Wheelchair Falls Resulting in Concussions

By "The Rollin' RN" Patty Kunze, BSN, RNC

My articles are usually written on maintaining health but I wanted to expand on a question asked earlier and further discuss CONCUSSIONS and WHEELCHAIR FALLS.  Concussions, in general, have been in the forefront of Sports Medicine lately, with the increase of head injuries in football and soccer alike.  No longer is this type of injury “accepted” as part of performing sports; experts are looking at this phenomenon from a different angle now.  Sitting in a wheelchair on a daily basis increases our chances of a fall, where we may strike our head, which results in subsequently, a head injury or concussion. It’s a fact of our life - but should not be ignored!  Why else would the rehab team train us how to protect our noggins in case of a fall?  I KNOW it has happened to all of us and if you are one of the lucky ones that hasn’t experienced a fall yet…..you will.  Being in a wheelchair for eight years now, I have experienced two major falls while seat-belted in my chair.  Once backwards onto a concrete tiled floor, causing a huge goose egg on the back of my head and once on the aggregate driveway of my home resulting in a scraped up face.  You all remember the Looney Tunes cartoons when the character is bopped on his head and stars circle around him, that’s what it feels like... But this topic is no laughing matter.   

But when a tumble results in knocking our brains around in our heads, a concussion may occur.  A CONCUSSION is a type of injury to the brain caused by a bump, blow, or jolt to the head that can change the way your brain normally works. Concussions can also occur from a fall or a blow to the body that causes the head and brain to move quickly back and forth. Health care professionals may describe a concussion as a “mild” brain injury because concussions are usually not life-threatening. Even so, their effects can be serious.

Symptoms of a concussion fit into four main categories:

THINKING AND REMEMBERING

• Not thinking clearly
• Feeling slowed down
• Not being able to concentrate
• Not being able to remember new information

PHYSICAL

• Headache
• Fuzzy or blurry vision
• Nausea and vomiting
• Dizziness
• Sensitivity to light or noise
• Balance problems (may be difficult to assess sitting in a wheelchair)
• Feeling tired or having no energy

EMOTIONAL AND MOOD

• Easily upset or angered
• Sad
• Nervous or anxious
• More emotional

SLEEP

• Sleeping more than usual
• Sleeping less than usual
• Having a hard time falling asleep

Concussions are usually diagnosed by a healthcare professional performing a thorough examination, a battery of neurological questions, and possibly a MRI or CT scan to confirm no bleeding into the brain or bruising.   Post-concussion care may result in hospitalization for observation.
 

CALL A DOCTOR OR SEEK EMERGENCY CARE RIGHT AWAY AFTER A DIAGNOSIS OF A CONCUSSION IF YOU EXPERIENCE ANY OF THE FOLLOWING SYMPTOMS:

• A headache that gets worse or does not go away.
• Weakness, numbness, or decreased coordination.
• Repeated vomiting or nausea.
• Slurred speech.
• Extreme drowsiness.
• One pupil that is larger than the other.
• Convulsions or seizures.
• A problem recognizing people or places.
• Increasing confusion, restlessness, or agitation.
• Loss of consciousness.

One other piece of information that I share being a Registered Nurse, is to invest in a blood pressure cuff, know how to use it, and know your normal blood pressure.  Normal BPs are usually around 120/70.  140/90 or higher CONSISTENTLY, is considered high blood pressure. I have a cuff that fits on my wrist; you know the ones doctors’ offices are using more and more now. These types of BP cuffs are not expensive, they seem very accurate, and they can be used independently.  This is my nursing advice……now listen or read closely……WE SHOULD ALL HAVE A BP CUFF AT OUR DISPOSAL DUE TO AUTONOMIC DYSREFLEXIA SYMPTOMS!!  Wheelchairs falls are a very good reason to take a BP.  Now if you take your BP immediately after a fall, don’t be alarmed if it is elevated BUT, and this is a big BUT…..IF IT REMAINS ELEVATED then that is NOT normal.  Seek medical advice.

This article is written with the bullet points as an easy to review informational guide.  My hope is in case of emergency, this information would be in a central location, easy to find.  When a head injury occurs that is not the time to google “head injury symptoms.”  So I purposely listed the signs and symptoms as I did.  

Illustration: Mitzie Bower

FINAL ADVICE……falls from our wheelchairs are nothing to take lightly and prompt medical attention should be received upon a fall.  We all remember Sonny Bono, Natasha Richardson, Michael Schumacher……they all sustained a blow to their heads that resulted in a head injury and either subsequently died or they are dealing with the injury and they were not in wheelchairs. Head injuries and concussions are nothing to take lightly.  Healing or recovering from a concussion takes time. It may take days to weeks, or maybe even months.   So let’s all be safe out there and protect our precious noggins.

It’s all good!

 

References:

Concussion – Overview.  Obtained August 21, 2014 from http://www.webmd.com/brain/tc/traumatic-brain-injury-concussion-overview

About the Author: 
           PATTY KUNZE is a Registered Nurse with more than 30 years of experience in clinical nursing.  She graduated with a Bachelor Degree in Nursing from Old Dominion University and began working in the Spinal Cord Injury Unit of a V.A. hospital immediately after graduation.  Later she trained to become a neonatal transport nurse in the Neonatal Intensive Care Unit and progressed in that field for over 15 years.  Following that, she was a Labor and Delivery manager for 8 years, and a successful nursing instructor prior to her accident.   
In 2009, Patty and her husband moved to a new home and while relocating they were involved in an auto accident in which she sustained a complete T3-4 spinal cord injury.  She experienced life as a patient instead of a nurse during her hospitalization and rehab, which proved challenging for a seasoned nurse with experience in spinal cord injury. 
Patty has been married to her husband for more than 27 years and they are proud parents of two sons, ages 24 and 20.  She works a part-time job as a nurse for her local hospital, as a nurse paralegal for local legal firms, and fulfills her need to help others by writing helpful medical articles for individuals with limited mobility and spinal cord injuries as The RollinRN.  She enjoys being the family supervisor, gardening, reading, research, travel, and spending time with their two dogs.