#HelmetSelfie Project

Even though football is now officially over until the fall, there are recreational and sports activities all year long that can be safer by wearing a helmet. During the winter months, it’s important to wear helmets while skiing, snowboarding and snowmobiling.



Did you know head and face injuries can be reduced by nearly 50 percent if you wear a helmet? Read the rest of the blog at our new site - https://saveinjuredkids.org/blog/helmetselfie-project/

What Youth Athletes Think About Concussions

Cailin Davis, 16, Emily Hunter, 17, Katie Mueda, 16, Brie Boothby, 17.

According to a new study by Safe Kids Worldwide, youth and teen athletes commonly ignore concussions and sports injuries because they feel pressure to play through pain. Elizabeth Murray and Sheinelle Jones from the TODAY Show shared a story last week about Brie Boothby. During a high-school field-hockey game in September 2013, near her Virginia hometown, Boothby was struck in the side of her head with an opponent's stick and blacked out. 

"The only thought in my mind was getting back in the game," she told Jones. And despite her injury, the field-hockey player kept playing. "I thought I had to be tough. I thought I had to go back in because we were losing and I needed to support my team."

That night, the 17-year-old felt nauseous, and began losing her memory. A trip to the doctor revealed devastating news: Boothby had sustained a serious concussion that left her with permanent brain injuries. 

It took Boothby 10 months of physical therapy just to be able to stand up without falling over. Since then, Boothby said that her school work suffered, and she's been diagnosed with ADHD. "MY GPA dropped so much that I'm really anxious about college," she said. "I'm not sure if I'm gonna get into what I've worked for my entire life."

Boothby's story is one of more than 1 million young athletes who are brought to the emergency room every year. And a new study by national research group Safe Kids Worldwide may help explain why one child is taken to the emergency room for a sports injury every 25 seconds. The study's results show that young athletes are engaged in a dangerous culture comprised of ignoring sports injuries, and feeling pressure to play even when they're hurt. 

The study, which surveyed 3,000 athletes, coaches and parents, found that:

• 42 percent of kids said that they have downplayed or hidden injuries so that they could keep playing.
• 53 percent of coaches said they've felt pressure to put injured players back in the game.
• Almost 1/3 of kids surveyed said it's "normal" to play rough in a game, to "send a message" to the other team.

While this problem in youth sports has been well-publicized, this new research found that many young athletes are still putting themselves at unnecessary risk. 

"The awareness we have about injuries and the risk to our children is not matching the behavior that we're seeing on the field," said Kate Carr, president of Safe Kids Worldwide.

Doctors can't say if Boothby made her injury worse by continuing to play, but there are very serious risks for athletes who continue playing with a head injury.

"If kids return to play too soon after a concussion or a head injury, they're at risk for second impact syndrome, which is a really serious brain injury," said Dr. Tracy Zaslow, a sports medicine physician at Children's Hospital Los Angeles.

All 50 states now require young athletes to be pulled from play if a concussion is suspected, and many have restricted contact in youth sports practices. Sports associations say they're training coaches to resist pressure to play injured athletes, and the High School Coaching Association is pushing for new laws that would require medical personnel at all youth sports games. 

Boothby said that until young athletes really understand the message, they'll continue to play. Even though it's now not what she recommends. "I think when in doubt, sit it out," Boothby said. "And yes, it might stink sitting under the lights on the bleacher. It's better to be safe than sorry. I mean, what is one game compared to your entire lifetime?"

For more information about the warning signs of concussions in youth sports, visit the CDC's website.

What is a Trauma Center? By Dr. Meredith

What's a trauma center? When people discuss the number of trauma centers in the country and the number of children's trauma centers they are referencing the American College of Surgeons' standards for being a trauma center. The American College of Surgeons writes those standards and it also has the ability to, through its verification committee, to verify that any given hospital meets those standards.

It does not designate, it verifies. The difference being it verifies that those resources are available. Only a state or a government body can designate a hospital as a trauma center. It is very common to see the words American College of Surgeons Verified State Designated Trauma Center. There are a lot of very good trauma centers in the country that have not gone to the American College of Surgeons for verification but are designated by their state. In doing so, in general, the state will require the hospitals to demonstrate basically the same requirements as the American College of Surgeons does.

So what is a trauma center? A trauma center is a hospital that has made a tremendous commitment to the care of an injured patient. It's made a tremendous commitment in terms of readiness and terms of expertise. Trauma is a disease which can occur in any part of our population, in any place in our country, at any time of day, on any day of the week.

It is a societal investment in the care of our citizens similar to the fire department or a police department. There are very good studies that analyze the effects of improving trauma care, most notably the NSCOT study, the “National Study on Cost and Outcomes in Trauma,” published by Mackenzie, Jurkovich and Rivara. In the New England Journal of Medicine it shows that the death rate for severe to serious injuries was 25 percent less in patients treated at trauma centers than in patients treated in non-trauma centers.

This is a huge difference. We go to an awful lot of trouble to administer, for instance, chemotherapy to a cancer patient with the hopes of garnering a 2 or 3, maybe a 5 percent increase in survival, or decrease in death rates. A 25 percent reduction in death rate is the sign of a very good treatment.

The marked improvement is made because these verified trauma hospitals have made a commitment to have a certain level of training and expertise amongst well-defined staff members, including surgical, emergency medicine, anesthesia, and other medical specialties. They make a commitment to have certain services immediately available, including diagnostic services like CT scanning. Most importantly, trauma centers have the ability of those surgical specialists and operating rooms and intensive care units to take care of the most seriously injured patients immediately and with a high level of expertise.

This is a huge commitment on the part of these hospitals. It's a huge cost on the part of these hospitals and trauma centers, and the public owes them a debt of gratitude. Many of us are privileged to live in communities and states that make this commitment. For others, there is still much work to be done. 

Of the 5,700 hospitals in the U.S., only 1,200 of those are trauma ready. That means only 20 percent of hospitals are truly equipped to handle a trauma. If we can save many more lives and reduce disabilities by having more trauma centers, then we need to discover how that can be done effectively and efficiently and share those plans with hospitals. We can save more lives, especially the lives of injured children, by improving the care they receive when emergencies happen.

Dr. J. Wayne Meredith, Medical Advisor, Childress Institute for Pediatric Trauma

Research Saves Injured Kids by Dr. Alison Gardner

I always wanted to be a pediatrician. First as a pediatrician and now as a researcher, it’s my job to care and lobby for kids. 

Sometimes our kids are injured no matter how many precautions we take and it’s our job to find the best ways to treat these seriously injured children. The golden hour is where you can intervene and improve outcomes from issues like airway troubles, and blood loss, and that sort of thing. That's where, in the emergency room, I come into play. 

Dr. John Petty and I were talking and he brought up the fact that he sees many kids come to the emergency department after trauma with low blood pressure but they have not lost blood. In fact, oftentimes their primary and only injury is a bad head injury. 

In medical school we are taught through the American College of Surgeon’s Advanced Trauma Life Support (ATLS) manual how to respond during that golden hour. It defines the standards of care for trauma patients. It says that if we see evidence of low blood pressure, or shock, that hemorrhage is what we're supposed to think. They're losing blood somewhere. If it's not blood loss out of their body, they're probably bleeding inside their abdomen or internally somehow. There is a sentence in the manual that says isolated or intracranial injuries don't cause shock.

Dr. Petty and I discussed and decided this might be different for kids than adults, and we decided to investigate because it might change our care. Instead of giving them fluids and blood we might do something different to help their blood pressure. In fact, if you've injured your brain, more fluids could cause the brain to swell more and that would be detrimental.

We started a very small study of patients that were treated at our Level I trauma center. We reviewed the details of 31 kids with low blood pressure to see the final cause of their injuries when they were discharge. We found that in kids under 5 years old that came in with low blood pressure and evidence of shock, 50 percent of the time they had an isolated head injury. They didn't have injuries that cause internal blood loss.

The question then becomes, what is the problem? That's guides our treatment. We found it was age dependent. In kids 5 to 11 years old, we found that about 25 percent of those kids had a head injury. This phenomenon disappeared in our teenagers.

After discussion with colleagues at other institutions, we decided to expand our study to review cases from the National Trauma Database. We don't know all the answers to our questions yet, but more research is needed. We need to find better ways to help save more injured kids during the crucial golden hour of treatment. Head injury is a real problem in kids, and it's something that's not entirely preventable.

Our infectious disease colleagues began studying the causes of mortality in pediatric patients decades ago and were able to develop vaccines and improve antibiotics in the mid-1900s. We don't see kids dying a lot from infectious disease anymore. Now we see the same thing with cancer. Childhood leukemia is not a death sentence anymore, and that’s due to hard work in the mid-1980s and 1990s. Their work is impactful.

Now childhood trauma is killing more kids than all other causes combined. I’m involved in the care of these injured kids every day. Since we can’t completely prevent injuries, it's our time to take on this challenge and help save the lives of injured kids.

- Dr. AlisonGardner, Assistant Professor of Pediatrics and Emergency Medicine at Wake Forest Baptist Medical Center

Fire Safety Saves Kids' Lives by Pamela Elliott

Life-saving fire sprinklers should be more prevalent

While on my flight to speak at a fire safety event, an article caught my attention. It was titled “U.S Requires New Cars to Have Backup Cameras.” My first thought was there must be a huge problem if the National Highway Traffic Safety Administration is requiring new cars to have backup cameras. Then I was somewhat surprised to read that there are nearly 210 backover deaths each year. About a third of those deaths are children, and many of these accidents are caused by parents. The article stated that rear-facing cameras would save between 59 and 69 deaths a year.

By contrast, the United States Fire Administration reports that fire kills 3,400 and injures 17,500 people each year. I was burned as a young child in a house fire. As such, I am acutely aware of the number of people who needlessly die or are injured in fires.

I sat on that flight with many mixed feelings. As a fire safety advocate, I’m excited any time a safety measure that will save even just one life is enacted. However, as a burn survivor, I felt frustrated and angry that similar safety measures haven’t been implemented in homes to prevent fires. What makes me even angrier is that the technology to prevent these deaths and injuries exists—they're called fire sprinklers. It’s taken quite a few decades to install them in new homes at a very slow rate.

NHTSA is to be highly commended and applauded for their public safety efforts. Since its inception, seatbelts have saved 280,000 lives and air bags have saved 28,000 lives. Now another safety device will be added to cars to prevent even more deaths.

Because of my past, I investigated how many children die in fires. I looked at the FEMA report “Fire Risk to Children 2010.” In 2010, 357 children died in fires. That’s about five times more children than those killed in backover deaths annually. The children most likely to die or be injured are newborns through age four -- those who can’t escape by themselves. If those statistics don’t grab at your heartstrings, I don’t know what would.

Anthony Foxx, United States Secretary of Transportation, said in the article, “Safety is our highest priority, and we are committed to protecting the most vulnerable victims of backover accidents—our children and seniors. As a father, I can only imagine how heart-wrenching these types of accidents can be for families, but we hope that today’s rule will serve as a significant step toward reducing these tragic accidents.”

Sometimes when children die in fires, no body is found. I can’t imagine having to bury a child, but I certainly can’t comprehend not having a body to bury. 

According to the FEMA report, 87% of fire-related casualties to children occurred in homes. That’s 87% of 357 children — 310 children who die in their own homes. We have the capability of saving 310 children a year. The technology exists — it’s a scientific fact that fire sprinklers save lives, reduce property loss and decrease injuries.

There’s no way to comprehend the devastating effects of burn trauma unless it happens to you or a family member. Why do we wait for a horrific event that warrants litigation before we’re compelled to change? Unless prevention becomes the highest priority of the fire service and its advocates, we can expect to continue to see these horrific statistics; this makes me very sad and irate at the same time.

I can only hope that comparing these statistics will somehow motivate fellow safety advocates and the fire service to take action. We need to stand united in the message that fire sprinklers save the lives of both citizens and firefighters.

- Pamela Elliott, RN and fire survivor