Many Victims of Domestic Violence Have Undiagnosed Traumatic Brain Injury

The New Yorker reports that medical professionals often fail to diagnose traumatic brain injury (TBI) in victims of domestic abuse. Per this news analysis, when emergency room personnel examine women following an attack, they usually don’t order CT scans or MRIs. A diagnosis of TBI frequently indicates that the victims of abuse are likely to become victims of homicide later. Without the TBI diagnosis, in other words, abuse victims go home from the hospital unprotected, unaware, and perhaps in imminent danger.

Strangulation Attempts Cause TBI

Approximately half of women victims of domestic abuse have suffered strangulation attempts. Such incidents can cause mild to moderate brain injuries from the cutting off of the oxygen supply. The lack of diagnoses revolves around the fact that most injuries from strangulation are internal rather than external. Only a small percentage show wounds visible enough to photograph, and law enforcement often characterizes the injuries in reports as minor abrasions to the neck. In addition, since victims tend to have poor recall of strangulation, authorities often downplay the harm, which results in prosecution of the abusers on less serious charges.

People Who Work With Abuse Victims Need Training Regarding Strangulation Signs

Since strangulations dramatically increase the risk of homicide, anyone working with domestic abuse victims, including police officers, attorneys and shelter workers, should receive training in how to recognize it and the TBI it causes. In addition to acquiring evidence from brain scans, personnel should watch for symptoms such as memory problems, hearing loss, dizziness, headaches and anxiety. The training should also involve how to conduct an investigation and how to keep a victim safe. Increased prosecution of perpetrators of strangulation will lead to a decreased number of homicides among domestic abuse victims. The National Center for Violence Against Women provides information in how to deal with strangulation cases.

How Is the NFL Handling Its Concussion Problem? A Look at the Statistics

Football is a dangerous sport. Players across the nation of all ages and levels of talent suffer injuries every day, from sprained ankles and pulled muscles to serious concussions, torn ligaments and tendons, and shattered bones. Fortunately, for the past several years, teams and leagues have made conscious efforts to decrease the number of player concussions. During the 2013 year, the NFL reported that the league saw a drop in concussions by 13 percent.

During the preseason and regular season in 2013, a total of 228 players got concussed. In 2012, by comparison, 261 players suffered concussions. Helmet to helmet contact, responsible for 53 percent of concussions in 2012, was responsible for less than half of concussions in the 2013 season. The NFL believes this improvement stems from a number of rule changes enacted to protect players from injury. Striking another player with the helmet can now be penalized, and intentionally striking another player in the head with the helmet, known as targeting, can result in an ejection from the game, The stiffer penalties and changes in culture – along with a growing understanding of the dangers of concussions – have led to positive adjustments that will hopefully continue.

Another potential method of protecting players from concussions has also appeared on the scene: head impact sensors. These devices can be used inside the helmet (and inside the mouth guard) to measure the force from a blow to the head. Developers hope the sensors can contribute to more sensitive safety engineering.

Laws of the Game: FIFA the Latest Sports Organization to Face Concussion Suit

On August 27, 2014, a coalition of soccer players and their parents initiated a class-action lawsuit against FIFA (the Fédération Internationale de Football Association). In the complaint, the plaintiffs charge the international soccer governing body of neglecting players in the monitoring and treatment of head injuries sustained during games.

Rather than pursuing financial compensation, the lawsuit seeks to change specific rules within the sport, including how many times players may “head the ball” during a match and how teams manage substitute players for individuals under examinations for head injuries.

The filing against FIFA notes high school soccer players suffer a disproportionate number of concussions compared to wrestling, softball, basketball, and baseball combined, representing nearly 50,000 injuries in 2010. Highly publicized head injuries during the World Cup event shed even greater light on the need for changes in rules and regulations within the sport.

The suit represents the most recent in a spate of concussion related cases, which have affected the NCAA, NHL, and NFL.

Steps to Take after Sustaining a Sports Related Concussion

Regardless of the rules, players of any sport should have the right to take proper measures after a head injury to get the treatment they need. When colliding with a ball, player, or other structure during play, take the following actions to protect yourself physically and legally:

  • Get immediate medical treatment. If you or a loved one are experiencing symptoms of a concussion, cease playing immediately and seek out the services of a physician.
  • Make a record. Retain any evidence that may have contributed to the injury, or ask a parent or other trusted individual to do this for you.
  • Watch for lasting effects. If a head injury continues to cause problems long after it happens, keep track of these issues and consider contacting a personal injury attorney.

Are Hospital Errors Really Becoming Less Common?

Given the unbearable costs hospital errors exact on our nation’s sick and injured population every year, it’s sometimes hard to muster optimism. However, a December 2014 report published by the Department of Health and Human Services suggests that medical workers and hospital safety experts may finally be winning the battle – or at least turning the tide.

  • The report said that “hospital acquired conditions” (e.g. staph infections caught in a hospital ER) declined over a three year period by 17 percent.
  • Medical errors, meanwhile, declined in practically every category.
  • IV blood infections, for instance, declined by almost 50 percent.
  • Bedsore ulcers — a plague that visits bedridden patients who are not moved frequently enough — declined by 20 percent.
  • Pharmaceutical errors also declined by nearly 20 percent.

The timeframe of the report covers 2010 to 2013.

In 1999, the Institute of Medicine found that such errors killed approximately 98,000 people a year in the United States. Later analysis determined that number could be much higher.

Some analysts credit the decrease in errors to the Affordable Care Act (a.k.a. “Obamacare”), which incentivizes hospitals through the “Partnership for Patients” program. This policy has been associated with a reduction in re-admissions (by 18 percent as of early 2014). A pilot program run at Mount Sinai Hospital in New York City found that a similar incentive system led to a drastic cut in re-admissions by over 40 percent.

However, an analysis published in 2012 in the New England Journal of Medicine suggested that government incentives do not necessarily correlate with decline in certain hospital infections.

Hopefully, researchers will analyze this progress more carefully and help us uncover how to make hospitals safer and less error-prone.

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