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Keeping families safe: the importance of injury prevention

September 14, 2017

When it comes to many injuries commonly seen in Emergency Departments around the country, including at Baystate Medical Center, what Benjamin Franklin once said is true that “an ounce of prevention is worth a pound of cure.”

Dr. Gerald Beltran, chief of Pre-Hospital Disaster Medicine in the Emergency Department at Baystate Medical Center, says it is absolutely essential as caregivers that we get the word out and reinforce to people the importance of utilizing safety strategies.

“Recently, we’ve seen quite a few patients who chose not to use helmets or seatbelts and who either died or were permanently disabled. It’s not just the patient who suffers, but family members, first responders and healthcare providers when we see patients with injuries which were easily preventable or avoidable,” he said.

Massachusetts lags behind in seat belt use

According to figures supplied by the Centers for Disease Control and Prevention (CDC), the percentage of drivers and front seat passengers wearing seat belts is 86% nationwide and 73% in Massachusetts.

“Clearly, we have a way to go to meet and surpass the national level,” said Dr. Beltran, who recalled treating a child before the mandatory car seat law, who was ejected from a vehicle and was left a quadriplegic.

It is law that drivers and adult front seat passengers must wear seat belts in the District of Columbia and all states except New Hampshire. All 50 states and the District of Columbia have child safety seat laws. Safety seat laws require children to travel in approved child restraints or booster seats and some permit or require older children to use adult safety belts. States differ on the age at which belts can be used instead of child safety seats. Young children usually are covered by child safety seat laws; safety belt laws cover older children and adults.

Rear-facing child safety seats

Several years ago, the American Academy of Pediatrics (AAP) issued a policy statement recommending that children ride in rear-facing child safety seats until at least age 2. Previously, the recommendation was rear-facing until at least age 1 and 20 pounds.

Research indicates that bicycle helmet laws are effective for increasing helmet use and reducing head and traumatic brain injuries and deaths among children and adults.

“I remember treating a bicyclist for minor bumps and bruises, who got into an accident with another bicyclist. He showed me his fractured helmet and burst into tears because the accident reminded him of a close family member, who had died after getting into a bicycle accident, but was not wearing a helmet,” said Dr. Beltran.

Bike helmets recommended for all ages

In Massachusetts, according to law, “anyone 16 and under must wear a helmet when riding a bike, traveling on one as a passenger, or using in line skates.” But, it is recommended that all cyclists and passengers wear helmets regardless of age.

While bicycling is a fun and healthy sport, it’s also important to follow the rules of the road such as going with the traffic flow, obeying all traffic laws and yielding to traffic.

Also, according to the CDC, the single most effective way for states to save lives is a universal motorcycle helmet law. In Massachusetts, all riders must wear motorcycle helmets. The law also extends to all low-power cycles including motor-driven cycles, mopeds, scooters, and various other two-wheel cycles.

ATV accidents are devastating

Motorcycle helmets saved an estimated 1,772 lives in 2015 in the U.S., according to figures from the CDC, and helmets reduced the risk of death by 37% and 69% for head injury.

“Some of the most devastating accidents we see are from ATVs, which often result in trapping riders underneath or throwing riders during a rollover, causing serious or fatal injuries. I once saw a child who had been thrown from his ATV and during the rollover was thrown onto a stick which impaled him in the abdomen. He nearly died,” said Dr. Beltran.

There are now tougher laws in effect in Massachusetts to protect children from the dangers of operating an ATV – no child younger than 10 can ride one, children younger than 17 are banned from vehicles designed for adults, and the rules apply to public and private property. Also, according to Massachusetts OHV Laws and Regulations, all recreational vehicle operators and those being towed are required to wear helmets.

Baystate's outstanding trauma team

“Our trauma team at Baystate does an outstanding job, but they cannot always save everyone. Simple strategies focusing on safety and prevention during recreational activities such as bicycling, riding a motorcycle or ATV, or even riding in a car, can help prevent deaths. It is crucial that all of us understand and utilize safety strategies while also following the law,” said Dr. Beltran.

Baystate Medical Center’s Emergency Department is the busiest in Massachusetts, and the hospital is the only Level 1 Adult and Level 2 Pediatric Trauma Center in Western Massachusetts.

Dr. Ronald Gross, chief, Division of Trauma, Acute Care Surgery & Surgical Critical Care at Baystate, noted that the American College of Surgeons Committee on Trauma mandates that all trauma centers like Baystate Medical Center engage in “meaningful and broad-based prevention activities.”

“One could say our goal is to put trauma surgeons out of business, but we can’t do it without the public’s help. People must understand that safety and injury prevention starts in their hands and is only achieved by doing things safely and following known injury prevention strategies,” said Dr. Gross.