Reported head injuries on the rise in Longmont; trauma doctors remind residents to use safety gear

LONGMONT, CO – July 1, 2021: Dr. Ian Wood in the trauma room at UCHealth Longs Peak Hospital Emergency Department in Longmont.(Cliff Grassmick/Staff Photographer)
LONGMONT, CO – July 1, 2021: Dr. Ian Wood in the trauma room at UCHealth Longs Peak Hospital Emergency Department in Longmont.(Cliff Grassmick/Staff Photographer)

Longmont trauma doctors say there is an increase in reported brain injuries and head trauma cases, but attribute it to a lack of using safety gear among youth and baby boomers, federally required reporting laws and returning to normalcy following the near end of the pandemic.

Colorado ranks ninth in the nation for traumatic brain injury deaths, according to Denver-based Brain Injury Alliance of Colorado, the state nonprofit organization responsible for maintaining head injury records in response to federal law. Colorado sees roughly 1,000 deaths yearly and ranks 13th for hospitalizations with roughly 5,000 residents hospitalized annually. The agency also reports that Longmont ranks second in the state in both categories and is seeing a 2% uptick over 2019.

Roughly 23,500 Coloradans visit emergency rooms each year for traumatic brain injuries; 15% of those are from Longmont. Males are two times more likely to sustain a brain injury and five times more likely in Longmont.

Generation Z and baby boomers have the highest risk of sustaining a head injury in Colorado, more heavily weighted by those aged 15-24 and residents 65 and older.

“It’s an unfortunate statistic that is totally preventable a majority of the time,” UCHealth Longs Peak Emergency Room Trauma Director Dr. Devin Rickett said. “One such prevention tactic is wearing safety gear when bicycling, rappelling, mountain climbing, skiing, sledding, skateboarding or any other extreme outdoor sport Coloradans, and especially Longmont residents, can enjoy year-round.”

Makenna Rademacher, 5, gets fitted with a bike helmet by Valorie Penslee, of UC Health Longs Peak. Mountain View Fire Rescue partnered with UCHealth Longs Peak to provide bike helmets and car seat checks on June 30, 2021.(Cliff Grassmick/Staff Photographer)

Rickett said, “although UCHealth Longs Peak is not necessarily seeing a measurable increase of head trauma cases at this hospital — there are several compounding factors that attribute to the state reporting higher cases.” He said those include a federal mandate to report all head trauma and brain injuries and population influx.

“It’s really just common sense when it comes to outdoor activities in relation to safety and preventing head trauma — such as riding a bike, which includes wearing a helmet and wrist guards as well as modeling that behavior for our children,” Centura Health Longmont United Hospital Chief Medical Officer Dr. Antony Pearson said.

Pearson said, “we are seeing more head trauma and brain injuries as people return to normal life following the pandemic, but also because now people are not as afraid to come to the hospital,” Pearson said.

Masha Heefemann, left, helps Larkin Reiter with her new bike helmet. Sam Arb does the same with Jess Krueger. Mountain View Fire Rescue partnered with UCHealth Longs Peak to provide bike helmets and car seat checks on June 30, 2021.(Cliff Grassmick/Staff Photographer)

“It’s not just the return to normal life,” Pearson added. “It’s also the mentality in older generations that safety gear isn’t attractive — such as the ‘hold my beer’ generation and boomers, who are enjoying life post-parenthood or even as parents still.” In general, Pearson said Longmont United Hospital is seeing more head trauma among residents in their late 20s to early 40s and those aged 65 and older.

“If we see a pediatric case, it’s often because of a skateboarding, bicycling or sledding accident where the child was not wearing safety gear,” Pearson explained.

On Dec. 21, 2018, former President Donald Trump signed the Traumatic Brain Injury Program Reauthorization Act of 2018 into law, directing the Centers for Disease Control and Prevention to implement a National Concussion Surveillance System, or NCSS, to better track and study head and brain trauma. The law provides states with grants to better aid head trauma survivors and helps to further research and state data collection.

The 2018 law stems from the TBI Act of 1996 signed into law by former President Bill Clinton on July 29, 1996. It has been revisited to allocate funding to various health agencies outside the CDC, such as the National Institutes of Health and Administration for Community Living. In 2000, the amended law required national health agencies to launch a brain injury and head trauma education and awareness program.

In 2008, the TBI law was amended to include veterans injured in the line of duty and ordered national health agencies to work with the U.S. Department of Veterans Affairs. The 2014 amendment ordered the CDC and NIH to coordinate an improved plan to track and study brain and head injuries as well as review scientific data related to brain injuries in kids, in particular to youth sports, to produce in a biannual report.

“Most residents hear TBI, or traumatic brain injury, and instantly attribute it to persons who are victims of shaken baby syndrome; persons who have experienced epilepsy or seizures; persons who have had one or more strokes; residents who have been in a serious-injury vehicle collision; or victims who have been assaulted; and most commonly to those who have sustained injuries during a high fall, but that’s not what current studies indicate the majority of TBIs are coming from here in Colorado and Longmont,” Rickett explained.

“Currently, a majority of serious brain injuries are coming from youth sports activities and residents engaging in extreme winter as well as summer sports,” Rickett added. “Injuries can come in all forms, like concussions and less-severe head injuries sustained from falling or auto collisions.”

“With the implementation of NCSS, doctors can track previous studies, active studies and see future studies relating to head and brain trauma and see what is or isn’t working for patients nationwide,” Rickett said. “The highlight of that is our doctors can utilize cutting-edge therapies and diagnostics to treat patients here in Longmont using the information reported on the NCSS.”

There are three types of head trauma both Rickett and Pearson said residents should be aware of and are ranked by severity based on things like loss of consciousness, loss of equilibrium and amnesia.

  • Grade 1 Mild: typical concussion from which patients get well quickly, usually within an hour and only experience mild forms of side effects like dizziness, blurred vision, no loss of consciousness and vomiting;
  • Grade 2 Moderate: usually caused by a subdural hematoma, or brain bleed inside the cranium; symptoms are aggravated and persist more than 15 minutes, persistent vomiting and typically requires medical intervention;
  • Grade 3 Severe: rare, and symptoms can be delayed up to a month, includes brain bleeding and requires medical intervention.

Other symptoms can include: drowsiness, inability to wake up or being overly lethargic, one pupil dilates larger than the other, slurred speech or decrease in coordination, persistent and intense headache, prolonged nausea and vomiting, increasing states of confusion and loss of consciousness.

Dr. Ian Wood in the trauma room at UCHealth Longs Peak Hospital Emergency Department in Longmont. (Cliff Grassmick/Staff Photographer)

“It sounds scary, but if a patient has an immediate goose egg at the impact site of their head, it’s a good sign that it’s a mild or less-severe head injury,” Pearson explained. “Any head injury should be at least discussed with an individual’s primary care physician.”

“We recommend brain rest for any head trauma or brain injury for at least a week following an incident,” Pearson said. Brain rest includes no reading books, no screen time and not returning to sports or jarring activities for a minimum of one week after being symptom-free.

Both UCHealth Longs Peak Hospital and Centura Longmont United Hospital have neurological doctors and surgeons staffed daily and always on call.