My Skid Lid — A Guest Blogger’s Take on Helmets

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Sometimes my wife argues that a brain injury in my case would be a minor problem, especially when she notices the number of backcountry ski setups on the rack in the garage. Ha! But seriously, I have seen enough trauma and death from head injuries to make me want to protect my head while skiing or doing various other activities that could bash my noggin, you’re head will thank you…

I recently finished a two day course about trauma for my RN job. The chapter in the book about head injury got my attention. And of course, I often relate things in my life to randonnee skiing and then really focus! So here goes.

In the early 1990s I decided that wearing a helmet while skiing in-area was a good idea. At that time I started wearing my classic fiberglass climbing helmet while skiing and patrolling on hard snow days. My decision came from seeing that quite a few of the serious fly-out injuries in the ski area were head injuries. It really got my attention to see some skiers fall on a blue square groomer and incur a head injury involving at least EMS transport and hospital evaluation, sometimes worse.

We saw many more serious head injuries during periods of hard refrozen Cascade snow. A 35 to 40 degree slope covered with “white asphalt” is quite unforgiving if one falls and goes for a slide, especially if the ride involves rocketing downslope into trees or rocks.

In 1998 I left my somewhat heavy fiberglass climbing helmet at home during a ski of the Cannon Mountain couloir up the Icicle Valley above Leavenworth (Washington). The steep entrance was a bit firm, and as I looked down the spectacular line with the granite wall-book to the right I longed for a helmet.

Luckily we had a safe and near-perfect corn ski run after negotiating the firm snow on the start. Even so, I soon shopped for lighter helmets and found the Grivel Mont Blanc with the cool Easy Rider graphics. I bought it, thinking that it was so light that I would not leave it at home, and I have worn it while randonnee skiing and lift skiing ever since.

One ultimate tragic experience in my life was watching my climbing partner Don fall backward from an unroped scramble, hit the slope 75 ft. below, then cartwheel and roll down a steep heather slope to his death. That morning at my cabin, I had handed Don a helmet and said that I thought we should wear helmets even though it was just a short 5.7 climb. I explained to him that there had been a tragic climber death from head injury in the local area that summer from a relatively minor fall. The victim wasn’t wearing a helmet.

The day I was with Don we had not donned our helmets since we were scrambling up to the base of the wall to start the roped climb. After the fall, the helmet on the back of Don’s backpack was scratched and green-stained from the vegetation. Since that awful day I have pondered whether Don would have survived had he been wearing that helmet, and after watching the fall and assessing his injuries, I believe he would have had a chance.

But even with a helmet you’ve got to be realistic. For example, one would gain protection from a helmet if one otherwise moderates behavior and speed — knowing there is a limit to that protection. I did observe on one occasion a man who fell into a tree-well headfirst while snowboarding. He was wearing a nice snowsports helmet, but the fall broke his neck and he died.

Via Google I found several articles affirming helmet use by skiers. From National Ski Areas Association:

“According to Jasper Shealy, professor at the Rochester Institute of Technology in Rochester, N.Y., who has studied ski related injuries for more than 30 years, recent research has shown that the use of a helmet reduces the incidence of any head injury by 30 to 50 percent, but that the decrease in head injuries is generally limited to the less serious injuries such as scalp lacerations, mild concussions (Grade I) and contusions to the head, as opposed to more serious injuries such as concussions greater than Grade II, skull fractures, closed head injuries and the like…Most fatalities are due to multiple causes or injuries. Approximately two-thirds of those who die who do not use a helmet have as the first cause of death some injury to the head. For those who die while wearing a helmet, only about one-third have a head injury as the first cause of death. It seems that while the use of a helmet may shift the distribution of the first cause of death, it is not sufficient to reduce the overall rate of death. In incidents leading to death, it appears that the severity of the incident simply overwhelms the ability of the helmet to prevent death.”

There are many more sources of information detailing the advantages of skiing with helmets from sources such as WebMD, Consumer Product Safety Commission, American Medical Association, and many more. I was impressed by the American Academy of Orthopedic Surgeons Position:

The American Academy of Orthopaedic Surgeons (AAOS) recognizes the severity of injuries associated with skiing and recommends the use of helmets and protective headgear for recreational skiing and snowboarding.

Thus, I’m convinced one may significantly reduce the incidence and/or the severity of head injury if a helmet is worn while skiing. And along with helmet use, if one controls speed and behavior then serious and fatal injury may be easily avoided.

But the paragraph in my trauma CE book that really caught my attention was the description of postconcussive syndrome: “Postconcussive syndrome may manifest immediately after the injury or may not occur until several days or months after head trauma. Symptoms typically resolve over several weeks but may persist for extended periods of time” Listed signs and symptoms for postconcussive syndrome include persistent headache, dizziness, nausea, memory impairment, attention deficit, irritability, insomnia, impaired judgment, loss of libido,anxiety, depression (Emergency Nurses Association. Trauma Nursing Core Course Provider Manual. Sixth Edition. 2007).

The point is that one may incur even a relatively minor head injury while skiing, may get up, shake it off, walk away with some memory loss, pain and other symptoms. However, one also may incur the above-described post concussive syndrome (or worse) and have a significant and lengthy interruption of normal activities including employment and other things that provide a good quality of life. Hence, I wear my helmet while randonnee skiing. Why not? I wouldn’t want to lose the ability to name the exact length and serial number for every ski on that garage rack!

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