Preventing winter head injuries

Heading out? What goes on a kid's head is more important than what goes on his feet

Winter sports are a fun way for kids to stay active and healthy during the chilly months. But those benefits — and your child — are at risk if he isn’t wearing a proper helmet. In Ontario alone, approximately 510 people per year — most between ages five and 14 — end up in emergency departments for tobogganing-related head trauma. And at least half of these injuries could probably have been prevented with proper helmet use: A recent study of downhill skiers and snowboarders, for instance, found that wearing a helmet reduced the risk of head injury by 60 percent.

The scary thing is that it’s not just those heart-stopping wipeouts that cause potentially lethal head injuries; sometimes, a seemingly minor spill on the ski hill can trigger life-threatening bleeding inside the skull — a lesson underscored by actress Natasha Richardson’s death last winter.

The good news? Helmets offer protection. “Helmets are designed to prevent skull fractures and intracerebral bleeds,” notes Laura Purcell, a paediatric emergency consultant at London Health Sciences Centre in London, Ont.

What helmets can’t do, says Purcell, is keep the brain from sloshing hard against the inside of the skull, which is what causes concussions. “Invisible” brain injuries that don’t show up on X-rays or CT scans, concussions can interfere with thinking, concentration and memory. They can come from a hit to the head (regardless of whether the person is wearing a helmet) or from the energy from a blow travelling through the body to the head (during a bodycheck, for example, or a hard fall on the backside).

Head injuries

What should you do if your child takes a hard knock to the noggin? First, have him call it a day: There’s no easy way to tell immediately if a kid has a concussion and, if he does, his balance and coordination could be impaired, putting him at risk of another injury.

Then watch for these symptoms over 24 hours:
• headache
• dizziness
• nausea or vomiting
• confusion
• short-term memory problems (repeatedly asking the same question, for example)
• difficulty concentrating
• difficulty sleeping or sleeping more than usual
• irritability
• uncharacteristic behaviour or emotions (crying easily, for instance)
• poor balance or coordination

If your child experiences any of the above, or you suspect something isn’t right, seek medical attention. If not promptly diagnosed and treated, your child may take longer than the typical seven to 10 days to recover.

Treatment involves both physical and mental rest, meaning no sports, school work, computer, reading, video games or (gasp!) texting until cleared by a doctor.

Does the helmet fit?

Make sure:
• the pads touch the forehead and cheeks
• the back clears the nape of the neck
• it fits snugly, but you can slip one finger under the chinstrap
• the front brim sits about two finger-660s above your child’s eyebrows
• there is little or no space between goggles and the helmet’s front edge

Headgear how-to

• Pick a helmet that’s designed specifically for the activity in question. For skating and sledding, opt for an ice hockey, skiing or snowboarding helmet.

• Choose a model that has been approved by the Canadian Standards Association. (The CSA recently developed standards for skiing and snowboarding helmets; the first CSA-certified models should hit stores this winter. Or look for one with an ASTM, CEN or Snell safety sticker.)

• Check the manufacturer’s label to see whether the skiing or snowboarding helmet you’re considering is single-impact or multiple-impact.

• Don’t let kids decorate helmets with paint or stickers, which can weaken the shell.

• Don’t let your child wear a hat (other than a liner or thin shell) under the helmet.

Of course, a helmet can’t replace other safety precautions — like ensuring kids take skiing and snowboarding lessons, and letting them hit the slopes solo only when they’re mature enough to recognize potential hazards and resist taking unnecessary chances.