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  1. Pirrung, Joan M. RN, APRN-BC, MSN

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As a trauma nurse, I've cared for many patients involved in motorcycle crashes who suffered severe and sometimes fatal head injuries. The frustrating fact is that lives could have been saved and head injuries minimized had more motorcyclists and their passengers been wearing a helmet.

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As of November 2008, only 20 states and the District of Columbia required all motorcycle drivers and passengers to wear helmets. Another 27 states require riders of a certain age (typically under 18) to wear a helmet. Three states-Illinois, Iowa, and New Hampshire-have no helmet laws.


More and more Americans, including many over 40, are riding motorcycles, according to the National Highway Traffic Safety Administration. As this number continues to rise, we nurses need to make this population a target for our crash and injury prevention efforts. Helmet use can significantly reduce serious injuries and death from motorcycle crashes. Unhelmeted motorcyclists involved in a crash are three times more likely to incur a head injury than helmeted riders. Motorcycle crash fatalities have dropped in states that enacted helmet laws and increased in states that repealed their helmet laws for adults. As nurses, we should encourage patients to wear helmets and contact our state legislatures to advocate for universal helmet laws.


Knowing that most crashes are preventable just makes it more disturbing when a patient suffers a traumatically amputated limb or severe spinal cord injury after being thrown from his motorcycle. Remind motorcyclists to drive responsibly, observe speed limits, and follow the same rules of the road as other motorists. Tell them to resist the temptation to weave around cars, and remind them that they're often hidden in another vehicle's blind spot and can easily be missed when a motorist checks his mirror. (To learn how to care for injured motorcyclists, see 'An Upward Trend in Motorcycle Crashes' starting on page 28 of this issue.)


About one-third of fatal motorcycle crashes involve drivers who had a blood alcohol content of 0.08 grams/dL or more. No one should drive any motor vehicle while intoxicated, but a motorcycle offers riders even less protection in a crash than an enclosed vehicle.


Finally, teach parents about the potential dangers of off-road motorcycling among children and teens. Recurrent concussions, which can have long-term consequences, are a risk of this increasingly popular but often dangerous sport. Helmet use is just as important for off-road motorists as for those driving on the highway.


Motorcyclists, motorists, lawmakers, parents, and healthcare providers must work together to make injury prevention a priority. Preventing motorcyclist deaths or life-changing injuries isn't as simple as strapping on a helmet or following the rules of the road-but those are good places to start.


Joan M. Pirrung, RN, APRN-BC, MSN


Program manager


Christiana Care Health System-Christiana Hospital Newark, Del.