HEAD INJURY – WHY NOT WEAR THE HELMET

Recently, during a Fourth of July parade, many bikers, cyclists, gymnasts, cheerleaders, rollerskaters, Shriners’ clowns, speed-skaters, and even horseriders were watched with such intensity…and were applauded for their acts, high flying or racing speed. BUT……..Why not wear a helmet?

Some states have passed and then repealed helmet laws. There has been some emphasis on kids with bicycles to wear helmets, and some push to wear helmets during down-hill skiing. BUT…..Why not wear the helmet always?

Is it a personal right NOT to wear a helmet? Is it a business right then for taxpayers, insurers, employers, disability companies and worker comp programs to refuse coverage retrospectively for such injuries and morbidity when someone does NOT wear a helmet? What about a seat-belt? What about smoking, drinking, obesity, and lack of exercise? Sounds far fetched?

Well, back to the parade…..

The Emergency Departments see generally over 2 million head trauma victims annually in the United States.  It is the leading cause of death in persons under 25 years old, with over 50,000 persons dying yearly from head injury.

Head injury crosses all boundaries of socio-economics, ethnicity, financial burden, and coverage.  Just ask the attorney that fell from the bus he was watching a parade from…a little too much partying possibly…Ask his wife who was unrecognized by this smart man after hitting his head.  Life as it was…over…New rules, new learning, new start – ALL difficult to say the least.  Career, family, dreams, and hopes all snuffed due to the head injury.

Some patients have intra-cranial bleeding from their head injury, which is about 5-10%.   This means there is bleeding either in the brain itself, or around the brain under the skull.  Each of the types of bleeding is extremely serious.  Some do not need surgery, while other types of head injury with bleeding inside the skull require immediate life-saving procedures and surgeries. 

High risk groups for “closed” (no external injury) head injury that need a CT scan, which now is the standard, are kids under 6 months, elderly, persistent vomiting, neurological or mental changes, alcohol abuse or overuse, prolonged loss of consciousness and those on blood thinners.  The medical legal world has driven the doctors to scan more often defensively, even with minor head injury.  This has been pushed by successful litigation for what appears minor, only later to be a significant injury.

Even the NFL has now taken up the banner.  It is evident now that boxers and football players with repeated or recurrent head injuries have shown brain disability later in life.  Most of the athletic associations understand now that head injury, even minor, is not to be taken lightly.   Even many of the “rough and tough” rodeo cowboys now wear helmets with the rodeo association.  The bronco-busters are leading the pro charge.

So what’s up with the ultimate boxing and cage fighting until loss of consciousness?  Should insurers, payors, and hospitals be forced to insure these programs and their victims? 

Long term complications of concussion, (which ranges from a confusion with loss of consciousness to complete coma)  are many.  Memory difficulties exist, and may stay persistent.  Dizziness, a general feeling of weakness or lack of energy may continue for months to years.  Headache is common, as well as a problem of focusing on projects or things that require intense thought.  Amnesia, or ability to remember is certainly a problem many victims of head injury encounter.  This retrograde (backwards) memory loss can be devastating.  Thus the attorney’s wife….sobbing….and wondering….

Generally there are three classes of initial head injury in evaluation and prognosis.  They are:  mild, moderate, and severe.  This category is really of doctor’s category based on an initial scoring designed by Glascow.

castMD in a previous post discussed more about head injury.  Please see the following link if you wish to read more about concussion and sports

http://www.castmd.com/?p=93

But head injury is a very serious matter…So teach your kids to wear their helmets by wearing yours.  Consider the no helmet-no activity rule for this. 

As for what the future will bring for insurance coverage for dangerous behavior regarding helmets is still up in the air…..but many insurance companies require a rider or no insurance coverage for trampolines now…..too many broken necks and spinal cord injuries!

I remember the little boy as he was lying there.  Absolutely beautiful 4 year old.  Unconscious.  Comatose.  Scheduled for long-term care preparation and surgeries.  No sign of external injury.  “Just a closed head injury…..”

Leave a Reply

You must be logged in to post a comment.