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 doesn’t 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.
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