The Natasha Richardson Tragedy & the Importance of Helmets
At the health club today, Natasha Richardson's ski accident earlier this week was the talk of the pool and locker room. From wondering if reports of her brain death were true to expressing sympathy for her family, people were clearly trying to make sense of a situation that doesn't really make sense based on what we've been told so far.Right now there are many conflicting reports and no official details about what Richardson's true medical condition is but the situation does not sound hopeful. We really can't say with certainty whether the fall caused the traumatic brain injury or whether the fall was secondary to some other medical event. Given the agony her family is in today, none of that may matter at the moment. Although, as one pool goer said "I hope for her boys' sake something else was going on - at least they won't have to live knowing this may have been preventable if their mom had been wearing a helmet." I would have to say I echo that concern and do wonder if the time has come for helmets to be more mandatory on slopes everywhere.
Stories like this make us all nervous, especially for our children. We begin to worry about issues of sport safety, in this case skiing, and equipment safety, such as helmets. We worry about missing symptoms that if caught early may make the difference in our child's health. We start to get nervous any time our child has a hit to the head or an accident participating in sports.
Tomorrow's podcast, A Dose of Dr. Gwenn, has been scheduled to be about youth sports for a while but given this week's tragedy to Natasha Richardson I'll be adding more on sports safety and concussions. As a reminder, Bob Bigelow, former NBA player, youth sports expert, and author of "Just Let The Kids Play", will be one to join in the discussion. Tune in at 4pm EST. As always, I'll be talking calls and there will be a live web chat going on.
Of all the topics we talked about at the pool today, do you know what the most talked about one was? How fragile life is and can change in the blink of an eye. Perhaps the small things in life we stress about are really not as important as we make them out to be all the time.
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The Natasha Richardson Tragedy & the Importance of Helmets
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No adult helmet mandates
I am all for ski safety, but the Richardson accident has been immediately exploited by the pro-helmet faction for mandatory helmet legislation in Canada, and similar articles in the US. I am a ski-induced brain injury activist of many years opposing mandatory helmet laws for adults at least, and defy any scientist or medical expert to prove that helmets prevent TBI or brain injury.
Indeed the best objective studies and anecdotal evidence support the view that there is no scientific proof that a ski helmet has ever by itself prevented a skiing induced brain injury. Data at www.ski-injury.com , run by expert ski doc Dr. Mike Langran, state that helmets have no effect at all on ski impacts of over 20 mph, and negligible effects at impacts under 20 mph. There is no scientific proof or formula whatever showing helmets save lives, reduce brain trauma, or predictably lessen injury at any speed. Not that helmets cannot and do not do these things, but there are simply too many variables in skiing to make these claims scientifically, and any claims to the contrary - and I mean any claims by an so called medical or other expert - have not been scientifically validated or peer reviewed, and are therefore specious. The discussion is purely based on biased observation and so called "common sense".
You are probably safer in a helmet in most circumstances. Kids and novices should wear them, given skiing risks to them. But there is no good scientific or other objective reason to mandate them for competent adults with solid skiing skills. I have skied and raced 40+ years sans helmet, indeed for 38 years before rec helmets existed, free of any kind of serious injury (and I ski over 50 days/year). So have 99% of my ski friends. The primary safety factors for skiing are good conduct and judgment. Helmets cannot compensate for them. Surely government cannot.
- harold burbank
March 20, 2009 11:45AM
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Yes adult helmet mandates
It is interesting that you quote Dr. Langran in support of your point, but I quote from his site:
7. Should I be wearing a helmet?
To cut a long story short, the current evidence strongly suggests that helmets may prevent or reduce the severity of many minor/moderate head injuries but there is no data to support the idea that they will protect against fatal head injuries - the forces involved in these sort of accidents are simply too great. Nevertheless, it seems clear that wearing a helmet will reduce the risk of less serious head injuries and if you ask me straight then yes, I recommend their use and I personally wear one - but remember, wearing a helmet does not make you invincible!
It is also interesting that you declare that there is no scientific proof but then go ahead to offer your own completely anecdotal evidence to try to prove your point.
I have no "proof" that it will prevent mild or severe injury but I do not need proof. To prove it, one would need to subject a human to controled trauma with and without a helmet to various force vectors. Unethical to say the least.
IMHO, as a radiologist, it is clear that the cranial vault is best protected from front and back assaults. Trauma to the side of the head where the vault is extremely thin, (often only 2 mm in thickness at its temporal fossa in the ADULT) is complicated by the presence of the middle meningeal artery which can be lacerated by a fracture leading to the epidural hematoma that Ms. Richardson experienced.
Hence, it depends on how the athlete falls. I have had patients fall from a standing position and cracked their skulls! You don`t need to be moving at a horizontal velocity at all.
We do lots of things in medicine and in life that are not proven to be useful but we do it anyway. Don`t smoke while filling up your car at the gas station. Look both ways before you cross the street. Learn to swim before you jump in the lake. None of these recommendations have been "proven" by scientific study as far as I am aware, yet you would not think it unreasonable to abide by them would you? You cannot wait for scientific proof to guide every decision in life. Some, as you say are just common sense. Now, back to the 2 mm thickness of your skull...is it common sense to give it a bit more protection than nature has offered in this area when skiing?
- Tom Jones
March 21, 2009 4:02PM
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