets, and 58% did not, with no difference in the mean ages of the groups. 13% of patients were women (n = 50), and 10% were passengers (n = 38). Women were 25 times more likely than men to be passengers (95% CI: 11 to 50), and passengers were 5 times more likely than drivers to not wear a helmet (95% CI: 2 to 16). Helmet use was not related to sex, even when the data were controlled for driver vs. passenger. Of 265 patients assayed for ethanol, 30% had >100 mg/dL, 7% had <100 mg/dL, and 63% had none. Non-helmeted patients were 3.6 more likely than helmeted ones to have detectable ethanol (95% CI: 2.0 to 6.5), but there was no association with sex or age. The mean ethanol level was 80 mg/dL in non-helmet users, and 24 mg/dL in helmet users (p <0.001). 39% of non-helmeted patients were legally intoxicated (ethanol > 100 mg/dL), compared to 11% of helmeted ones.

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Resources: Internet Resources for the Independent Medical Evaluator – 2007

Guides Newsletter ◽

10.1001/amaguidesnewsletters.2007.julaug02 ◽

2007 ◽

Vol 12 (4) ◽

pp. 4-7

Author(s):

Christopher R. Brigham ◽

Jenny Walker

Keyword(s):

Head Trauma ◽

Clonic Seizure ◽

Acute Subdural Hematoma ◽

Orbital Fracture ◽

Orbital Wall ◽

First Occurrence ◽

One Year ◽

The One ◽

Neurological Injuries ◽

Medial Orbital Wall

Abstract Rating patients with head trauma and multiple neurological injuries can be challenging. The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, Section 13.2, Criteria for Rating Impairment Due to Central Nervous System Disorders, outlines the process to rate impairment due to head trauma. This article summarizes the case of a 57-year-old male security guard who presents with headache, decreased sensation on the left cheek, loss of sense of smell, and problems with memory, among other symptoms. One year ago the patient was assaulted while on the job: his Glasgow Coma Score was 14; he had left periorbital ecchymosis and a 2.5 cm laceration over the left eyelid; a small right temporoparietal acute subdural hematoma; left inferior and medial orbital wall fractures; and, four hours after admission to the hospital, he experienced a generalized tonic-clonic seizure. This patient's impairment must include the following components: single seizure, orbital fracture, infraorbital neuropathy, anosmia, headache, and memory complaints. The article shows how the ratable impairments are combined using the Combining Impairment Ratings section. Because this patient has not experienced any seizures since the first occurrence, according to the AMA Guides he is not experiencing the “episodic neurological impairments” required for disability. Complex cases such as the one presented here highlight the need to use the criteria and estimates that are located in several sections of the AMA Guides.

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