First came the news of the tragic death of Tony-award-winning actress Natasha Richardson from a traumatic brain injury (TBI) after a fall on a Canadian ski slope. Then came the article about Janice Jackson, of Cincinnati, who died from a head injury after being thrown off a motor scooter while vacationing in Cozumel, Mexico.
Their stories are similar in some ways: Both were 45-year-old women having fun on a foreign vacation with their loved ones until sustaining ultimately fatal head injuries during a fall – head injuries that medical experts say they might have recovered from had they been transported by air to an appropriate specialty-care facility sooner.
In Richardson’s case, medical experts say precious time was wasted because she initially refused treatment and then was transported by ground-ambulance instead of being flown by medevac helicopter. She died two days later. With regard to Jackson, who was eventually airlifted to the United States but died 16 days later, critics contend that the initial emergency-medical response was too slow, that the resort area in Mexico did not have an appropriate trauma-care facility and that lack of travel-insurance coverage caused further treatment delay.
“The untimely deaths of these two women should serve as a caution to adventuring vacationers everywhere,” said Association of Air Medical Services (AAMS) President Sandy Kinkade. “Especially given that their deaths may have been prevented – if only they had planned ahead, taken greater safety precautions and received timely evacuation and treatment for traumatic brain injury.
“That’s why AAMS wants everyone to check into foreign-travel and medical-evacuation health insurance options and potential treatment facilities before leaving the country, to wear a helmet whenever engaging in sports-related activities that involve the risk of head injury, and to know the signs of TBI,” she added.
Such awareness is especially important for college students and others who are planning spring-break vacations. One such student, Brandon Lacko of Columbus, Ohio, learned his lesson the hard way during his spring break vacation in Cabo San Lucas, Mexico, last year. The 22-year-old suffered a severe head injury while jet skiing in the Sea of Cortez and required air-medical evacuation to El Paso, Texas, where he had emergency surgery following a temporal-bone skull fracture and shattered eye socket.
“There was a lot of difficulty between the language barrier, and the hospital in Mexico not being able to treat Brandon because of brain swelling and other severe injuries,” his mother Renae Mariano-Lacko recalls. “They also had to perform surgery to stabilize him prior to his med flight out of the country, and the hospital demanded payment for everything upfront before making a move. We weren’t expecting that.”
Brandon, who is now a senior at Marshall University in Huntington, W.V., was lucky. He recovered fully from his injuries. But his story could easily have had an ending similar to Natasha Richardson’s.
“The med-flight people and the doctors at the hospital in El Paso were a godsend,” his mother says. “We were just so happy to get Brandon back to the States, where everything went smoothly, because the hospital in Mexico didn’t have the capabilities to determine or treat the full extent of his injuries.”
Receiving swift medical evaluation and treatment for head injuries is critical, medical experts say, because while most TBI victims – who number about 1.4 million every year – are treated and released, TBI still is categorized by the Centers for Disease Control and Prevention (CDC) as a major cause of death and disability. An estimated 50,000 Americans die from TBI every year, and another 5.3 million experience long-term or permanent mental and physical impairments resulting from their injuries.
The potentially good news, though, is that TBI can often be successfully treated if caught in time. “That is why it is imperative to recognize the signs and symptoms,” said AAMS Board Member Daniel Hankins, M.D., FACEP. “Like Natasha Richardson, many people seem fine at first after bumping their head, even after a period of unconsciousness, and then suddenly deteriorate after this lucid interval. Repeated vomiting, severe headache, dilated pupils, sudden lethargy, trouble focusing or remembering – these are all possible indicators of a potentially serious brain injury.”
The most important catch-phrase to remember is “‘Time equals brain,’ which is a common saying in medical circles,” said Hankins. “That’s why calling 911 and seeking swift emergency medical attention is key – because even a few minutes can make the difference between life and death, or mild injury versus permanent disability.”
For details regarding TBI, see The Mayo Clinic’s Symptom Checker at http://www.mayoclinic.com/health/traumatic-brain-injury/DS00552. For traveler’s health tips from the CDC, see http://wwwn.cdc.gov/travel/ and for U.S. State Department information, see http://wwwn.cdc.gov/travel/. For a list of air-medical service providers that also offer medical-evacuation insurance coverage, contact AAMS.
The Association of Air Medical Services (AAMS) is the trade association serving the entire air and critical care ground medical transport community. AAMS, together with its charitable arm, the Foundation for Air-Medical Research and Education (FARE), strives to enhance the medical transport industry by promoting the highest level of industry safety; promoting quality patient care; inspiring commitment to the industry’s work, causes, and viability; and providing superior service to its members.