Bike safety and signs of head injury

The nice weather is here and we are all trying to get outside. Bike riding is a common activity for all ages. You should never ride a bike without a helmet. People of all ages should be wearing helmets and we should protect ourselves as best we can. It is important to review bike safety recommendations and rules of the road before hitting the pavement.

When you ride a bike, it is often at a high speed or on the road near fast moving cars. Simply going down a small hill may seem like no big deal until you hit a rock and are catapulted over your bike handlebars head first into the concrete. Even a slow moving car can cause major damage to a bike and send you flying. Most bicycle accidents occur between a motor vehicle and a bike. The vehicle will always be ok—according to a NYC study, 100% of car operators are just fine. Your head will take the impact and a helmet can take on some of this impact before it gets to your skull, which can help diminish the injury to your brain, head and neck.

An article by US News reports that only 1 in 10 children and teens who suffered head and neck injuries from cycling crashes said they wore a helmet, and only 1 in 5 for adults. Head injuries increase with the good weather as people are out and about in the summer. One third of non-fatal bike injuries are to the head, and brain injuries account for 80,000 emergency room visits annually, according to the National Safety Council.

What’s in a bike helmet?

First off, make sure you are always wearing a helmet when you ride a bike. More than half of bikers in fatal accidents in a 2016 study were reported not wearing helmets. The helmet can’t help if you aren’t wearing one! Wearing a helmet properly is just as important. A good fit will help to protect your brain so lets be sure your helmet fits!  

  1. Make sure that you have a helmet appropriate for your head size. Not all companies are the same, so measure your head and make sure to read the size requirements. You also want to try on the helmet for a comfortable fit. Most are adjustable to provide a nice snug fit.  
  2. Check to be sure that the helmet sits low on your forehead. You can check by measuring about 2 finger widths above your eyebrows.
  3. Adjust the side straps to form a “V” shape that sits below and just forward of the ears. Lock the straps in place in this position.
  4. Adjust the chin buckle so that it is under your chin.
  5. Buckle the chin strap and be sure that there is not more than 2 fingers of space between your chin and the buckle.
  6. Finally, check the helmet! It shouldn’t rock or slide around. If it does, go back and readjust!

How to avoid a bike crash

Avoiding crashes in general is the goal here but we know that is not always possible. There are, however, some steps you can take to help avoid a crash. Both common falls and more serious crashes with motor vehicles can cause damage to your body, brain injuries, or death. The National Highway, Traffic and Safety Association (NHTSA) reports that regardless of the season, bicyclist deaths occurred most often between 6 p.m. and 9 p.m and are 8 times more likely in men than women. So men, take note of these bike safety tips! They recommend the following steps to prepare yourself for a safer ride:

  • Ride a bike that fits you—if it’s too big, it’s harder to control the bike.
  • Ride a bike that works—it really doesn’t matter how well you ride if the brakes don’t work.
  • Wear equipment to protect you and make you more visible to others, like a bike helmet, bright clothing (during the day), reflective gear, and a white front light and red rear light and reflectors on your bike (at night, or when visibility is poor).
  • Ride one per seat, with both hands on the handlebars, unless signaling a turn.
  • Carry all items in a backpack or strapped to the back of the bike.
  • Tuck and tie your shoe laces and pant legs so they don’t get caught in your bike chain.
  • Plan your route—if riding like a vehicle on the road, choose routes with less traffic and slower speeds. Your safest route may be away from traffic altogether, in a bike lane or on a bike path.

 Be alert and follow the rules of the road:

  • Ride with the flow, in the same direction as traffic.
  • Obey street signs, signals, and road markings, just like a car.
  • Assume the other person doesn’t see you; look ahead for hazards or situations to avoid that may cause you to fall, like toys, pebbles, potholes, grates, train tracks.
  • No texting, listening to music or using anything that distracts you by taking your eyes and ears or your mind off the road and traffic.

What happens if I crash?

A bike crash can be non-serious and you might end up with just a few scrapes or bumps. Unfortunately, this isn’t always the case. In 2015 in the United States, the CDC reports over 1,000 bicyclists died and there were almost 467,000 bicycle-related injuries. 

If you have a more serious crash, collide with a car, hit your head, or have an injury, it is important to get checked out. Always call 911 for a serious crash. If you hit your head in your crash but it seems like you are ok, it is important to know that you could have a brain injury or concussion and may need to be seen.

Signs of a serious head injury

The first concussion symptoms we often see are headache, fatigue, irritability, memory loss and confusion. Some people will feel dizzy, dazed or overly emotional. They can experience headaches, vomiting, nausea or blurred vision. Go directly to the ER if you had a bad collision or fall, or if you are vomiting, have worsened headaches, pass out, or have a seizure. According to the CDC, you should call 911 or go to the Emergency Room with any of the following dangerous signs and symptoms of a concussion:

  • One pupil larger than the other
  • Drowsiness or inability to wake up
  • A headache that gets worse and does not go away
  • Slurred speech, weakness, numbness, or decreased coordination
  • Repeated vomiting or nausea, convulsions or seizures (shaking or twitching)
  • Unusual behavior, increased confusion, restlessness, or agitation
  • Loss of consciousness (passed out/knocked out). Even a brief loss of consciousness should be taken seriously

Wear a helmet and be safe

According to a self-reported consumer survey in the Journal of Safety Research, “Despite the fact that bicycle helmets are highly effective at reducing the risk for head injuries, including severe brain injuries and death, less than half of children and adults always wore bicycle helmets while riding.” Wear that helmet and set a good example for your family and friends. A helmet can’t help if it’s not on your head! Young children look up to adults and often will model your behaviors. If they see you wearing a helmet on every bike ride, they are more likely to do the same.

If you have had a mild injury and aren’t quite sure if you should be seen, don’t hesitate to reach out to us. We hope to help make summer extra safe, so be sure to read up on our water and sun safety recommendations, too!

The opinions expressed in Nurse-1-1 Health Center Blog are solely opinions of the writer. Other than information received directly by you from your personal provider, the health center blog should not be considered medical advice. Read more.

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