Head & Spinal Injuries

Facts About Head & Spinal Injuries

Head and spinal injuries comprise less than 10% of ski-related injuries. These incidents are commonly due to collisions, falls, or chair lift mishaps. Assertive male skiers are more prone to these accidents than other demographics, with speed as the biggest factor.

A head injury, whichever way it was incurred, always produces anxiety to the person, the relatives, and the medical team. Most patients, however, appear worse than they really are. Nevertheless, it does not change the fact that this type of injury is very serious and can even lead to permanent disabilities or death.

Undeniably, the use of helmets appears to have evolved from "lame" to "hip". In fact, helmet sales in the U.S. have increased between 1998 and 2001. The most recent figures from Switzerland illustrate that 30% of boarders and skiers now use helmets. So what are the real facts about head injuries, and what are the accurate statistical risks? Are they great enough to necessitate compulsory wearing of helmets?

Mild Head Injuries

These injuries include superficial abrasions, low impact head blows, and lacerations. Abrasion, commonly caused by a sliding contact between the scalp and the snow, can be rather painful but fortunately require not much medical intervention except for clean up and a prescription of pain killers. Normally, they're best left exposed to the air to facilitate drying and scab formation, or else they can become soggy if the dressing was left on longer. Since the scalp is abundantly supplied with blood, secondary infection is rather rare and reveals itself with growing redness, pain, and pus around the wound. Minor lacerations, on the other hand, can bleed profusely at first yet once controlled can often be remedied in the ski patrol room. Tiny cuts can be applied with sterile adhesive strips, while bigger cuts are likely to close up using medical superglue. Low impact bumps may yield a fairly striking bruise (haematoma) yet no major damage is really incurred.

Severe Head Injuries

Potentially Serious Head Injury or PSHI, consists of all episodes of assumed skull fractures, unconsciousness, penetrating head injuries and large scalp wounds. Associated trauma to other body parts often exists, and medical intervention needs to be quick, coordinated and competent. Needless to say, all stable patients with severe head injuries require immediate transport to a hospital either by ambulance or helicopter. Dependent on the circumstances, a straight transfer to a neurosurgical department may be the most fitting option. In addition, the probability of allied spinal injury should always be considered and the patient has to be packaged with care.

Medical Management of Head Injuries

In dealing with head injuries, the customary "Safety ABCDE" scheme should be followed.

• Safety 
• Airway 
• Breathing 
• Circulation 
• Disability 
• Exposure

Prevention of Head & Spinal Injuries

Research evidence on the efficacy of helmets in the reduction of injury risks is varied. In low velocity crashes, the incidence of minor concussions had decreased. Nevertheless, higher velocity collisions have shown to reduce the effectiveness of the safety gear against injuries since trauma is often passed on to the spine. This is especially true in kids who don’t have mature muscles to bear the weight of the helmet and the burden on the neck eventually becomes intolerable.

What to do in the event of a Head or Spinal Injury?

All head and spinal trauma require thorough assessment by a physician. Patients with an apparently mild head injury have the potential to worsen quickly, so it is crucial for them to acquire prompt medical intervention and to be observed closely within the next 48 hours.