Guest: Dr. Keith T. Borg - Emergency Medicine
Host: Dr. Linda Austin – Psychiatrist
Announcer: Welcome to an MUSC Health Podcast.
Dr. Linda Austin: I am Dr. Linda Austin. I am talking today with Dr. Keith Borg, who is a physician in the Emergency Department here at the Medical University of South Carolina. Dr.Borg, if you had one message for the American public to improve their health drastically, what would it be?
Dr. Keith T. Borg: I think prevention is really important. I work in emergency department and we see a lot injuries that could have easily been prevented beforehand if people wear helmets when they are riding bicycles or motorcycles, they wear appropriate safety equipment when riding other things like ATVs, if they wear their sit belts in cars, and if people drive sober, I wouldn’t have knew the business I have to do.
Dr. Linda Austin: Let’s talk about helmets, just how helpful are bike helmets from preventing head trauma?
Dr. Keith T. Borg: Extremely preventable. Most studies say between 80% and 90% of significant head injuries and traumatic brain injuries could be prevent with helmets.
Dr. Linda Austin: Now, do you ever get folks who have come in and they have had helmets on, but put them on inappropriately or not using properly?
Dr. Keith T. Borg: It’s hard because nobody says they had a helmet inappropriately, but you can be fairly suspicious that it wasn’t worn correctly and you see certainly among motorcyclists a lot of the fake helmets that are not full-face helmets or, you know, just the top of their head, it don’t provide that kind of protection what they need.
Dr. Linda Austin: In this state, South Carolina, certainly the use of ? where they mandated the legislated use of motorcycle helmet is a political issue, what’s your view on the importance of that?
Dr. Keith T. Borg: I think it’s absolutely important, I think it’s viable. You can prevent significant injury and you can prevent significant suffering for your family. Even if you don’t want to wear helmet as a rider, let me tell you the conversion that I have with your family members about your outcome if you can prevent that and your family having to go through that by wearing a helmet, it’s entirely worth it.
Dr. Linda Austin: What are some of the consequences of head injury?
Dr. Keith T. Borg: Millions and millions of dollars are spent working up treating, taking care of head injury patients and the rehab of head injury patients. It’s a huge expense and that’s borne by society because of our choice in the state not to have a law that mandates helmet use. That’s a significant expense -- it’s a significant burden on healthcare. It fills up our intensive care units, it fills up by rehab units, and it’s a significant cause.
Dr. Linda Austin: As a psychiatrist, I actually have had the opportunity to follow patients, who have had concussions and what amazes me is that even a concussion that does not seem that serious may be a loss of consciousness for 5 or 10 minutes can have remarkably profound effects that can last for months or even a few years.
Dr. Keith T. Borg: Oh! Absolutely, in the long-term prognosis after head injury can be devastating, even relatively minor head injuries. They change people’s and family’s lives for ever.Dr. Linda Austin:So, what is going on in the brain when there is a concussion?
Dr. Keith T. Borg: Concussion is a swelling or a bruise in the brain. The problem is the brain is encased by the skull, which is a fixed structure. So unlike being hit in your arm where you get some swelling and some blood around the muscle there, you swell inside that tight structure, which damages not only the area that’s swelling, but also adjacent structures and other areas, which causes significant problem. In addition, the brain doesn’t heal and redevelop those new patterns and areas unlike muscle or other tissues.
Dr. Linda Austin: You must see I would imagine a lot of concussion due to sports injuries?
Dr. Keith T. Borg: A fair amount, although in organized sports, we don’t see nearly as much because of again mandated helmet use and protective equipment. So, despite the fact that people injure their heads playing football, or baseball, or lot of other things, there is appropriate protection, so we don’t see nearly significant injuries in those sports than we do with people who are exercising without helmets and protective gear.
Dr. Linda Austin: Do you have any guidelines for how to wear a helmet correctly?
Dr. Keith T. Borg: Sure, having appropriately certified helmet is important for both bicycle and motorcycle helmets. There are certifying bodies and you can check on the box or inside the helmet and make sure it’s a certified helmet. Next, you want to make sure that helmet fits you correctly, fits your head, feel snug, but not too tight; you won’t have the chin struck down, so it’s below your ears so you can open your mouth and when your open mouth, it pulls that helmet tight, so that the chin-straps are not loose. You want to have it about an inch or two above your eyebrows, so your forehead is not shown.
Dr. Linda Austin: How about there are very young children, any particular guidelines for them?Dr. Keith T. Borg:Certainly, they need a different kind of helmet and again they need a helmet that fits and kids will go through a couple of different kinds of helmets as they are growing up, but helmets are very cheap, and a lot places even have them free sometimes.
Dr. Linda Austin :Dr. Borg, thank you so much.
Dr. Keith T. Borg: My pleasure.
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