Any time a person is hit in the head, someone at the scene should perform a quick “mental status exam” to make sure he or she is not suffering from confusion or memory loss, signs of a potentially life-threatening concussion or internal bleeding (which was likely the cause of Richardson's brain damage). This includes asking simple math and knowledge questions, making sure the injured person can follow your finger with his or her eyes, and asking if he or she can tell you what happened in the last few minutes. “On the sideline of a sporting event, a trainer will do this,” says Dr. Mayer, “but in reality, you really dont need any special training to do this. A lot of it is common sense.”
“The language we use is ‘altered consciousness,” says Dr. Mayer. “It's a whole spectrum: You could be out cold, or, recently were diagnosing a lot of concussions in which the person remains standing, with eyes open, with just kind of a glazed look.”
Take confusion or sleepiness seriously
Its not so much pain that should be a warning sign of serious injury; anyone who gets a hard wallop to the head is likely to develop a monster of a headache, whether theres internal damage or not. But any type of confusion, dizziness, memory loss, nausea, or sleepinessanything to signal that the brain is malfunctioningshould not be taken lightly. Call 911, and get to a hospital right away.
“Its better to waste an afternoon in the E.R. just to make sure everything is okay than to brush it off and underestimate how bad an injury might be,” says Dr. Mayer. “The key thing we know about traumatic brain injuries is that our ability to help is tremendous within the first hour. Then, its a little less in the second hour, less than that in the third, and so forth. Time equals brain, we say.”
Anytime helmets are optional (as in biking, skiing, or any other sport that involves high-speed or high-altitude movement), wear one. “When I was a kid, seat belts werent mandatory in cars; neither were helmets for motorcycle riders,” Dr. Mayer says. “Helmets arent required for skiing now, but that may change. Ill be honest with you, I ski, and I dont usually wear a helmet. But Im going to change after this.”