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Spine safety for the Summer Solstice

June 21, 2016

Matthew Vasey MD


Department of Emergency Medicine, Tampa General Hospital | Teamhealth, an affiliate of University of South Florida

Disclosure: Opinions reflect neither employer nor affiliated institutions, soley those of the author.



The 2016 Summer Solstice is here, and with that comes a few sobering memories of injuries related to Summer swim fun. Growing up in Florida, much of the year is spent near, on or in the water. When the year is at its hottest many are getting in the water with greater frequency, haste, energy and impairment. With this increase in excitement, comes increased risk of diving injury. Scuba diving, hyperbaric and other maritime pathophysiology are for another day. This entry is to highlight trauma to the head, and neck with risk of drowning or near-drowning.

The mechanism of injury relates to unanticipated shallowness of water where one has entered leading to blunt trauma injury to head, flexion-extension-compression injury of neck and potential aspiration of water within lungs. The WHO suggests up to 14% of spinal cord injury are diving related. [1] Young males prove to be most susceptible. [2]

Best case scenario, one bumps their head, strains their neck, shakes it off without a scratch and resumes life uninterrupted according to plan. The darker side is one of permanent course correction of life for family and self. This nightmare includes outcomes not limited to paralysis by spinal cord disruption, anoxic brain injury otherwise brain death due to lack of oxygen due to near-drowning event and of course prompt death due to traumatic syncope otherwise being knocked unconscious from head trauma or paralysis with inability to move your body followed immediately by drowning.

Please take a moment this Summer when eagerness, enthusiasm or maybe even an otherwise responsible entertaining impaired indulgence hijacks higher cortical thought ... pause ... and at least jump feet first, but ideally, do not jump at all. You never know what lurks 3 feet beneath the surface waiting to change your life and that of those who care about you.

REFERENCES:

1. Greenberg RD, Buckley II CJ. Head Injury and Spinal Cord Injury. In: Cooney DR. eds. Cooney's EMS Medicine. New York, NY: McGraw-Hill; 2016. http://accessemergencymedicine.mhmedical.com/content.aspx?bookid=1650&Sectionid=107956627.
2. World Health Organization. Water-related diseases: spinal injury. Geneva. 2001.http://www.who.int/water_sanitation_health/diseases/spinal/en/. Accessed June 14, 2011.





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