How Doughnuts Can Save Injured Kids

On Saturday November 15, we ran the 6th annual Matthew Gfeller Memorial Doughnut Run. It was a freezing cold day, about 30 degrees by race time at 9:00 a.m., but we had a great turn out. We had 790 runners; a little less than last year, but given the weather, we did very well. We had bright sunshine and lots of fun with family, friends and supporters. We had the Boy Scout troop that Matt belonged to attend. The band from R.J. Reynolds High School also was there to sing the National Anthem and the Alma Mater. NBC media personality Kenny Beck was our emcee and Benji Jones Racing Company this year helped us put on the event.

Most of the runners are families. You see multi-generations; grandparents, parents, kids, dogs, strollers, and a lot of friends. Friends running with friends. We had family members there from Virginia and Oklahoma. Our kids, Robbie and Haley, came home and they brought some friends to run. It was just a successful event.

The most important thing about the event is keeping the spirit of Matthew alive. Matt was fun-loving. He loved Krispy Kreme doughnuts. His friends, Camden, John and Thomas, invented the run and actually John and Camden, who are both seniors in college, attended the event this year. That's what Matt would have been, a senior in college. Those two guys joined us on stage when we delivered all the running awards and all the wonderful raffle prizes that our sponsors gave us.

The proceeds from the race are divided evenly between the Childress Institute for Pediatric Trauma and Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center at UNC Chapel Hill. We're hoping that the proceeds will be greater than last year. Last year, each organization received $21,000 to go to research, education, and outreach. This year, we raised $46,000! That's $23,000 for each charity and an increase over last year. We are already debriefing about this year’s event and planning for 2015. Maybe we will run it earlier in the year so it's not as cold! I want to thank everybody who came and of course, all of our sponsors and we look forward to next year. 

The money donated to the Gfeller Center has funded a Ph.D. student for a year and they will work on one project that's related to traumatic brain injury in sports. Sometimes that's associated with an NCAA study. Sometimes that's been associated with a local Chapel Hill high school study and it really depends on what Dr. Guskiewicz and Dr. Mihalik have on the docket for the next year.

At the Childress Institute, the money received from the race has been used to continue The Childress Institute's investment in the multi-year study that was the KIDS study and is now the iTAKL study that measures head impacts in youth football players. It goes to purchase equipment that's needed for the on-field study with the kids. It's also helped to fund the athletic trainer along the way. Knowing that Dr. Stitzel, Powers, Maldjian, and Whitlow will continue the study through 2019, gives us confidence that the money donated to The Childress Institute from the Matt Gfeller Doughnut Run is doing good work. We know Matt is smiling on us for all the good work the run accomplishes.

- Bob Gfeller, Executive Director of the Childress Institute for Pediatric Trauma

ATV Safety Facts by Bob Gfeller

A major goal of the Childress Institute for Pediatric Trauma is addressing the issue of mild traumatic brain injury in youth when they participate in recreation and sports. By youth, I mean these are boys and girls roughly 15 years old and younger. By recreation and sports, I mean all the sports the kids play such as boys playing football, hockey, soccer, basketball, lacrosse and girls playing soccer, basketball, cheerleading, and volleyball, as well as other sports. 

From a recreational standpoint, we're specifically talking about outdoor recreation on ATVs, four wheelers, motocross, and of course bicycles. I'd like to focus in on the ATV issue for this blog because the statistics are really surprising. We have studied a lot of literature and a lot of studies that have been done in this area. In fact, we have funded a couple of papers in this area, one of which should come out at the end of 2014.

There are about 10 million ATVs in use throughout America today. Injuries on ATVs are up approximately 70 percent over the past ten years and injuries in children have now reached 40,000 emergency room visits per year. Why is that? When you look at injuries on ATVs, children represent only 20 percent of the riders, but 50 percent of the injuries. These injuries include both a singular injury, which means a head or limb injury, but over 20 percent of them are multiple injuries, meaning limb and head or internal organ and head, so they're pretty severe injuries when we look at them.

For example, a study published by Dr. Allison McBride shows that in North Carolina 27 percent of ATV injuries are children but they are only 14 percent of the riders. There are three major factors:

1. Kids are driving machines that are just too big and powerful for them to control

• There is legislation in all states defining legal ages for children to drive an ATV, with specific guidelines for size and power based on age
• Most states say that children under 16 cannot drive an ATV unless they have parental supervision

My two cents: These rules are pretty hard to enforce when you're in rural areas around the country

2. Drivers and riders are too young

• Average age of a driver is 12
• Average age of a rider is 9

My two cents: These are little kids driving and riding on powerful machines

3. “Reckless” activities on ATVs

• 90 percent of riders do not wear a helmet
• Driving too fast
• Riding an ATV on paved roads
• Alcohol consumption

My two cents: If you have ever ridden or driven an ATV, you know that when it hits a paved road the tires bounce and you can easily flip

Why does all this matter to the Childress Institute for Pediatric Trauma? Part of our equity is that the Childress family is very involved and passionate about the outdoors. We know that families love the outdoors – hunting, fishing, hiking, camping and other activities – and to get to many remote areas in our beautiful country ATVs are used. As the economy improves, more ATVs are being sold. We want to work in the area of ATV injury prevention and treatment.

As we look toward 2015, we will work on two recreation initiatives:

• Improve research and knowledge on what causes people to ignore safety regulations for riding ATVs
• Get involved in educational and outreach programs to make ATVs safer, which may include encouraging the use of helmets among both adults and children

Please remember this as you head into the fall recreational activities:  if you wear a helmet, injuries to the face and head could be reduced by 50 percent. A simple helmet can save you a world of grief and pain if you or your child are injured riding an ATV. Our goal is to save the lives of injured children. Your actions can save a life!

Stay inspired!!
Bob Gfeller, Executive Director of the Childress Institute for Pediatric Trauma

Building Our Future by Bob Gfeller

I've now been in my position for 120 days, and the team and I spent a lot of time looking at what we do well, what we need to do better, and clarifying how we will build our future.

In the six years since the Institute started in 2008, the death rate for injured children has been reduced from 12,400 to the 9,500 per year in the U.S. Many organizations are focused on improving those numbers. The Institute wants to work on topics that have societal impact over the long haul, so we need to clarify our message so that our audience understands what we do.

Part of that is clarifying our mission. Our new mission is to discover and share the best ways to prevent and treat severe injuries in children. We're going to focus on identifying and sharing best practices, particularly from the best pediatric trauma centers to the ones in need. We are going to work more in the area of prevention in addition to treatment and care after an injury.

Our three overarching strategies will now be funding research, education and advocacy, with measurable outcomes for each. From an advocacy standpoint we have to ignite the discussion of pediatric trauma at the local, state and federal government levels, because we need funding help from the government. Additionally, we are going to redesign our private fundraising initiatives to insure that we can raise at least $5,000,000 over the next five years.

With those three strategies we are going to focus our work in two areas:

1. Raising the level of pediatric trauma care nationwide

If your child is cared for at a Level I pediatric trauma center after a severe injury, they have a 25% better chance of surviving than if they're not. The bottom line is certain communities are better prepared to address a severely injured child when they show up at their hospital doorstep than others. We have an opportunity to help those in need get better prepared.

•    Determine pediatric trauma readiness

We've preliminarily mapped the U.S. and identified a number of states like Idaho, Nevada, Montana, Utah, and Georgia, whose pediatric trauma readiness clearly lags states like North Carolina, Oklahoma, Texas, Ohio, and New York, particularly as it relates to having a Level I or Level II pediatric trauma center in their state.

• Pediatric Trauma Summit 2015

We are planning another pediatric trauma summit for 2015, which will resume the work laid out at the 2013 summit. The next summit will move theoretical ideas to more concrete action plans behind two specific aims: 1) extend pediatric trauma care to rural communities through innovative ways, and 2) create a toolkit to share best practices, tools, and techniques from well-established Level 1 pediatric trauma centers to others.

2. Prevention and treatment in youth sports and recreation

• Youth Sports

You've heard a lot about injury in sports, mainly from all the news about traumatic brain injuries (TBI) and concussions (mTBI) in football. We have funded the ongoing iTAKL youth football study for three seasons now. We need to focus on youth, 14 and under, because there is very little work being done for that age group. We plan to go beyond football to learn more about sports injuries for boys, particularly hockey, and we need to research soccer, basketball, lacrosse, cheerleading and other injury-prone sports for girls.

• Youth recreation

Additionally, we need to discover ways to improve safety and treatment for recreational injuries to children, especially regarding ATV safety in the U.S. There are millions of ATVs on the road and there are millions of kids riding ATVs improperly, even though all states have laws regulating children riding ATVs. The problem is that they're riding without supervision, without helmets. They're riding on and driving equipment that's too powerful for their age, and they're falling.

Twenty-one percent of injuries amongst children on ATVs are multi-causal – head, bone, internal injuries. Nationwide, the research says that while children are only 20% of the riders on ATVs, they are 50% of those injured on ATVs. The most astounding fact is that 90% of kids riding ATVs don't wear helmets. We will leverage our relationships and Richard Childress' passion for the outdoors to help address this issue.

We will keep you posted on our progress through our newsletters as each initiative evolves. As always, we welcome your input and support.

Stay inspired!

BobGfeller, Executive Director

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.

- Bob Gfeller, Executive Director of the Childress Institute for Pediatric Trauma