Bike Accident (ER Story)

5-year-old Garrett Morris was riding a bike, made a sharp turn and crashed.

“You also have a big bump on your head, is that from the accident too?” ask Kathleen Nelson, M.D., a Professor of Pediatrics.

The question is: did he injure his brain?

“Can you make muscles, keep them up there?” asks Dr. Nelson as she takes him through a battery of tests, ”Close your eyes, I want you to touch your nose with this finger… touch your nose, touch my finger, touch your nose…stick out your tongue, now wiggle it around… I want you to walk to the door like you’re walking a tight rope…

Everything, says Dr. Nelson seems o-k. “His neurological examination was normal. He was a pretty lucky boy that he did not hurt himself worse than the cut on the chin and the bump on the head.“

But the key question Dr. Nelson wants to ask…“Were you wearing a helmet?

His answer: No. He cut his chin, and bumped his head, but without his helmet it could have been worse.

“It should be ingrained in children, and it really should be promoted for children that they don’t get on a bicycle without a helmet. Just like they don’t get in a car without fastening their seatbelts, they don’t get on a bike without putting on their helmet,” says Dr. Nelson.

He seems to be fine, but his parents will have to watch him closely.

“Whenever a child has a bump on their head,” says Dr. Nelson, “It’s important to watch them particularly for the next six to twelve hours. And we watch to make sure they use both sides of the body evenly and equally, watch for any vomiting or any dizziness, any sort of change in his personality.”

When a kid like Garrett goes dashing out the door to ride his

bike…you may have to remind him: hey… don’t forget your helmet!

“He’s only five years old. He does not have the judgment for himself that necessarily would tell him, put on the helmet, but his is really the age where those kinds of habits become formed,” says Dr. Nelson, “And so it’s important for parents to enforce that and to really promote it with their children.”

Injuries related to riding a bicycle are a significant risk factor, especially for children 14 years old and younger. According to the National Safe Kids Campaign, …

• Approximately 200 children ages 15 and under die in bicycle-related crashes each year.
• Nearly 400,000 children were treated in hospital emergency rooms for bicycle-related injuries.
• In the simplest terms, kids are at risk for bicycle-related injuries because kids – more than 70 percent of 5- to 14-year-olds – ride bicycles. This age group also rides about 50 percent more than the average bicyclist.
• Children are more likely to die from motor vehicle-related bicycle injuries in the summer and in the late afternoon than at other times. They are much more likely to die in crashes in the middle of the street, on bike paths or on the sides of streets than at intersections.
• Children are four times more likely to be injured when riding in low light (nighttime, dawn or dusk) than in daylight.
• Head injury is the leading cause of death in bicycle crashes and is the most important determinant of death and permanent disability. In fact, riders who don’t wear helmets are 14 times more likely to be involved in a fatal crash than riders who do. Unfortunately, national estimates report that helmet use among child bicyclists ranges from 15 to 25 percent. It is lowest among children ages 11 to 14.
• The single most effective way to reduce head injury from bicycle crashes is to wear a helmet. A single rule – “wear a helmet” – can reduce the risk of head injury by as much as 85 percent.

For a variety of reasons, it can sometimes be difficult to get children to wear helmets when riding their bicycles. Here are some suggestions from the National Safe Kids Campaign for parents of bicycle riders:

• Don’t negotiate. It’s estimated that 75 percent of bicycle-related deaths among children could be prevented with a bicycle helmet.
• Buy a helmet that meets or exceeds current safety standards developed by the U.S. Consumer Product Safety Commission.
• Correct fit is essential. Helmets should be comfortable and snug, but not too tight. They shouldn’t rock back and forth or side to side.
• Make sure your child wears his/her helmet correctly – centered on top of the head and always with the straps buckled. Children who wear their helmets tipped back have a 52 percent greater risk of head injury than those who wear their helmets properly.
• If your child is reluctant to wear his/her helmet, try letting him/her choose his/her own. Helmets come in many colors and styles – allowing children to choose a helmet that’s “cool” may make them less likely to take it off when you’re not around.

Talk to other parents and encourage them to have their kids wear helmets. Let your children see that you wear a helmet, too. Children are more likely to wear helmets when riding with others who wear them.

National Safe Kids Campaign
Bicycle Helmet Safety Institute
Brain Injury Association of New York State