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This is my experience as Director of a Medical ICU in a major city Public General/Trauma Hospital in the State of Texas USA in the mid-1980's
The State had passed a mandatory motorcycle helmet law that had taken effect on Jan. 1 At the end of Jan, the NICU Director called as asked if I would accept some ventilated patients in transfer since his unit was full. I went to the ICU to evaluate them..
The NICU had 10 beds and 8 were filled with ventilated quadriplegic patients, All 8 had been riding motorcycles WITH helmets. After discussion, the NICU Director's hypothesis was that motorcycle riders that were previously killed in accidents from head trauma were now surviving their head trauma due to wearing helmets and were now suffering neck fractures. We had no idea how prevalent this NICU's experience was. Later, t State of Texas subsequently rescinded the law and the number of quadriplegics deceased.
My question to the authors is: Were there more quadriplegics from wearing helmets in your data?