Catastrophic injury
Cervical spine trauma is most common in sports and activities involving contact and collision, particularly American football, rugby, ice hockey, gymnastics, skiing, wrestling, and diving.
[12] A study in the province of Ontario in Canada based on epidemiological data from 1986, 1989, 1992, and 1995[13] states that the greatest incidence of catastrophic injuries occurred in snowmobiling, cycling, ice hockey, and skiing.
[17] Most alcohol-related injuries were sustained in snowmobiling (124), fishing (41), diving (40), boating excluding canoeing (31), swimming (31), riding an all-terrain vehicle (24), and cycling (23).
[18] Other studies have concluded that alcohol consumption is a common risk factor "associated with all types of exposure" (that is, activities) for traumatic brain injury.
[20] Sports classified as non-contact include archery, badminton, body building, bowling, flatwater canoeing and kayaking, curling, dancing, golf, orienteering, power lifting, race walking, riflery, rope jumping, rowing, running, sailing, scuba diving, swimming, table tennis, tennis, weightlifting and weight training, the track and field events discus, javelin, and shot put and all track events.
[22] Indirect fatalities in high school and college football have been attributed to heat stroke, heart-related conditions, viral meningitis, and even lightning strikes.
[9] This form of tackling was banned in 1976 for high school and college football,[24] resulting in a significant reduction in catastrophic injuries of this type.
[25] In the paper Catastrophic Football Injuries: 1977-1998 published in 2000 by the journal Neurosurgery, Robert Cantu and Frederick Mueller recommend that "players should use the shoulder for blocking and tackling" instead of "using the head as a battering ram".
[26] The purpose of rules against spearing, ramming, and butting is to protect both the tackler and the opponent from head trauma or catastrophic injury.
[27] Mueller also suggests that coaches remove players from a game if they exhibit symptoms of concussion, such as dizziness, headaches, nausea, or sensitivity to light.
[32] High-risk activities include the construction of pyramids, which result in several catastrophic injuries each year,[10] the 'basket toss',[21] and tumbling, all of which are usually performed over hard surfaces.
Equipment issues generally involve penetrative injuries from the use of hooks and harpoons, but may also be caused by the fishing rod, lure, sinker, or bait.
Environmental causes may include overexposure to solar radiation, lightning strikes, hypothermia during ice fishing, snakebites, and viral infection spread by mosquitoes.
[38] Elite gymnast catastrophic injuries to the spinal cord have been recorded in China, Japan, and the United States,[38] the most notable being to Sang Lan and Julissa Gomez.
[43] Increased standards for hockey helmets and the requirement that they be worn in competitive play has resulted in a decrease of serious head injury and fatalities.
[44] Porters who carry loads on their heads are subjected to axial strains that exacerbate degenerative change in the cervical spine,[45] and has an etiological role in spondylosis.
[11] Research from Australia states that injury prevention in youth rugby should focus on the scrum and the tackle, and that risk factors are level of play (age group) and player position.
[2] Other fatalities and catastrophic injuries in track and field occur by a participant or bystander being struck by a discus, shot put, or javelin.
[55] From 1981 until 1999 in the United States, 35 catastrophic injuries related to wrestling were reported, one in college and the others in high school, an incidence of 1 per 100,000 per year.
[59] The greatest incidence per 100,000 population were recorded for snowmobiling (0.706), cycling (0.701), ice hockey (0.462), fishing (0.307), boating excluding canoeing (0.273), diving (0.256), swimming (0.243) and baseball (0.217).
[62] In the United States, the Consumer Product Safety Commission (CPSC) recorded nearly 1,000 fatalities between 1967 and 1987 as a result of riding an all-terrain vehicle, more than half of which were individuals less than 16 years old.
[64] The types of acute catastrophic spinal injuries are those associated with unstable fractures and dislocations, intervertebral disc herniation, and transient quadriplegia.
[65] Response to a non-fatal catastrophic spinal cord injury by the patient varies by "social, economic, and educational background".
These include cardiovascular complications, such as deep vein thrombosis, pulmonary embolism, orthostatic hypotension, bradycardia, autonomic dysreflexia, altered thermoregulation, and changes to cardiac function as a result of injury to the sympathetic nervous system.
[76] In Catastrophic Injuries in Sports and Recreation: Causes and Prevention : A Canadian Study, Charles Tator states that the average case of non-fatal catastrophic injury costs about $7.5 million (Canadian dollars, normalized to 2006) in lost earnings, lifetime care, and rehabilitation services, and cost the economy of Ontario about $2.125 billion annually.
Education is intended to inform the participants of potential dangers of risky behaviour in the activity, and engineering "involved modifying the environment to create safer surroundings",[80] such as maintaining playing fields or improving the design of equipment.
[83] This was designed to protect member institutions "against the sudden and substantial costs of injury benefits",[83] typically obtained by the student via worker's compensation claims and litigation.
This allows a catastrophically injured student athlete to receive "medical, rehabilitation, and work-loss benefits"[84] until death by waiving rights to litigation.
The institution thereby need not invest the human and financial resources associated with litigation, in addition to a potential award to the plaintiff, and the student receives immediate and lifelong benefits.
[86] In South Africa, the largest malpractice settlement for the Medical Protection Society as of 2011 was for R17 million, awarded to a patient who had catastrophic neurological damage as a result of a surgical procedure.
