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Head Injuries, Sprains and Broken Bones
Participating in sports and physical activities is enjoyable and beneficial for our health. However, the risk of injuries comes with the fun and excitement of sports. Sports-related injuries, including sprains, traumatic brain injuries and broken bones, are more common than we realize and can land you in the emergency room. Dr. Scott Shepherd, Emergency Medicine Physician, provides a wealth of information. Traumatic Brain Injuries: The Invisible Threat Traumatic brain injuries come in many forms. From “mild” brain injuries, concussions, to major brain injuries and bleeds. Sometimes it is very difficult to tell the difference between a major injury and a minor injury because many of the symptoms are the same. Concussions Concussions are a type of “mild” traumatic brain injury resulting from a blow to the head or a violent shaking of the body that causes a transient alteration in mental function. They are particularly prevalent in contact sports such as football, soccer and boxing. A concussion can affect memory, judgment, reflexes, speech, balance and muscle coordination. Typically, concussions are not life threatening and usually short lived. However, multiple concussions can lead to permanent disabilities. So, remember there is nothing “mild” about injuring your brain. Contusions The more serious brain injuries from brain contusions (actual bleeding in the brain material) and bleeding that presses on the brain are life threatening. These injuries are caused by the same blow to the head as a concussion and the symptoms are the same from memory deficits, loss of coordination to coma. Because of this, anyone who has a blow to the head and is not acting normal should be evaluated by a medical professional. Anyone suspected of having a severe head injury should seek immediate medical attention and follow a strict protocol for rest and a gradual return to play. It is important to note a person may not lose consciousness if they suffer a concussion; however, major consequences can occur if not properly managed. If you suspect you have an emergency that needs immediate medical attention, please call 911 or visit an emergency room near you. While it is impossible to prevent traumatic brain injuries altogether, the severity of the injury can be mitigated through proper helmet usage and knowing your skill level when participating in high-risk activities. The guidelines for picking a helmet for summer activities such as mountain biking, dirt biking and riding off highway vehicles are similar to those of picking a helmet for winter sports. Learn more about choosing the right helmet. Any blow to your head, neck or upper body can result in a major head injury Signs to watch for include the following: Headache Dizziness Blurred vision Difficulty with thinking, attention or memory Sensitivity to noise or light Ringing in the ears Changes in hearing Double vision Changes in behavior Balance issues Nausea/vomiting Sprains: The Annoying Twist One of the most common sports injuries is a sprain, which occurs when ligaments that connect bones are stretched or torn. Sprains typically occur in joints, such as the ankle, knee or wrist, and are often caused by sudden twists or impacts. Symptoms may include: Pain Swelling Bruising Limited range of motion Rest, ice, compression and elevation (RICE) are the initial recommended treatment, followed by physical therapy to regain strength and mobility.
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As 70,000+ People Congregate for Burning Man, 100 Miles Northeast of Reno, Renown Health’s Emergency Teams and Hospitals Prepare to Serve
Burning Man is an annual event inspired by the values reflected in the Ten Principles and united in the pursuit of a more creative and connected existence in the world. As over 70,000 congregate this week, between Aug. 27 to Sept. 4, in the high altitudes of the hot and windy Black Rock Desert, Renown Health’s emergency and clinical care teams are ready to care for Burners who may find themselves ill and in need of additional urgent, emergent care or hospitalization. This year, people from across the world are expected to make the journey in RVs and cars brimming with tents, food, water, artwork, and costumes, temporarily turning Black Rock into the state’s third largest city. “The Burning Man Project has done an excellent job preparing participants to have a safe, healthy, and wonderful time building Black Rock City and living on the playa for nine days to nurture the distinctive culture emerging from that experience. However, bringing over 70,000 people together in a high altitude, desert environment with limited access to water, food, and sanitary conditions- always presents a challenge,” says Brian Erling, MD, MBA, president and CEO of Renown Health and an experienced emergency medicine physician. “Having excellent care on the playa and plans in place back here in Reno helps to mitigate that risk and ensure the health and safety of all participants.” “We welcome every Burner to northern Nevada,” says Bret Frey, MD, the board-certified emergency medicine physician who heads up the largest Emergency Department at Renown Regional Medical Center; which has the highest-level trauma center for 100,000 miles, located in Reno, NV. Dr. Frey has 23 years of experience in the medical field, and 23 years of experience treating people who have experienced Burning Man. “Burning Man is a fascinating event, and most people have a great time. However, if things go wrong, they are fortunate to have the BlackRock City Emergency Services Department, 24/7, to help. Back here in Reno, we serve as their ‘back up,’ providing care as needed, for the ill and injured and supporting clinical teams when they’re feeling overwhelmed.” Renown Health is home to three 24/7 Emergency Rooms that provide the highest level of emergency and trauma care in the region: Renown Regional Medical Center is the only Level II Trauma Center between Sacramento and Salt Lake City. Located near downtown Reno, this Emergency Room has several helipads and ambulance banks for patients requiring emergency and trauma care. Renown Children’s Hospital at Renown Regional Medical Center is home to the only Pediatric Emergency Room in the region designed just for kids. This location is staffed by pediatric specialists and provides child-sized equipment and family-friendly areas. Renown South Meadows Medical Center includes South Reno’s first 24/7 Emergency Room. Located just off I580, this location is designed to treat patients who need immediate attention for emergencies. These locations are designed to assess and care for emergency situations, including: Heart attack symptoms Stroke symptoms Broken bones Shortness of breath Seizures Severe bleeding Head injuries Chest pains Severe pain Venomous stings and bite All of Renown’s emergency rooms are staffed by Northern Nevada Emergency Physicians, including pediatric specialists and physicians who have completed fellowship training in specialty areas such as sports medicine, ultrasound and emergency medical services. A few interesting medical conditions (Playa Foot and Playa Lung), are associated with Burning Man. The Black Rock Desert in northwestern Nevada is part of the lakebed of the ancient Lake Lahontan, a deep lake that existed 15,000 years ago. Lake Lahontan left fine sediments on the lake bottom to form the extremely flat surface. Playa dust is made of both larger and smaller particulate matter. The Playa dust is in the air, on the ground, and on everything in Black Rock City. People combat the dust with masks, bandannas, and colorful respirators to keep the chalky dust out of their mouths and nostrils, but the effort is often futile. Playa Foot is a malady unique to the Black Rock Desert caused by the alkali dust that makes up the desert. It is, in essence, a chemical burn. The best prevention is keeping feet covered as much as possible, applying a moisturizing skin lotion before bed and wearing socks and closed shoes each day on the playa. “Playa Lung, where the particulate is breathed into the lungs, may cause coughing, throat pain and loss of voice in the short-term,” says William Graham, MD, a specialist in Pulmonary Medicine and Critical Care Medicine at Renown Health. “The dust can cause health issues for smokers, children and elderly and people with pre-existing conditions like asthma and COPD. The best prevention is to get a mask that’s comfortable with n99 filters, wear the mask as much as possible and change the filters often. Be sure to drink lots of water and take protection from windstorms. A doctor visit is recommended if any effects of breathing in dust persist beyond a week or two.” Dr. Derek Beenfeldt is the Chief Medical Officer for Renown’s not-for-profit insurance arm HometownHealth, and has been a frequent participant in the Burning Man experience over the years. In the interest of wanting every person to have a wonderful experience while here- especially since over half of the participants live outside the U.S. health care system, he reminds people of the number of free and low-cost on-site health care and testing resources provided on the playa at Black Rock City. “It is important for Burning Man participants to know that without US health care insurance coverage, the costs can be significant for transportation off the playa for a medical evacuation, hospital emergency department care or hospitalization. Even for people who have insurance, in the past, some have faced some significant out-of-pocket expenses for the flight or transportation to Reno-area hospitals or emergency departments.” He shares the following information; On Site Medical Response A community of EMTs, paramedics, nurses, medical students, and physicians are on site at Black Rock City in RVs to provide emergency response and urgent care to participants as needed. Local Hospital Response Since 2011, the Burning Man organization, has contracted with Humboldt General Hospital in Winnemucca, Nev., to staff and equip Rampart Urgent Care, a field hospital that offers X-rays, ultrasounds, a hand-held head scanner, lab tests and a pharmacy. The single-room wooden structure is easily seen- it is painted pink and yellow. The hospital’s 40 beds are located in adjoining tents. At Rampart, when possible, patients are treated on site. EMTs, medics and nurses are empowered to practice medicine to the fullest ability their licensing and credentialing allow. Patients are not charged for Rampart Urgent Care services, which is covered as part of their ticket fee. The Nevada State Health Division, Bureau of Health Protection Services is also on the playa. You will know them by the Nevada State Health Division logo on their shirts. All Renown’s physicians remind people that if they are experiencing symptoms of a heart attack or stroke, they should go to the closest emergency room (ER) to get needed medical care. Delaying care for a medical emergency, such as a heart attack or stroke, can be life threatening or lead to serious complications. About Renown Health Renown Health is the region’s largest, locally governed, not-for-profit integrated healthcare network serving Nevada, Lake Tahoe, and northeast California. With a diverse workforce of more than 7,000 employees, Renown has fostered a longstanding culture of excellence, determination, and innovation. The organization comprises a trauma center, two acute care hospitals, a children’s hospital, a rehabilitation hospital, a medical group and urgent care network, and the region’s largest, locally owned not-for-profit insurance company, Hometown Health. For more information, visit renown.org.
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Department Spotlight: Respiratory Care
This Department Spotlight is dedicated to Jason Simpson, Manager of Respiratory Services at Renown Children’s Hospital. Take a moment to breathe deeply. Inhale in, exhale out. We rely on our lungs to provide us with the air we need to live a healthy life – and this essential bodily function is something that many of us don’t think twice about since it comes easily for us. Now, imagine yourself as someone who is living with severe asthma, chronic obstructive pulmonary disease (COPD) or someone who was recently diagnosed with a frightening respiratory condition like COVID-19 or pneumonia. The simple act of breathing can prove to be an intimidating venture requiring the care of a professional. Who are the people that take on the challenge? Meet Renown Health’s Respiratory Care Services department. Serving patients across 13 service lines, three acute facilities, outpatient locations and telehealth, our respiratory specialists – including respiratory therapists, respiratory care aides, inpatient COPD respiratory therapy navigators and educators and more – use their expertise to help restore the vitality of all their patients with every inhale and exhale, shaping a healthier livelihood one lung at a time. The Guardians of Respiratory Wellness Whether they are managing lifelong respiratory conditions or offering crucial support in emergencies, the Respiratory Care team strives to enhance the quality of life for every patient. As an indispensable member of the clinical team at Renown, our respiratory therapists work collaboratively with doctors and nurses to tackle a wide range of tasks, tailoring care for each patient’s unique needs. “Respiratory care is involved with all stages of life, from beginning to end,” said Sarah Kurtz, Respiratory Therapist. “We work closely with nurses and doctors and perform arterial punctures, breathing treatments, weaning maneuvers for patients on life support, intubations and much more. We assess patients constantly to see if their care needs to be upgraded or if they can be weaned to get them back home with their families.” “You start your morning researching your assigned patients,” added Tim Start, Respiratory Specialist. “We go over lab values and chest radiographs and decide the best plan of care for each patient. Our objective is to improve their respiratory status by giving them medications and doing breathing exercises. We participate in other forms of care with nurses, such as activities of daily living (ADLs) and mobilization. We work as a team, and that enables us to provide great patient care.” For patients living with COPD, enjoying all that life has to offer comes with a separate set of obstacles. According to the Centers for Disease Control and Prevention (CDC), over 200,000 people across the Silver State are living with this chronic condition. Luckily for them, Renown has a specialized team to help these patients optimize their life and manage their condition with individualized treatment and education. “We run a report every morning to identify all the patients currently admitted who have a history of COPD, take respiratory medications or smoke,” said Amber Beck, Inpatient COPD RT Navigator. “After looking through their charts, we visit with the patient (and possibly their family) at the bedside to help them better understand how to manage their breathing issues.” As a vital part of the Respiratory Care team, Renown’s respiratory care aides help ensure the seamless operation of our respiratory care services. These dedicated professionals provide essential support to respiratory therapists not only during intricate procedures but also outside of face-to-face patient care by transporting equipment, restocking supplies, assisting in the mobilization of patients and more. “We are responsible for the maintenance of unit supplies and making decisions regarding levels of stock to be maintained,” said Dia Ramos, Respiratory Care Aide. “We also transport equipment, refill the oxygen tanks on the floors and intensive care units (ICUs), order and stock respiratory care supplies, mobilize patients and assist the respiratory therapists during bronchoscopies in the ICUs. In addition, we clean respiratory equipment like mechanical ventilators, continuous positive airway pressure (CPAP) and bilateral positive airway pressure (BiPAP) machines, high flows and aerosol poles.” Once the COVID-19 pandemic hit, a special spotlight shined upon respiratory care teams across the country for the heroic care they provided patients in respiratory distress. While their roles in health systems have gained a better understanding nationwide, this team understands it is vital for them to educate the community about the important jobs they hold for our patients. “Respiratory care can be under the radar,” said Pam Umek, Respiratory Specialist. “Once, when I told someone that I am a Respiratory Therapist, they said, ‘Oh, like a yoga breathing instructor?’ I then explained all the things we do: intubation, extubation, bronchoscopies, transports, traumas, codes, rapid responses, pediatrics/NICU, breathing medications/therapies, open heart rapid ventilator weaning … needless to say, that individual walked away with a better understanding of not just Respiratory Care Services but also the enormous effort it takes to care for our community.” The accolades and achievements continue to pour in, from national awards and certifications to implementing different jobs in care units to optimize the patient care experience. “We have earned and continue to maintain the Joint Commission Disease-Specific Certification for COPD,” said Amber Beck. “We are well below national averages for 30-day readmissions, lengths of stay and mortality due to COPD. Sandy, one of our COPD Coordinators, was a recipient of a patient advocacy award from the American Association of Respiratory Care and FACES Foundation.” “We have started implementing Respiratory Care Aides in the critical units, starting with the Cardiac ICU,” added Dia Ramos. “We work as one team and are always helping each other with their tasks.” Education and mentorship are at the core of Renown’s mission to make a genuine difference in the health and well-being of every patient. Nurturing the next generation of medical professionals – including respiratory care professionals – is a task that the Respiratory Care team takes seriously. “It has been great being able to help educate students in different disciplines,” added Pam Umek. “We have been able to offer shadow shifts to students in emergency medical services (EMS), nursing and medical school. These opportunities help students entering the medical field have a better understanding of the many ways we can help care for our respiratory patients.” From the moment of birth to the final stages of life, Renown is fortunate to have a Respiratory Care team that tirelessly ensures every breath counts, safeguarding their role as a trusted partner within our health system. A Tribute to Jason Simpson, Healthcare Hero