(February 19, 2010 - Insidermedicine)
Skiers and snowboarders should eschew current fashion trends in favor of safety and wear a helmet, according to a commentary published in the Journal of the American Medical Association.
Here are some recommendations for assessing adults with traumatic brain injury (TBI) in the acute setting, from the American College of Emergency Physicians:
• A noncontrast head CT is indicated in head trauma patients with loss of consciousness or posttraumatic amnesia only if one or more of the following is present: headache, vomiting, age greater than 60 years, drug or alcohol intoxication, deficits in short-term memory, physical evidence of trauma above the clavicle, posttraumatic seizure, Glasgow Coma Scale (GCS) score less than 15, focal neurologic deficit, or coagulopathy.
• A noncontrast head CT should be considered in head trauma patients with no loss of consciousness or posttraumatic amnesia if there is a focal neurologic deficit, vomiting, severe headache, age 65 years or greater, physical signs of a basilar skull fracture, GCS score less than 15, coagulopathy, or a dangerous mechanism of injury.
• In mild TBI patients without significant extracranial injuries and a serum S-100B level less than 0.1 micrograms/L measured within 4 hours of injury, consideration can be given to not performing a CT
Neurosurgery experts out of St Michael's hospital in Toronto urge skiers and snowboarders to wear helmets by pointing out the facts. Head injuries are the leading cause of hospital admission and death from these sports, and approximately 120,000 head injuries occur annually in North America while engaging in them.
Wearing a helmet can reduce the risk of a head injury by up to 60%. The key is to quash cultural stigmas against helmet-wearing. Some recommendations the authors make for doing so include putting helmets on the heads of skiers and snowboarders appearing in advertising, having parents wear helmets to promote the practice in their children, and formal instruction on the importance of helmet use at ski resorts, schools, and other places where novice skiers and snowboarders may be found.
Today's commentary highlights the importance of helmet-wearing while skiing and snowboarding and recommending this practice to patients.