Play It Safe

Spring is here and children of all ages will be spending lots of time out of doors. Bike riding, skateboarding, playing baseball and climbing on playground equipment are enjoyable warm weather activities. All of these activities, however, include a risk of brain injury that parents must anticipate and prevent. 

Traumatic brain injury, commonly referred to as a concussion, affects one person every 23 seconds in the U.S. The Centers for Disease Control and Prevention say some 1.5 million people sustain mild to severe brain injuries each year.  A blow or jolt to the head that disrupts brain function is considered a traumatic brain injury. Mild symptoms might include a brief feeling of being dazed or confused, while a severe case could result in an extended period of unconsciousness or amnesia after the injury.

Helmets are a Must

   The key to preventing these injuries is to wear a helmet, and it is important to choose the right one that fits properly. And, critical to its effectiveness, it has to be worn during the activity!  Bicycle helmets should display stickers that show they meet safety standards set by the American National Standards Institute (ANSI), the American Society for Testing and Materials (ASTM) or the Consumer Product Safety Commission (CPSC). The helmet should cover the upper part of the forehead and sit level on the head, two finger widths above the eyebrows. The foam pads inside should enable the helmet to fit snugly – it should not slip around. The chin strap should fit tightly so the helmet pulls down when the child opens his/her mouth. The two side straps should meet in a “V” right under each ear.

   Most of these helmets, which can also be worn by in-line skaters and skateboarders, need to be replaced if they are involved in a single accident. The foam compresses to absorb the impact and cannot protect from a second impact. 

   Baseball helmets should be certified by the National Operating Committee on Standards for Athletic Equipment (NOCSAE). Again, make sure the helmet fits snugly, with ear flaps on both sides and a chin strap.

   For climbing on playground equipment, it’s actually recommended that your child not wear a helmet, since the strap could be become entangled on the equipment and pose a choking hazard. Instead, look for soft surfaces below the equipment that absorb impact like sand or wood chips that are 10-12 inches deep. Rubber mats may also be acceptable. Avoid asphalt, concrete, grass or soil surfaces.

If Your Child is Injured

  The symptoms of brain injury range from obvious loss of consciousness to more subtle and brief problems. If your child’s head is injured, look for these signs: brief feeling of being dazed, confusion, problems thinking clearly, trouble following directions, inability to remember the injury and perhaps minutes afterwards, worsened memory, headache, nausea, vomiting, dizziness, sleepiness or loss of consciousness.

   The Centers for Disease Control and Prevention recommend that if your child suffers a concussion, you should:

•        Stay with your child for 24 hours after the injury.

•        Look for headache, changes in vision, dizziness, unusual feelings, nausea, vomiting, drowsiness or memory loss.

•        Wake your child every few hours while they’re sleeping to make sure they are able to be awoken and ask questions like “Where are we?” “What is          the date?”

•        Only give medication after consulting a doctor. Avoid aspirin since it can cause internal bleeding.

•        Seek immediate medical treatment if your child has severe or persistent headaches, does not wake up, has convulsions or seizures, repeated vomiting, severe neck ache, obvious personality changes, stumbles or demonstrates lack of coordination, has weakness in arms or legs, ringing in ears, blurred vision, is bothered by loud noises or bright lights or has short-term memory problems.

When Is It Safe to Play Again?

  It is very important not to rush back into an activity after a concussion, since there’s a risk of sustaining more significant damage if a second concussion occurs before the first one has healed. The player should not return to play until all signs and symptoms of the brain injury have disappeared. Recommended resting times range from days for lesser grade concussions to months or more for concussions of higher grades or for multiple concussions of any grade. Consult your doctor to be sure you are not risking further injury to your child by clearing him/her to play too soon. If symptoms of brain injury persist, seek assistance from a brain injury rehabilitation physician.

Flora Hammond, M.D. is Chief of Medical
Affairs at the Rehabilitation Hospital of Indiana.