Injuries are almost always preventable

Published: February 25, 2004
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Ron Roskos literally fell into his job as head of the Utah Brain Injury Association.

Roskos was walking across the parking lot to work as an operations manager one day when he slipped on a patch of ice. He’s not sure how long he lay between two cars, unconscious, but that moment 13 years ago was the curtain dividing his life dramatically into “before” and “after.”

Injuries can be like that. And area emergency room physicians say they’ve seen it all, from the life-altering burn to the game-canceling sprains and strains. They see the results of children not buckled into car seats and the drownings and near-drownings when children are left unattended or watched by other young siblings as they take a bath. They’ve sewn fingers sliced by snowblowers and toes cut off by lawnmowers.

The common thread, they say, is that injuries are almost always preventable, the steps to avoiding them simple.

When Roskos got up, he was soaked. He could hear people talking but couldn’t tell what direction it was coming from. He had a funny taste in his mouth and his ears were ringing.
In the emergency room, he had trouble communicating with the doctor who checked his neck and sent him home. He had to call his wife to find out how to get home. It was a Thursday. He slept until Sunday. Monday, when he was getting ready for work, he couldn’t figure out which shoe went on which foot.

He had a traumatic brain injury, a common injury in a world where people don’t buckle up, don’t wear helmets biking or skiing or skating, and think nothing of using a swivel chair for a ladder. Strokes and aneurysms also cause traumatic brain injuries. Infants get them from being shaken.

Roskos managed to hang onto his job for two more years, in spite of short-term memory loss. It still bothers him, especially when he’s tired, and likely always will.

He wanted to learn what was happening to him and started volunteering with the Utah Brain Injury Association. Eventually, that became his full-time career.

There are 5.3 million Americans living with a traumatic brain injury, and 1.5 million such injuries occur each year. At least 50,000 people die each year from brain injuries, more than new cases of cancer, AIDS, Multiple Sclerosis and spinal cord injuries combined. In Utah, 40,000 people are coping with such an injury, and 8,000 more each year will sustain one.
Prevention and education, experts say, are the only cure.

The statistics are downright depressing: Roskos said that when a spouse has a brain injury, divorce results 80 percent of the time. It jumps to 96 percent when a child suffers brain injury. And that’s just one type of injury.

Cyndi Bemis hates the word “accident.” It implies that something couldn’t have been avoided, which is almost never the case, she said. With most injuries, someone somewhere did something wrong.

Bemis is an injury and violence prevention spokeswoman in the Utah Department of Health. And she, too, has seen it all.

James Melton, now 18, was in a car crash five years ago. The teenager was a consistent seat-belt user, but that day he didn’t put one on. When the vehicle, driven by a friend’s mother, hit a tree, he slammed into the windshield.

Today, the boy who was taking college-level computer courses at age 10 is a different person, said his mother, Diane Melton. He once wanted to borrow the microwave but feared he’d get in trouble, so he replaced it with the toaster, thinking no one would notice.

One day he decided to walk from Herriman to Sandy to use his computer. He slogged along in sandals without socks, arriving the next day.

Bemis offers statistics on injuries, such as the four Utah children who died in their driveways last year when someone backed over them. Nationally, 700 children a year are struck by cars. A young child is a very bad pedestrian, incapable of judging distance or car speed, usually certain they’re seen by a driver because they can see the car.

About 10 Utah children a year are shot, some in gang violence, most not.

Every day in Utah a child suffers a head injury, often doing something like riding a bike sans helmet, Bemis said.

For the elderly, falls are the leading cause of injury-related deaths, according to the Centers for Disease Control and Prevention.

Homicide is a leading killer of children, as are car wrecks. Janet Brooks, co-chairwoman of the Utah Safe Kids Coalition, says that car crashes are the No. 1 killer of children older than 1.
Healthy infants are most likely to die from airway obstructions ranging from choking on food to getting caught in the curtain cords. The second leading cause of death in children under 4 is drowning. Children also die from poisonings and from falls. For children, one-third of emergency room visits are fall-related, with 80 percent of the falls occurring at home, Brooks said.

Children also die or are injured when furniture falls on them — anything that’s heavy and moveable should be mounted on the wall.

While parents seem to know they must put their infants in a child safety seat, children ages 4-8 are often ignored. They need a booster seat — they’re too small for a regular seat belt and can suffer severe abdominal injuries in a crash.

Lauri Judkins believes the only reason she and her son are alive is proper use of passenger restraints. In September their car was in a serious crash. The impact was so fierce the car broke in half. The little boy was slightly cut by broken glass, she had a bruised leg.

Utah is 19th highest in the nation for bicycle crashes, and the Ogden-Salt Lake metro area is the 12th most dangerous place for pedestrians.

And though it’s not as common as helmetless crashes, both Dr. Erik Barton, chief of emergency medicine in the University Hospital emergency room, and Dr. Robert Keddington, an emergency room physician at Pioneer Valley Hospital, say they see a lot of people injured clearing their snowblowers. Even when the engine’s off, the blade is under tension. Reach in and you’ll lose your fingers.

Barton said injuries account for as many as 20 percent of emergency room visits — some caused in unexpected ways. People sometimes ignite barbecues and hibachis in their house instead of turning the heat on, he says. He sees them for smoke inhalation and carbon monoxide poisoning.

Children are seldom scalded because the water heater’s set too hot, but they come in with “pull-down” burns, grabbing pot handles on the stove that have not been turned inward. Nearly 100,000 children were treated in U.S. emergency rooms last year for burns, most of them thermal — kids grabbing hot curling irons or touching room heaters and burners. Playing with matches is the most common cause of house fires resulting in injury or death of children 9 and under.

Children are also injured when toy box lids close on their heads or when they fall on toys. And toys need to be age-appropriate to be safe, Brooks warns. Even then, safety is not assured. Scooters are the leading cause of toy-related deaths.

Adults who drink alcohol to keep warm in frigid temperatures sometimes wake up in the emergency room with Hypothermia, if they wake up at all.

Besides possible head injuries with sports like biking, in-line roller skating, snowboarding or skiing, wrist guards and other protective gear prevent sprains and strains and breaks in other places, especially in beginners, Barton said. Even wearing the wrong shoes for walking conditions can get you a trip to the ER.