Friday, August 15, 2014

Concussions in Kids



Many of you have heard a lot of talk in the news lately about concussions and head injuries from kids playing sports. I’m personally invested in this issue because my wife Lisa and I lost our younger son, Matthew, after he sustained a traumatic brain injury during a high school football game in 2008. I’m professionally motivated by the issue as the executive director of the Childress Institute for Pediatric Trauma.

As your kids go back to school and sports this month, we wanted to give you facts about concussions to help kids continue to play it safe:
  • Young children and teens are more likely to get a concussion and can take longer to recover than adults 
  • Recognizing and responding properly to concussions when they first occur can help prevent further injury or even death 
  • Athletes who have had a concussion, at any point in their lives, have a greater chance of getting another concussion 
  • Traumatic brain injuries (TBI) or concussions are a contributing factor to 31 percent of all injury-related deaths in the U.S.
Although the NCAA and NFL have pledged millions of dollars to study college and youth sports safety, up until now the effects of sports on kids have been vastly understudied. Did you know that 70 percent of the U.S. football-playing population is younger than 14? The Childress Institute is in its third year of funding a long-running study of 9- to 12-year-olds to track the cumulative impact on the brain of head contact across multiple seasons. The good news is, people are paying attention and we can start to make a difference as we learn more.
  • Symptoms may appear mild, but the injury can lead to significant life-long impairment
  • Each year, U.S. emergency departments treat an estimated 175,000 sports-related TBIs for boys and girls 
  • During the last decade, emergency department visits for sports-related TBIs, among children and adolescents increased by 60 percent 
  • 62 percent of sports-related injuries occur during practice not games
Based on the research we do have, we can help prevent and reduce injuries:
  • Limit contact during sports practices (when appropriate for the sport) 
  • Change rules and/or ban or limit the use of certain drills or techniques to help reduce the chances of injury 
  • Check sports equipment often to make sure the equipment fits the athletes well, is in good condition, stored properly, and is repaired and replaced based on instructions from the equipment companies 
Action can help improve outcomes for kids:
  • Educate coaches, parents, athletic trainers and athletes – inform and educate coaches, athletes, and their parents and guardians about concussion through training and/or a concussion information sheet
  • Remove athlete from play – an athlete who is believed to have a concussion should be removed from play right away – “When in doubt, sit it out”
  • Obtain permission to return to play – an athlete can only return to play or practice after at least 24 hours AND with permission from a health care professional trained in concussion care
My best advice as a parent of children who played multiple sports is not to be afraid to go to practice and ask questions. You are your child’s best advocate, so the more you know the better off everyone is.

To learn more about recognizing concussions in your young athlete, visit the CDC’s concussion website. You can learn more about my family’s personal story with sports-related traumatic brain injuries by visiting MattGfellerFoundation.org. We hope you will all help kids play it safe this fall.

 

Wednesday, August 6, 2014

Accidents Happen by Ty Dillon



I used to really enjoy riding my dirt bike. 

My brother and I have a track behind our house that has some cool jumps, curves, bends, and hills. We would ride almost every weekend around the track and in the woods, doing tricks and revving up our motors as high as they would go. We are racers, and super competitive in almost everything we do – whether it’s a foot race to the car, or on the race track, Austin and I are competing.

I had to force myself to stop riding my dirt bike about three years ago when I got into two serious accidents. They weren’t life threatening, and I’m thankful to be able to walk away, but sometimes I think back on how lucky I was to be wearing the proper equipment during my accident.

I had a very deep cut in my leg that was several inches long when a piece of the dirt bike pierced my leg. It could have been a lot more serious if it had hit one of the major arteries. I don’t remember a lot of pain in my leg, just being in shock.

Then, I broke my two major bones in my lower leg, my fibula and tibia. Both obviously very important bones in my body to be able to race each weekend. After that accident, I made a pretty difficult decision to give up dirt bike riding.

Racing has been a huge part of my life in the past 10 years. It’s been around me for my entire life, but since I began racing on a regular basis when I was 12, I realize that I sometimes have to give things up that I really enjoy doing. I look back to the accidents that I was involved in and how it kept me out of a race car for a long time. Thankfully, doctors today are equipped with medical treatments that healed my leg quickly, and I was able to get back to racing quicker. I was even able to get back into our Richard Childress Racing ARCA Series car in 2011 and win the series championship.

Overall, I’m a believer in living life to its fullest, making the most of everything you are given, and live life with no regrets. I’ve learned a lot since hurting my leg a few years ago and spent a lot of time in-and-out of doctor’s offices. It’s hard not to ride my dirt bike anymore, but racing in the Nationwide Series this season in the No. 3 car is important. We’re focused on winning another championship and my health is an important factor in doing so.

My grandparents started the Childress Institute for Pediatric Trauma in 2008. The Institute’s goal is to help seriously injured kids get the best treatment possible when they need it the most across the U.S. I’m lucky to live in a place that has great EMS and a high level of medical care available 24 hours a day so that when I was injured as a child, I had a great outcome. Not everyone has that fast access.

In racing, it takes speed, technology, talent and great equipment. The same is true for helping injured kids get the best care in an emergency. In the race to save more injured kids, the Institute is helping improve those odds.

Wednesday, July 30, 2014

Saving Kids Worldwide



One of the leading causes of death worldwide is injury to children, especially between 1-14 years of age. Most people are unaware that injury should be considered a disease. There is so much awareness of the benefits of immunization to prevent childhood disease but injury continues unabated. Action to prevent injury and death will save the lives of children and reduce the disability that results.

Worldwide, the challenge is the “burden of injury” which creates a significant economic and social impact upon the family, community and society. The effect upon the family is significant: absence of the child from school, loss of employment by the parent, reduction in income for the family who must care for the child and isolation of the family from the community. After a child steps upon a landmine or plays with unexploded ordinance, the mobility of the child is eliminated after an amputation of an extremity. In many cultures the family is shunned by the community. The “burden” affects the entire community that is responsible to provide a safe environment for the child. Surgeons can prevent death, improve the quality of life and provide a chance for rehabilitation following disability from injury.

Nevertheless, about 10% of the injuries to children worldwide challenge the best surgeons and health care systems. We rely upon a team of people to help save children once they are injured. It takes a system that includes response at the point of injury, acute treatment and a commitment to rehabilitation, to prevent the death of the child and restore them to health. The initial response time has impact upon the outcome. It is imperative that we prepare the first responder and the Emergency Medical System to save the life of the child and to provide transfer to an appropriate level of trauma care.

Sudden events that result in injuries, such as earthquakes, riots or political conflicts, create a challenge for all levels of the system. It takes a long time before you have a response by emergency services, so the bystander and local team need to be able to initiate emergency care while providing transfer to a facility for acute treatment. In the United States, only 10% of injured children have access to a verified pediatric trauma center, so that means 90% receive acute care in general hospital facilities.

The big question is “how do we take care of these kids no matter where they are in the world?” After 10 years of war in Iraq and Afghanistan, the approach to care for the injured child changed. This knowledge and experience affects the system of care and the approach to treatment that makes a difference to children. Better prevention, acute care and rehabilitation will improve the quality of life for the community.

A community has the opportunity to learn from the global experience with injury or to share them with colleagues throughout the world. The convenience and accessibility of using web-based technology can share life-saving ideas quickly. We now can provide access to new surgical techniques and to accelerate practical application in a matter of weeks, instead of years. As an example, The Childress Institute for Pediatric Trauma creates web symposia to provide cutting-edge practice to medical professionals in 33 countries over the past two years.

The timely transfer of pediatric trauma care knowledge is saving the lives of injured children worldwide. The challenge to provide contemporary trauma care to the worldwide community is worthy of our efforts. 

- MartinR. Eichelberger, M.D., Professor of Surgery and of Pediatrics at George Washington University, Children’s National Medical Center in Washington D.C.

Thursday, July 17, 2014

Long-term Goals for Kids by Dr. Meredith



The National Institutes of Health (NIH) is an agency within the Department of Health and Human Services and is the principal biomedical research arm of the Federal Government. The NIH is comprised of 27 institutes and centers focused on various health issues facing Americans. The institute that is focused on children’s health issues is the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD).

It is a very good thing, in my opinion, that the NICHD formed the Pediatric Trauma and Critical Illness Branch (PTCIB) in 2012. It demonstrates a recognition that, in our nation, one of the most serious public health problems for children is injury, and that injury in children requires and merits some focus by our nation's most important federally-funded research support structure. I'm very gratified to see that Valerie Maholmes has been appointed as the chief of this division. She has a lifetime of commitment to children, to children's health issues, children's injury issues. I believe she will exhibit great leadership for this branch.

In late April, Dr. Maholmes convened a strategic planning group that met in Bethesda to
clarify what its mission should be going forward and to advise the new branch on how it can best accomplish its mission.  It was a group of fantastically bright and dedicated people interested in the well-being of children, particularly children’s injury issues.  Over the course of two days in multiple brainstorming sessions, the group identified a set of issues and developed a set of recommendations that I think will serve as a great architecture to both define and begin the process of executing the strategic plan for children's injuries within the branch.

Personally, I believe that all of the parties in our country, who are interested in improving the care for children's injuries and changing outcomes for the most common cause of death and disability of our children, need to get behind this effort at the NIH. Furthermore, we need to approach this journey with a long-term view.

At its core, pediatric injury is a huge health problem in our country and we need to assist, support and foster this branch with a vision toward its long-term success.  Long-term success means it would be a highly-funded source for research information and for convening and deliberating on all research issues that relate to pediatric injuries for our country; a national resource.

It will take years for that vision to be realized; years of research productivity; years of matriculation through the NIH institutes; years of well-meaning grassroots efforts by those of us who are in trauma centers and pediatrician's offices, and families and churches and synagogues that are interested in making sure that we do something about the plague of death that trauma represents amongst our children.

It's going to be worth the long-term ride and if we all try to assure the investments that are made are not aimed at short-term studies, short-term turnarounds, short-term goals but, instead, are aimed at long-term, big vision, strategic efforts, I believe this branch will turn out to be something great.

- Dr. J. Wayne Meredith, Wake Forest Baptist Medical Center, Chair of the Department of Surgery and Medical Advisor to the Childress Institute for Pediatric Trauma