and in safeguarding student athletes through concussion management guide- lines. While the state doesn’t have a child helmet law, TMA’s Hard Hats for Little Heads program provides bicycle helmets to children throughout Texas and advo- cates injury prevention in all wheeled sports and activities through helmet use. (See “Hard Hats Save Heads,” below at right.) Proven approaches to preventing childhood injuries, such as helmet use and concussion management, can help reduce the health and economic burden of injuries. A 2006 article titled “Inci- dence and Lifetime Costs of Injuries in the United States” reports one person dies from an injury every three minutes. Every year, injuries generate $406 bil- lion in lifetime costs for medical care and lost productivity, according to the article, published in Injury Prevention. The National Federation of State High School Associations reports about 140,000 high school students suffer con- cussions annually. With TMA backing, the legislature last year passed a bill re- quiring school districts to create concus- sion oversight teams that include at least one physician and to establish return-to- play protocols that involve a physician evaluating the athlete. The law also requires the University Interscholastic League and DSHS to approve training courses on concussions for coaches and athletic trainers. (See “Concussion Edu- cation Resources,” page 39–40.) Dr. Kaplan says his practice has “got-
ten more aggressive about following the return-to-play guidelines and with refer- ring patients to sports medicine experts for follow-up testing.” The state helps protect children in au- tomobile accidents, as well. According to the Texas Peace Officer’s Crash Reports, 38 percent of children aged 8 and young- er killed in car accidents in 2009 were unrestrained, up from 32 percent in 2008. A 2010 Texas Transportation Insti- tute study observed child passengers in 14 cities across the state and found 10.5 percent of them weren’t in a safety seat. Dr. Terk calls the child safety seat law passed by the Texas Legislature in 2009 “one of the most important posi- tive policy changes in recent years.” That
bill requires that children younger than 8 or shorter than 57 inches be secured in a child passenger safety seat. The initial fine for not doing so is $25, but subse- quent fines can reach up to $250.
Helmets reduce injury risk As a pediatric neurosurgeon, David Do- nahue, MD, has seen horrific child head injuries. After witnessing the effects of several preventable injuries and experi- encing one himself, the Fort Worth phy- sician got involved in the Hard Hats for Little Heads program.
“I witnessed a helmetless 10-year-old
bike rider bounce first off a car’s hood, then twice on the pavement on his head. He was hospitalized for weeks,” Dr. Do- nahue said.
He admits he’s been the victim of fail- ing to wear a helmet. “I was rollerblading aside my two sons. They were wearing helmets, but I wasn’t. Rolling down a ramp, I lost con- trol and slammed into a cast-iron histori- cal marker head first. I ended up in the emergency room but escaped with a few stitches in my scalp and just a chip out of the outer table of my skull,” he said. Skull fractures, brain hemorrhages, facial lacerations, permanent brain in- jury, and coma are common injuries Dr. Donahue has seen in children not wear- ing helmets in an accident. Dr. Donahue learned of TMA’s Hard
Hats program when his wife, Angela, was the TMA Alliance’s vice president of community health.
Hard hats save heads
TMA’s Hard Hats for Little Heads program urges children to wear the correct helmet for their sport or activity and make sure it fits properly. The program promotes exercise and teach- es parents and children about the importance of wearing a helmet.
It has given away more than 125,000 bicycle helmets since its
creation in 1994. Hard Hats has support from physicians, medical students, TMA Alliance members, county and local medical societies, and specialty societies. The TMA Foundation, TMA’s philanthropic arm, provides funding, thanks to top donors — Blue Cross and Blue Shield of Texas, Prudential, and an anonymous foundation — and gifts from physicians and their families. The foundation has awarded TMA more than $554,000 for Hard Hats since the program’s inception. To make a tax-deductible donation to the TMA Foundation, visit
www.tmaf.org or call (800) 880-1300, ext. 1664. To find out how to give helmets to youth in your community,
visit
www.texmed.org/hardhats; email tmaoutreachcoordina
tor@texmed.org; or call (800) 880-1300, ext. 1470, or (512) 370-1470. For more information, log on to
www.texmed.org/hardhats.
October 2012 TEXAS MEDICINE 37
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