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nalure du inciudc an abundance of by Dr. A. n. ��lintz, slatcs Il�al, � iiead injuries which can result in a "about ono-fowth of Ihe children varic�y of permanem damngc slmes with iNracrani�l hemorrhagc do nul run6��B from minor brain damage �o have an assrociated fracturc."° This � death. The risk is r¢al ond rhe po(en- same article discusses thc problem of � lialJorfhemos(severeiNUryisimmi- delayed reactione to hcad trauma: nmt with every folL "(emphnsis "Thc pf4µ4o5�s t�sually is p�niE � added) , j,. f.� � �. �� -�: ilmt musi cii�Iaee�! reCOVer fWly Pibm The �surp�se of �lhis arlicle ic head injury: Somechildren, however, twofoid!' Finl, m underscore i� have problems ufler head trauma. polemially sefip.uS..Aat9[e__oL1M. One of these is the so-callcd posh g•pical_playground accident. and sec- traumatic epilepsy which occurs in ond,_tQ exsmine the iasue of rcspon- about 10 percem af children who sibilitLThe serenty� 1fie pio6�fem � have had significant head injuries. medically can best be understood by The onse� is usually between one relating reuamh on head trauma to month and �wo vears afier ihe head data on human impacl tolerance injury, and one should treat Ihese pa- devlo0ed in the field of kinetics. While the courls alone can decide liability in particular ceses, general aspec�s of iegal responsibili�y will be discussed herc. SomeMedinlAspecta •••[hE IQB� 1SSUE Ifl playground in- A sea¢h of the medical literature juries...should not be on the su6jat of head injury leads to that of supervision, 8S twomainconclusions:(1)verylittleis necessar 8S I[ 15� bU[ known about what actuaily goes on Y inside the human head when it is sub- K'tlet�lE[ O! IIOL [h0 SUC- jxted [o a severe blow; (2) while face onto which the ^^w. children tend lo recorer sooner than vietim fell could , adults do from injuries, the possibili- pOSSI�)�y �73VE BbSOfbC(1 -�` �y (or Nnctional impairments is greater if a Aead injury occurs during the impact oF a human �h�ianooa. being falling from a According ro an articte on head g��en height. trauma by Doclors Nancy Geniaer and Melvin Decker: "Few children reach adulthood wi�hout having sus[ained trauma ro the head. Out of approximarely 200,000 children ho$p�lalioPd a��. tients as one would any other seizure � year wiih head trauma,lhemousiiq� disorder.'^ is 1.5 Oerceni but !he percenmge oJ As has bern ciced by researehers in �morbidityremainsunkrtown."(em- other areas of child developmem, phasis added) s0��alists in head �rauma observe In general, the phrase frnctured that, in generai, the eadier such an skul( has a drama�ic and menacing event ocwrs, ihe grea�er i�s conse- qualiry, suggesling that ihe very worst quences are likely to be. In Dr. Bryan has happened to ihe the patienfs Jenne�PS words: head. In facl, however, while a(rac- ••A period of impaired ture of t6e akull is always taken neurological lunction in boih Ihe seriously, of itself it says nothing physical and mental spheres, even if about the severity of permanent comple�ely rccovered from eventual- damage which may or may not have ly, may have serious eftcc�s during a ocwrrcd ro the brain itsdL As Doc- periud when the brain is developing rors Genieur and Becker poim our. rapidly."? "Certainly in children Ihe prcsence Legal C%PCf15 will undoubtedly or absrncc of a tracture does not have already discemed a complex �� rclittl the degrec of pa�hologic problem �rilh rcgard ro dclermining changes in thc undedying brain and thc eatenl o( Ihe playground accidcm i;; coverine., ••• ��iaim's ha�A injuries. Who is !o sny Ano:l��: Ji:.cus�ion uf Ihc aubjcct. �hat b7aq' or Johnny. wUo apV�ars tu havc recovered (rom a fall sustained I:KI xTek, will not at 5ome fulure datC exhibit aberrant 6ehavior, or symp- toms of impaired motor functionT The issue is, of course, funher com- Plicated hy ihs fact thai the�victimc ut� j i�;""und es such' arc in- cap56�F'�iYY ecting on their own behalf until they have rcached their majori- tY. Given the higli incidence of injuries resWting from impacting pla7ground surfa<es, the question of Ihe rclation- ship between these surfaca and hwnan impact tokrence arises. � Some Physfcs of the Yroblem How great an impacl wn Ihe human head withstand before aus- taining serious injury? At wha[ point is a blow to the head likely lo be fatalT Even among physicists w6o specialiu in Lhis area, there is disagreement over estabiishing objec- tivc criteria since it is not possibie to ezperiment wi�h human subjects. Swdies done on cadaven for Ihe automolive industry, for instantt, yield information relative to head bone wlerance, bu1 not lhethe efPocts of imnact on the brain. As a result, Ihe cri�eria used will depend largely uDOn the physicis[ consultcd: some uu "ayera8" r._r---=--.•�• ^ athers Dreftt "peak G-fy�;' and a[ timu both l'al�n rerms of milliseconds. In discussing the problems of 6ead protection, Arlhur Hiruh describes the situation as follows: '•Our knowledge is sufficiem to � develop adequate protation for the skull. What of our knowledge of brain vulnerability? Here pm[ection by rational design is no[ O�sible: we find atmost nothing in the literawre that enables us to relate injury to Ihis al4imporlant rcgion of the head with some level of physical auack, despite the fact that such a relationship is necessary for answers m the prottt- tion of design enginmrs' ques[i0ns, whal material and howmuch.^� In Hirsch's opinion, [he best ah tempt at meeting this need emerged from Wayne Siate Universily, in a curve which associa�es trauma and at- tack Ievel, and which is reproduad in his arlicle. It is Ihis aDP�a�cA which was follo�attl and adaD�� Y. Dr. Frc�l W.endt.. of .FrantliaJnstilwc Rcuvch Laboralorics.jn_dcmtopjuC a crilcrim� for tIm acc�oiabifi�s. sr various playgwund surfacing