I was shadowing in the ED radiology reading room the other day when we received a stat request for a CT read. 20ish female bicyclist* with severe head trauma after crashing into a car on a neighborhood road, flipping over it, and striking her head. Glasgow Coma Score at the scene was 6. She had not been wearing a helmet.
As soon as we began reading her CT scans, we knew the prognosis was extremely poor. Multiple skull fractures, subdural, subarachnoid, and intraparenchymal hemorrhages, dissection of a carotid that explained the pulsating blood coming from her ear. It was truly heartbreaking. In the words of the ED radiologist, "I have to detach myself from this. Otherwise I could never read these images."
I never saw the patient, as she was rushed off to the OR soon after arrival. A few days later, I learned that she had died that day on the operating table.
People, please, please wear a helmet. I don't care if you think you're skilled enough to not need one, or think it doesn't look cool - it's going to be way less cool if you scramble your brains. At my college, most people rode bikes to get to class, and I was always stunned that the vast majority of students never wore helmets. Biking accidents are common and while most are minor, sometimes, the terrible occurs. Remember to learn to ride safely and please wear a helmet and protect yourself.
*details of case have been changed to protect privacy
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