Traumatic Head Injuries from Skiing: Keeping on Eye on Sara Burke, Yourself, and Fellow Winter Sport Participants (Part 1: Primary Prevention)

by on November 11th, 2014
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Each year, skiers and snowboarders are amazing everyone with new, increasingly more complex, more high flying, and more dangerous tricks. Winter sport fans wait with anticipation for world class events, such as the X Games or the 2014 Sochi, Russia Olympics.

Whether you are a professional or beginner, falls (sometimes spectacular) and head injuries happen. On Jan. 10, 2012 at Park City, Utah, Canadian freestyle skier Sarah Burke was practicing for these world class events and suffered a vertebral artery dissection (I.e. artery tear in the back of the head area) and associated intracranial hemorrhage (I.e. bleeding inside the skull). She had finished a 540 degree flat spin ski maneuver on the 22 feet high superpipe, bounced sideways, whip lashed, and landed on her head, according to witnesses and Peter Judge, CEO of the Canadian freestyle team. Currently, she is in the Salt Lake City, Utah University of Utah Hospital neuro-intensive care unit(NICU), after undergoing torn vertebral artery repair.

Here is how to keep on eye on Sara Burke and anyone enjoying winter sports and address ski and snowboard head injuries before they happen.

Skiing and Snowboarding Head Injuries: Primary Prevention Checklist

1. Always wear a ski helmet and other safety equipment (newest innovation: airbags). Instead of letting your uncovered head take the full physical impact from a fall, a helmet will help absorb the force and trauma.

2. Note all your ongoing medical symptoms and signs, before you start skiing or snowboarding:

vital signs (blood pressure, heart rate, breathing rate, temperature) physical bumps on your head, their size and color
headaches and rate them on a scale of 0-10 (0= no headache, 10=worst headache of your life)
mental confusion, dizziness
blurry vision, pupil dilation, or other eye problems
hearing problems
numbness or differences in feeling in the various parts of your head and body
muscle weakness in the muscles of your face, arms, legs, or body
chest pain
breathing problems or difficulty
pain in your abdomen (when present alone, not usually caused by head injuries)
problems going to the bathroom (I.e. urinating, bowel movement)

If the above problems were present before you participated in a winter sport, your problem is most likely not a traumatic head injury, especially if you have not hit your head from any cause. Most likely, it is from another cause.

If you have any of the above symptoms and signs, you should get a checkup from your physician before you participate in a winter sport. Importantly, you should let your physician, friends, family, or all or them know about these symptoms and signs.

(Active Diagnosis: If you experience any of the problems on the list while skiing and falling, you should get checked out immediately. You may have experienced an emergency traumatic head injury. An injury can happen after only one fall and can range from contusions and concussions to intracranial hemorrhages.) (parts 2-3 of this article series will address these areas more in depth.)

3. Find how far the nearest hospital with full medical and neurosurgery services is from your winter sport destination.

The nearest local hospital is not always this type of hospital. Most hospital and emergency rooms can hand the other types of skiing and snowboarding injuries, such as wrist fractures from not wearing wrist guards. However, they usually are not equipped nor staffed to provide full neurological and neurosurgery services, such as diagnosing and performing vertebral artery dissection repair on Sara Burke. Instead, the full service or tertiary care hospital can.

4. For emergency care, the quicker you get to a tertiary car hospital and get treated, the better your chances of survival.

With modern medicine in 2012, your life can be saved or you can save someone else’s life, despite emergency and complicated traumatic head injuries. Time is of the essence. Medical diagnosis and treatment is needed before irreversible brain and body damage is done.

Fortunately for freeskier Sara Burke, she took the quickest transportation possible: An AirMed helicopter took her from Park City Mountain Resort to the University of Utah Hospital in under 30 minutes. (By ambulance or vehicle, 51-58 minutes without speeding).

In March 2009, actress Natasha Richardson suffered an epidural hematoma (collection of blood inside the skull) after falling on the beginner’s slope. Initially, she declined medical help on the ski slope, but asked for assistance while in her hotel at 2:59pm. Almost 4 hours had passed before she entered the important tertiary care hospital at 6:38pm (after an ambulance first transported her to the local hospital). By that time, it was too late and the brain damage was irreversible. Reports have noted that an air helicopter, if made available, could have transported Mrs. Richardson from the hotel to the tertiary care hospital in under 30 minutes. Her life may have been saved, if she arrived at the appropriate hospital and was diagnosed and treated more rapidly. Her symptoms could have been relieved and her life rescued by emergency neurosurgical procedures, such as drilling a burr hole (opening a hole in the skull bone) and epidural hemorrhage evacuation to relieve pressure on the brain. Many times, it is not the fault of the involved health care providers, but the current best efforts are not enough to save a life.

5. Improve Community Healthcare Services
If you are a concerned citizen, healthcare provider, or winter sport enthusiast, you can help make winter sports safer and more enjoyable for everyone:

1. Work with your local hospitals and ski resorts. Develop procedures, to make sure injured persons can get to the appropriate treatment areas as quickly as possible. (snow mobile, helicopter, and ambulance transportation; ideally, less than 1/2-2 hours).

2. Build or improve local nearby hospitals with qualified health care providers to handle traumatic head injuries

A safe and speedy recovery for all injured winter sports participants!

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