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| Q&A: Dr David Hartman on Head Injuries (824 Posts)
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Phil's friend
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On 4/17/2006
Dr. Dave
wrote in from
United States
(68.251.nnn.nnn)
Phil
The best answer to both your questions is the same: Wear a helmet for all boarding and tell everyone else to do the same. If one person with severe brain injuries saves the lives of even two other people, that's pretty important.
The best helmet is the one that you'll wear all the time, that gives you coverage on the front, back and sides, and that's CPSC or equivalent rated. Vented, whatever. Just wear it. Everybody's head is different, so everyone has a different preference, but if it's a rated helmet, it's the best we got.
If your friend is recovering, he might benefit fron a rehabilitation program that emphasizes cognitive and motor rehab, and maybe hook up with a neuropsychiatrist who has experience with antidementia medicines to see if he qualifies. He should have his cognitive function worked up by a hospital or outpatient neuropsychologist to see what's working and what's not. And if you are really his friends, take his boards away unless and until his doctor says it's O.K. When he's able, play video games with him, talk to him, make him think. The axiom 'use it or lose it' applies to your brain as well as other parts.
Good luck to you both.
Dr. Dave
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Cracking of the Skulls
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On 4/12/2006
Phillip Hickey
wrote in from
United States
(71.193.nnn.nnn)
hey dave...
so my good buddy took a horrible dive off his board yesterday, cracked his skull in two places, and has severe brain trauma, and all of us who have been longboarding for bout 10 years now, are lookin in to all getting good helmets, and all that s#@!...umm any good suggestions..?
and also what can we do for my buddy? like what is the BEST thing we can do to help him out?
thanks...
phil
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Sarah Burgess
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On 4/10/2006
Dr. Dave
wrote in from
United States
(68.251.nnn.nnn)
People, if Sarah needs donations, find out what she needs. Help her out if you can.
A couple of comments. First. CONCRETE PILLARS!? Whoever designed that ramp set up needs to get a clue that padding is a good idea. I hope that the park fixes that ramp before the attorneys descend.
Second. Don't remove a helmet of someone who is having a seizure unless you are a paramedic and have training. Removing a helmet involves moving someone's neck, and if their neck is broken, they can be paralyzed or killed by the movement. Keep them on the ground, get the paramedics fast. Unless they last a long time, seizures are scary, but not intrinsically harmful. Don't give them something to bite or fish for their tongue or those other myths. Just keep them from hurting themselves further on the ground.
Third. Get Sarah referred for a neuropsychological evaluation when she is physically recovered. This will help figure out the state of her brain from the accident.
Fourth. Somebody hold on to Sarah's boards for a while.
Fifth. Boarding helmets should protect the side of the head. If the helmet rides too high, it's too easy to smash up the side of your head. The helmet should protect front, back and sides. Don't use a bicycle helmet. It's not enough coverage. Use the chin strap.
Sarah, if you are reading this, we're with you. Stay strong.
Dr. Dave
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No Tow!
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On 4/10/2006
Dr. Dave
wrote in from
United States
(68.251.nnn.nnn)
This is sad because there is no safe way to get towed on a board. You rapidly ramp up to speeds that shortboards can't handle well, and even greater than longboards or kiteboards typically see. The board isn't stable at those speeds, and needless to say, without a helmet, there's really no chance of coming out of a collision. It's like being dropped on your head from a 20 story window. The only thing that helps, I think is to publicize as much as you can the dangers of tow-boarding and skating without a helmet.
I agree, It's not "cool" to lose 3/4's of your life span on a sure-lose bet. If you are going to do it anyway, sign your organ donor card and make sure your will is exactly the way you want it. If you have kids of your own, think of them making their way in the world without you because that's the most likely scenario. I am deeply sorry for your loss.
Dr. Dave
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Frankie's Flatland Head Question
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On 4/10/2006
Dr. Dave
wrote in from
United States
(68.251.nnn.nnn)
Apologies for the delay, people. It's been a hectic month. First, Frankie, think of your head as the top of a hammer and your body as the handle. You are moving on the board on flatland. The board hits a pebble, stops, and you continue the momentum of the board. Junior High Physics so far? O.K. Your head then effectively acts like a hammer into the ground.
Now I've got a real human skull sitting in my office front of me (Doctors get interesting paperweights) and when I upon up the skull (it's pre-sawed) and measure, the thickness of the bone is about 1/8" on the sides above your ears (Temporal Bone) and about a 1/4" at the thickest in the front at back.
With me so far? Your head is a hammer 1/8-1/4 inch thick and it is headed into the asphalt from about 4-6 feet off the ground. Got the picture? It's not a pretty one (see the other posts recently). Bottom line is that even in flatland, your head is not designed to hammer into the ground. Bucket up!
Dr. Dave
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Sarah Burgess
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On 3/31/2006 SFPS
wrote in from
United States
(68.114.nnn.nnn)
I just got the full story on Sarah Burgess (portland advocate who was injured earlier today) Kent Dahlgren just posted this account of what happened earlier today in the forums on our main site...
Kent wrote:
"The miniramp at the DOS has concrete pillars on the sides, on the flatbottom. They have a 45 degree beveled edge on them.
She slammed on a 50-50, slid down the transition, and hit her temple on the edge of the concrete pillar. She had a helmet, but it came in under the edge. I was standing and watching it happen, so was able to respond in moments; I knew from how hard she hit that it was dammed serious. It twisted her head sort of gross and she went limp.
She was in convulsions for 5-6 minutes. I took my shirt off, took her helmet off (as gently as possible). I've been trained for first aid in the service, and another skater was a lifeguard. We cleared the ramp and assigned someone to get an ambulance.
I held the shirt on a large and flowing head wound (3-4 inches) while I checked her for breathing and heartbeat. She was in convulsions, making grinding noises, and shaking all over. Her fists rigid. It scared the f#@! out of me. It's been said that when Sarah falls even Duane Peters has to turn away. This was one of those slams.
As she came out of the convlsions she started fighting and screaming. I had to sit on her right arm while Jason held her left. She's not big, but she's exceptionally strong, and I needed to hold the shirt on her head. She'd already soaked my shirt with blood, my hand was soaked, and it was pooling deep on the ramp. She lost a lot.
Ambulance arrived and within minutes she was congiscent, barely. They loaded her up and we've been at the hospital ever since. I guess it happened at 4:30 this afternoon.
She's had a couple cat scans. So far, no indication of brain bleeding, but her vitals are screwy, blood pressure low, and there's concern about her neck. She gets another one tomorrow am and an appointment with the neurologist. She'll probably stay a couple days at the hospital and may be released this weekend."
OK, so there's the skinny, straight from a witness...
She's gonna need some help folks, and she deserves it-shes raised thousands of dollars for parks here in portland, and her video-screening-as-fundraiser has been duplicated all over the country to great success everywhere. To put it simply, Sarah is a f#@!ing soldier.
Please, take a moment to send positive energy/prayers/a slappy session on your favorite curb/etc her way.
Thanks for reading, and keep a good thought for Sarah.
If you'd like to make a donation to help Sarah with what is no doubt going to be some pretty major medical expenses, we have a paypal account on the main site, located at www.skatersforpublicskateparks.org Please be sure to include a note indicating the $$$ is for Sarah.
any companies, band, etc who could donate merch for an auction, please let us know. Lance from voxx shoes has already stepped up and offered some autographed shoes. every little bit helps. Do what you can, even if it's just doing a grind in her honor. She'd like that.
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Another Sad Example
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On 3/29/2006 Andy (GBJ) Bittner
wrote in from
United States
(69.140.nnn.nnn)
Hey Dr. Dave, I'd like to note, for the record, that a 23 y.o. young man from San Diego, named David Hays, decided, last week, that towing from the bumper of a car on his skateboard, while wearing no helmet, would be a fun and entertaining way to pass some time. Well, the car got going faster than David could handle and when he cast off, he lost control and fell, hitting his head on the pavement. David Hays was my cousin. Brain dead from the accident, they turned off his life support equipment today and let him die. (Unbelievably, this is actually the second cousin I've lost in a skateboard/car towing incident.) The bottom line is that "cool" and unworried about safety issues is not worth dying for. Always... ALWAYS wear a helmet when skateboarding and never tow from cars or other powerfully motorized vehicles.
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Skateboarding Head Injuries
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On 3/24/2006
Frankie
wrote in from
United States
(64.136.nnn.nnn)
My parents require me and my brother to always wear a helmet when skating. We only skate techical, not speed-skating. Do you think it's necessary for us to wear a helmet, since we only skate on flat asphalt most of the time?
Thanks,
Frankie
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Way to Go!
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On 3/16/2006
Dr. Dave
wrote in from
United States
(24.13.nnn.nnn)
Gavin,
I think you've got it EXACTLY right! Get them into gear early so it just seems like part of the whole process. And lock up that board when you're not around! Little kids have no frontal lobe decision-making capacity, and it would be just like a kid his age to grab the board and head off into traffic. . .
Dr. Dave
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helmets for kids
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On 3/16/2006 gavin
wrote in from
United Kingdom
(86.143.nnn.nnn)
'Does your 3 year old want to skateboard?'
yes, very much so and i can't leave a board lying around the house otherwise he grabs it. but i hear exactly what you are saying.
the level of skating i will allow him to do is nothing more than rolling along at a walking pace holding my hands, but even for this i want him to be adequatly protected (i also want him to wear gear right from the start as i believe it then becomes part of the way you do something. my dad allowed me to ride motorbikes from three years old, but i always had to wear the proper kit and for that reason i can't touch a bike unless i've got helmet, boots, gloves, back protector etc - it just don't feel right without it all).
i definitely will not let him loose on his own until he's much older.
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Skate helmet for a 3 year old?
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On 3/15/2006
Dr. Dave
wrote in from
United States
(24.13.nnn.nnn)
Gavin,
Does your 3 year old want to skateboard? I wouldn't recommend it. Three year olds don't have the coordination or judgment for that kind of thing. If you have to helmet him for something else, like being on the back of a bicycle or motorcycle, I would get him a helmet for the appropriate vehicle. There may also be ski helmets for kids that young as well.
Personally, I wouldn't do it. I wouldn't want it on my conscience if anything happened. The ground is hard and it's a long sorry lifetime for little kids who survive a severe head injury.
Dr. Dave
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kids helmets (again)
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On 3/13/2006
gavin
wrote in from
United Kingdom
(81.156.nnn.nnn)
i'm still after a helmet for my 3yr old but am increasingly confused. i'd like to get the fuller coverage and better fit of a skate helmet, but both tsg and capix are rated for 5yrs and over. which leaves a cycle helmet as the only 'certified' option for the age, more polystyrene padding but nowhere near the coverage or fit and the helmet shapes tend to be more pointy which i see some safety sites are saying is not a good thing.
if anyone can give me some advice either via the forum or email it would be great. the helmet companies themselves never answer my queries which i guess may be more a legal thing than slackness.
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Aeon Flux Board
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On 3/1/2006
Dr. Dave
wrote in from
United States
(24.13.nnn.nnn)
Spoke,
I haven't posted it anywhere, but if you send me your email, I'll send you the jpg and you can post it anywhere you want. :)
I'm at drdavidhartman1@comcast.net
Dr. Dave
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Aeon Flux
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On 2/28/2006
SPoKe
wrote in from
United States
(67.53.nnn.nnn)
Doc, Good to hear from ya.
Do you have a pic of the board I could see? Is it on the net any where?
-SPoKe
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Typo
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On 2/28/2006
Dr. Dave
wrote in from
United States
(24.13.nnn.nnn)
Should be "CPSC" standard.
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Bradford's Bucket question
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On 2/28/2006
Dr. Dave
wrote in from
United States
(24.13.nnn.nnn)
Bradford,
You can't make any generalizations about how the helmet looks or feels. If it's certified for the purpose it should work to the level of that certification standard. ASTM sells its criteria for 29.00 dollars on the web, so maybe we can convince Adam to spring for it, eh? Snell's standards are public and I believe that the CSPC standards are also public domain, so you can access those on the web.
And skateboard helmets don't just focus on the top of the head - bike helmets are more like that. A good skateboard helmet will give you side and back of the head coverage as well. Which is good because boarders don't tend to fall on top of their heads.. .
Dr. Dave
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Well SPOKE n
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On 2/28/2006
Dr. Dave
wrote in from
United States
(24.13.nnn.nnn)
Hey SPOKE, You have a good memory! I did get the Superbow and it has a long, perfect picture of Aeon Flux on the bottom. As far as looks, it's the coolest board in my collection. As far as skating, it's not my favorite board because it's got too many plies for me to really push-pump it at my weight range (around 160). So it hangs on a door, Aeon-side up. :)
Dr. Dave
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energy absorbpion and shell & padding design
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On 2/27/2006 Bradford C. Riendeau
wrote in from
United States
(64.19.nnn.nnn)
Does relatively a soft shell helmet which gives create a sharper point of impact compared to a hard shell helmet?
Hockey helmets have a soft spot in the temple where the two parts slide to enlarge the helmet for "fit" purposes. I think that spot is particularly vulnerable.
Also why do helmets focus on the impact on the top of the head? My guess is that except for spearing injuries in football, most impact and most concussions are caused by rotation of the body after an impact to the front, side or back of the head and the impact of the front side or back of the head on the ground ice pavement guardrail bumper windshield etc.
Where can one find the actual impact energy absorbed by given helmets?
The ASTM standards are copyrighted and thus the numbers are not publicly accessible.
I think, therefore, there is a false sense of security. For example, I would like to be able to compare hockey helmets to wool net tuques to get a real world comparison.
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Aeon Flux
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On 2/26/2006 SPoKe
wrote in from
United States
(67.53.nnn.nnn)
Hey Doc, its been a while. I talked to you years ago about Pumpkin decks. I I have that 48" x 10" Pumpkin SuperBow with the Aztec Sun God on the bottom. Did you ever get that Aeon board you were talking about? Hope all is well.
-John P
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Snowboarding Helmets
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On 2/19/2006
Dr. Dave
wrote in from
United States
(24.13.nnn.nnn)
The specs for snowboarding helmets are very similar to skateboard helmets, with similar head coverage. I recommend them for anyone who is skateboarding in a cold climate, since they are better insulated, but still vented.
I snowboard and, for the first few years, strange as it seems, hadn't worn a helmet, thinking that as a green and blue run beginner, I was not going to run into situations that would put my head in danger. That changed after talking to a snow-pro at Whistler a few years ago. He told me that most of the very serious head injuries in snowboarding are not because the boarder flew off a cliff or didn't see a tree coming, but rather because an experienced boarder was hit in the head by a flying, unleashed board, or because they were smashed into by a little kid, flailing amateur or hotdogging racer. So the injuries were coming from completely unpredictable sources. From then on I never went on the slopes without a helmet. And for you Canada snowboarders, Whistler/Blackcomb does NOT require board leashes.. . .
Dr. Dave
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head wraps
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On 2/19/2006 snoball
wrote in from
United States
(65.35.nnn.nnn)
Someone mentioned using snowboarding helmets and I've wondered about them myself. I noticed though that in this Olympics bordercross, their helmets look like motorcycle helmets but I don't know if they are. Even if you don't use a full face like that, are snowboarders helmets - that look an awful lot like skaters helmets - better built than skaters helmets? Or do they just have some thermal lining 'in addition to..'? I've snowboarded without a helmet ( and not very well I'll add ) and caught a heel edge bringing the ground up to the back of my head pretty quick and man that hurt!! I just wondered if the snowboard helmets would be a good compromise between skate helmets and going full face ( which most skaters I know don't want to do because they're not downhilling )?
Brain injuries suck kids. Really.
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Hockey Helmet
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On 2/17/2006 David
wrote in from
United States
(69.150.nnn.nnn)
Ryan is now wearing his full face hockey helmet. I warned him that it would take some time to get used to it. Initially, he was indeed frustrated. However, after several days, he loves it. As previously mentioned, he was initially also worried about the reaction from his friends and other observers. Most, if not all of his friends think it is pretty cool. Maybe not from the helmet per se but maybe more that he was willing to climb back up on the horse after a pretty serious accident. Ryan says that it does not hinder him in any significant way and that, actually, it gives him some additional security to try things that he otherwise wouldn't because he knows the risks have been drastically reduced. I laugh because we don't have to worry about him eating the board again, we only need to worry about broken bones.
With regard to the last post, I'm not confused between the tech and the downhill. I know that this site is more suited to the downhill enthusiast but it appears that almost all types of boarder's post here. I also know, from this site and others, that eating a board or cement or a post can happen regardless of your board interests. This site is wonderful and has been the source of a great volume of information. You should be very proud of it and the message that you folks are communicating.
In the meantime, I'll watch Ryan skate and I will sleep very well. We have found a way to keep him going in a sport that he loves(among others). He continues to heal(his teeth are stabilized and straight and the surrounding bone and gums are filling in nicely) but we still have another month or so of close monitoring. I know from the responses that a hockey helmet is not the ideal choice but the ideal choice has yet to make it to market. Maybe someone from this site could work towards that end. That being a tech skateboard helmet that could be, if desired, fitted with a full face mask.
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Tech Skating in a full face?
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On 2/12/2006
Mike P
wrote in from
United States
(129.210.nnn.nnn)
David, I would like to strongly recomend that you reconsider making your son wear a hockey helmet. I am definately an advocate of helmet use, following a bad fall I had downhilling in the Oakland hills. I always wear my snell shell when speedboarding, and a regular bucket for everything else (sliding, street and park.) Your son is not going to be able to skate in a hockey helmet. It would be like requesting a tenis player to wear one. There are undoubtably facial injuries that are part of the risk of the sport. Nobody knows that better than your son, and he is not stupid, and does not want to eat his board again. If he does not want to wear the helmet though, it's not just that he will look stupid, it's that he knows he won't be able to skate in it. I cannot even imagine trying to street or park skate in a full face helmet.
You may be confused by the reports of facial injuries on this site. Most of them are from downhill (this is, after all the Northern California Downhill Skateboarding Association.) If I speedboarded in just a bucket, I would lose a lot of skin off my face. Catching a skate in the face is not that common. Possible, but not common enough to warrant a helmet that makes skating nearly impossible.
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Thanks Paul
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On 2/12/2006
Dr. Dave
wrote in from
United States
(24.13.nnn.nnn)
Paul, thanks for the props. I think every helmet wearer has the potential to save lives - their own and anyone they convince to follow suit. Definitely good karma, either way.
Any readers have the experience of putting someone in a helmet, and finding out later they walked away from a header?
Dr. David
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This whole forum
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On 2/10/2006 Paul Howard
wrote in from
United States
(64.5.nnn.nnn)
I haven't really followed this forum because I'm a helmet wearer already (full face Gyro for slalom and regular helmet for skateparks). I just want to say "Thanks" for doing this forum and am glad to see it. Adios-Paul
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