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Physical Challenges- Possible Paralysis 

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Physical Challenges- Possible Paralysis 

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With Burke hitting her neck and injuring one of her vertebral arteries, she very well could have severely injured her spinal cord. She would have to live everyday without being able to use certain parts of her body and this affects many everyday activities. SH

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Spinal cord injury - Symptoms and causes

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Learn what may happen after the spinal cord has been damaged.

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Physical Challenges- Effect of Brain Bleed

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Physical Challenges- Effect of Brain Bleed

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When the brain bleeds, it keeps oxygen from getting to the brain and cells die. As a result of cell death, neurological dysfunction occurs which can be anything from severe headaches to loss of motor function. SH

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Patricia Nevins, RN, MSN

Patricia Nevins is a registered nurse with nearly 20 years of nursing experience. She obtained her Master of Science in nursing with a focus in education from the University of Phoenix. Nevins shares her passion for healthy living through her roles as educator, nursing consultant and writer.

Hemorrhage means "to bleed." Trauma or disease can cause cerebral blood vessels to rupture and hemorrhage. According to The American Stroke Association, there are two types of brain hemorrhages: a subarachnoid hemorrhage, which is a bleed between brain and skull, and an intra-cerebral hemorrhage, which is a ruptured blood vessel within the brain. A disruption in normal blood flow to brain cells can lead to cell death in a few minutes.The effects of a brain hemorrhage can be devastating.

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The brain needs a constant flow of blood to bring vital nutrients and oxygen to its cells for optimum functioning. Registered nurse Donna D. Ignatavicius and M. Linda Workman, Ph.D., authors of "Medical-Surgical Nursing: Critical Thinking for Collaborative Care," explain that the brain cannot store oxygen or glucose, which is absolutely necessary for brain cell metabolism and neuronal function. A ruptured cerebral blood vessel will cause blood to leak into surrounding tissue rather than reaching individual cells. The areas of the brain fed by the ruptured blood vessel will experience ischemia from a lack of oxygen; cell death occurs leading to neurologic dysfunction.

Hemorrhage into the brain causes an increase in pressure inside the brain. The brain is housed inside the cranium, which is an inflexible capsule that keeps the brain safe. Intracranial pressure (ICP) is the pressure inside the brain cavity and it affects how well the brain is perfused. Barbara McLean, a critical care nurse practitioner, and Dr. Janice Zimmerman, authors of "Fundamental Critical Care Support," discuss how ICP is affected by cerebral oxygenation and swelling. Bleeding into the brain decreases oxygenation and causes swelling that increases ICP. This increased pressure makes it harder to get adequate blood flow to the brain. The outcome of uncontrolled elevated intracranial pressure can be death.

The effects of a brain hemorrhage on neurologic function include severe headache, decreased level of consciousness characterized by confusion or unconsciousness, visual disturbances and weakness or loss of motor function.

An effect of a brain hemorrhage is vasospasm, which is narrowing and constriction of cerebral blood vessels. Blood is very irritating to brain tissue and cerebral arteries. Blood in the brain causes vasospasm of the blood vessels in the area of the bleed. Vasospasm worsens cerebral ischemia because not only the brain cells fed by the ruptured cerebral blood vessel are without oxygen and nutrients, but now all of the surrounding tissue is experiencing a decrease in blood flow because of the vasospasm. This effect worsens neurologic damage.

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What Are the Effects of a Brain Hemorrhage?

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Hemorrhage means "to bleed." Trauma or disease can cause cerebral blood vessels to rupture and hemorrhage. According to The American Stroke Association, there are two types of brain hemorrhages: a subarachnoid hemorrhage, which is a bleed between brain and skull, and an intra-cerebral hemorrhage, which is a ruptured blood vessel within...

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Burke was placed on life support because she did not have enough oxygen and could not breathe on her own. Had she lived after being on life support, her vocal chords and lungs could have been damaged. SH

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In order to complete these important documents you should have a sense of what types of life support treatments are commonly available, as well as the benefits and drawbacks to help you make informed decisions.

How To Evaluate Life Support Treatments

All life-support treatments have benefits and disadvantages. For example, while a certain treatment may improve a particular function, it may also cause the patient discomfort. When considering life-support treatments, you should talk with your doctor about the nature of these treatments, as well as any specific treatments your particular health situation may require.

For each treatment, it's helpful to consider the following questions:

What purpose does this treatment serve?

What are the side effects?

Does this treatment usually improve overall health, or does it simply extend life?

You don't have to do this alone. Your doctor can help you figure out the impact that certain treatments may have, and can work with you to complete your Living Will.

Types Of Life Support Treatments

Life-support treatments may include:

Medical devices to aid breathing. A ventilator (also known as a respirator or breathing machine) provides air to your lungs through a tube if you're unable to breath on your own. This tube can be inserted in the mouth, nose, or an opening made in the throat. Apart from being uncomfortable and impairing the ability to speak, The National Heart, Lung and Blood Institute reports that it may lead to infections (the most common being pneumonia), lung damage, and damaged vocal chords.

Medical devices to provide food and water. Also known as a "feeding tube" or "tube feeding," this provides nutrition and fluids through a tube inserted in the nose, stomach, or intestines. The possible negative side effects include aspiration (inhaling the liquid food into the lungs), organ puncture, and infection.

Cardiopulmonary resuscitation (CPR). If your heartbeat or breathing has stopped, CPR may be administered to restart the heart or breathing. CPR techniques range from blowing air into the mouth (mouth-to-mouth resuscitation) and pushing on the chest (chest compressions), to electric shocks delivered to the heart (defibrillation), to breathing tubes inserted into the windpipe (intubation). The American Heart Association reports that conventional CPR can cause fracturing of ribs and/or the breastbone (sternum) in at least one third of cases. However, they also report that "the chance of surviving an out-of-hospital cardiac arrest is near zero for a victim who does not immediately receive high-quality chest compressions...followed by additional therapy within minutes."

Blood transfusions. If you have lost a significant amount of blood, it may be replenished with an intravenous supply of blood from a donor. According to The Center For Disease Control and Prevention (CDC): "Negative side effects of blood transfusion therapy are uncommon but can include blood transfusion reactions, infections, the development of red blood cell antibodies, and iron overload in different organs of the body."

Dialysis. If you have experienced kidney failure, measures may be taken to mechanically filter your blood (as the kidneys would). Dialysis usually entails removing blood from the body, filtering the blood, and returning it to the body. Depending on the type of dialysis you receive possible side effects include infection, hernias, and low blood pressure.

Antibiotics. If you have developed a bacterial infection, antibiotics may be used to kill the infection. The most widely reported side effect is antibiotic resistance. According to the CDC, while the benefit of antibiotics has been enormous, "these drugs have been used so widely and for so long that the infectious organisms the antibiotics are designed to kill have adapted to them, making the drugs less effective. People infected with antimicrobial-resistant organisms are more likely to have longer, more expensive hospital stays, and may be more likely to die as a result of the infection."

Related Reads & Resources:

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How To Evaluate Life Support Treatments And What They'll Do To Your Body

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In order to complete these important documents you should have a sense of what types of life support treatments are commonly available, as well as the benefits and drawbacks to help you make informed decisions. All life-support treatments have benefits and disadvantages.

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Burke died from hypoxic ischemic encephalopathy. This is hwen the brain is deprived of oxygen. SH

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Despite major advances in monitoring technology and knowledge of fetal and neonatal pathologies, perinatal asphyxia or, more appropriately, hypoxic-ischemic encephalopathy (HIE), remains a serious condition that causes significant mortality and long-term morbidity. Hypoxic-ischemic encephalopathy is characterized by clinical and laboratory e...

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Burke landed on her neck rather than her helmet, which caused more fatal injuries. Had she landed on  her helmet, then her injuries might have been less severe.  AG

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2. https://tse3.mm.bing.net/th?id=OIP.jLiJBqAxOM3zKqOG5404ngHaEx&w=291&h=188&c=7&o=5&dpr=1.1&pid=1.7
3. https://tse3.mm.bing.net/th?id=OIP.K-LMAQ-QpdehSrVi2WyS3QDIEs&w=115&h=168&c=7&o=5&dpr=1.1&pid=1.7
4. https://tse3.mm.bing.net/th?id=OIP.PVd6Y0fUK5Oew0zZjwThYQHaKX&w=147&h=197&c=7&o=5&dpr=1.1&pid=1.7

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CNN's John King talks to senior medical correspondent Elizabeth Cohen about the death of Olympic skier Sarah Burke.

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When her vertebral artery ruptured and all the blood rushed to her brain, it caused Burke to have an intracranial hemorrhage. This caused massive bleeding that surgeons could not stop. (referenced in NY Time article) AG

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Intracranial hemorrhage (ICH) refers to acute bleeding inside your skull or brain. It's a life-threatening emergency. You should go to the emergency room right away or call 911 if you think you or someone you know is experiencing ICH.

There are four types of ICH:

epidural hematoma

subdural hematoma

subarachnoid hemorrhage

intracerebral hemorrhage

Epidural hematoma

A hematoma is a collection of blood, in a clot or ball, outside of a blood vessel. An epidural hematoma occurs when blood accumulates between your skull and the outermost covering of your brain.

It typically follows a head injury, and usually with a skull fracture. High-pressure bleeding is a prominent feature. If you have an epidural hematoma, you may briefly lose consciousness and then regain consciousness.

Subdural hematoma

A subdural hematoma is a collection of blood on the surface of your brain.

It's typically the result of your head moving rapidly forward and stopping, such as in a car accident. However, it could also suggest abuse in children. This is the same type of movement a child experiences when being shaken.

A subdural hematoma is more common than other ICHs in older people and people with history of heavy alcohol use.

Subarachnoid hemorrhage

A subarachnoid hemorrhage is when there's bleeding between the brain and the thin tissues that cover the brain. These tissues are called meninges. The most common cause is trauma, but it can also be caused by rupture of a major blood vessel in the brain, such as from an intracerebral aneurysm.

A sudden, sharp headache usually comes before a subarachnoid hemorrhage. Typical symptoms also include loss of consciousness and vomiting.

Intracerebral hemorrhage

Intracerebral hemorrhage is when there's bleeding inside of your brain. This is the most common type of ICH that occurs with a stroke. It's not usually the result of injury.

A prominent warning sign is the sudden onset of neurological deficit. This is a problem with your brain's functioning. The symptoms progress over minutes to hours. They include:

headache

difficulty speaking

nausea

vomiting

decreased consciousness

weakness in one part of the body

elevated blood pressure

Most ICHs are due to a head injury. Any activities or lifestyle choices that put you at risk for a head injury can lead to ICH.

Factors that increase your risk include:

The signs and symptoms of ICH vary depending on the type, but they usually include:

a sudden and severe headache

a headache associated with a recent blow to your head

a mild and long-lasting headache

a headache accompanied by neck stiffness

confusion

drowsiness

vomiting more than twice in 24 hours

seizure

coma

ICH in children

ICH in a child can indicate child abuse. The damage may be the result of a blow to the head or by shaking the child. This can lead to shaken baby syndrome. This is a condition that occurs when violent shaking leads to serious brain damage in a child.

Other signs of child abuse are:

swollen head

retinal hemorrhages

vomiting

seizure

unconsciousness

fractures of arms and legs of different ages

Babies less than 12 months old may develop a swollen fontanel, or soft spot.

Report suspected child abuse right away by calling 911 or 1-800-4-A-CHILD (1-800-422-4453).

The first step your doctor will take to diagnose ICH is a CT scan of your head. A CT scan can show abnormalities in your brain like swelling or clots.

The CT scan may not show any sign of ICH. If you're still having symptoms, your doctor may choose to perform a lumbar puncture, or spinal tap, to test the fluid that cushions your spine and brain.

ICH is a medical emergency. Survival depends on getting treatment right away.

It may be necessary to operate to relieve the pressure on the skull. Drilling a small hole in the skull releases blood. Drilling a larger hole or removing a piece of the skull may be necessary to remove a blood clot.

Medications

The following drugs may be necessary:

An ICH can lead to any of the following complications:

seizures

paralysis

headaches

brain development problems in children

memory loss

dizziness

difficulty concentrating

Basic preventive measures that can help avoid head injuries include the following:

Always wear a helmet when riding a bike, motorcycle, skateboard, or scooter.

Always wear your seatbelt.

If you're of older age, try to avoid falls.

Call 911 or 1-800-4-A-CHILD (1-800-422-4453) to report suspected child abuse.

The outlook depends on the severity of the hemorrhage and how quickly you get medical care. Remember, ICH is a life-threatening condition.

Depending on the severity of the hemorrhage, draining a hematoma can lead to recovery. Physical or occupational therapy is sometimes needed to help you return to normal activities.

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Intracranial Hemorrhages: Types, Risk Factors, and Symptoms

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Intracranial hemorrhage (ICH) refers to acute bleeding inside your skull or brain. It's a life-threatening emergency. You should go to the emergency room right away or call 911 if you think you or someone you know is experiencing ICH.

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Burke ruptured her vertebral artery when she hit her head, which caused blood to rush to her brain. AG

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One physical challenge that Burke unfortunately experienced was death. She died from "irreversible damage to her brain due to lack of oxygen and blood after cardiac arrest". SH

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SALT LAKE CITY -- Canadian freeskier Sarah Burke died Thursday, nine days after crashing at the bottom of the superpipe during a training run in Utah.

Burke, who lived near Whistler in British Columbia, was 29. She was injured Jan. 10 while training at a personal sponsor event at the Park City Mountain resort.

Tests revealed Burke suffered "irreversible damage to her brain due to lack of oxygen and blood after cardiac arrest," according to a statement released by Burke's publicist, Nicole Wool.

A six-time Winter X Games champion, Burke crashed on the same halfpipe where snowboarder Kevin Pearce suffered a traumatic brain injury during a training accident Dec. 31, 2009.

As a result of her fall, Burke's vertebral artery was torn, which led to severe bleeding on the brain, causing her to go into cardiac arrest. CPR was performed on the scene, according to the statement.

Burke's organs and tissues were donated, as she had
requested before the accident, Wool said.

"The family expresses their heartfelt gratitude for the international outpouring of support they have received from all the people Sarah touched," the statement said.

Burke will be remembered for the legacy she left for women in superpipe skiing, a sister sport to the more popular snowboarding brand that has turned Shaun White, Hannah Teter and others into stars.

Aware of the big role the Olympics played in pushing the Whites of the world from the fringes into the mainstream, Burke lobbied to add superpipe skiing to the Winter Games program, noting that no new infrastructure would be needed.

Her arguments won over Olympic officials, and the discipline will debut at the Sochi Games in 2014, where she likely would have been the gold-medal favorite.

"Sarah, in many ways, defines the sport," Canadian Freestyle CEO Peter Judge said before her death. "She's been involved since the very, very early days as one of the first people to bring skis into the pipe. She's also been very dedicated in trying to define her sport but not define herself by winning. For her, it's been about making herself the best she can be rather than comparing herself to other people."

She was, Judge said, as committed to the grass roots of the sport -- holding clinics for youngsters and working with up-and-coming competitors -- as performing at the top levels.

"She was a great, positive person for the whole team, the whole sport," said David Mirota, the Canadian team's high performance director. "She enlightens the room, and she's great."

News of Burke's death spread quickly through the action-sports
world, where the Winter X Games are set to start next week in
Aspen, Colo., without one of their biggest and most-beloved stars.

"She's probably one of the nicest people I've known in my life,
and that's about the only thing I have to say about it," said
American superpipe skier Simon Dumont, a multiple X Games medalist.

Jeremy Forster, the program director for U.S. Freeskiing and
U.S. Snowboarding, said freeskiers would remember Burke "first, as
a friend, and then as a competitor who constantly inspired them to
do greater things."

"She was a leader in her sport, and it's a huge loss for the
freeskiing community," Forster said.

"Shocked and saddened," former freestyle Olympian Jeremy Bloom
said on Twitter. "Sarah was a true champion in everything that she
did."

Her popularity transcended winter sports. Burke met New York Knicks forward Amare Stoudemire at an ESPN The Magazine shoot, and Stoudemire tweeted Thursday: "The world lost a great athlete and innovator today, Prayers go out to her family."

Burke's death is also sure to re-ignite the debate over safety on the halfpipe.

Pearce's injury -- he has since recovered and is back to riding on snow -- was a jarring reminder of the dangers posed to these athletes who often market themselves as devil-may-care thrillseekers but know they make their living in a far more serious profession.

The sport's leaders defend the record, saying mandatory helmets and air bags used on the sides of pipes during practice and better pipe-building technology have made it a safer sport, even though the walls of the pipes have risen significantly in the past decade. They now stand at 22 feet high.

Some of the movement to the halfpipe decades ago came because racing down the mountain, the way they do in snowboardcross and skicross, was considered even more dangerous -- the conditions more unpredictable and the athletes less concerned with each other's safety.

But there are few consistent, hard-and-fast guidelines when it comes to limiting the difficulty of the tricks in the halfpipe, and as the money and fame available in the sport grew, so did the tricks. In 2010, snowboarding pioneer Jake Burton told The Associated Press that much of this was self-policed by athletes who knew where to draw the line.

"If the sport got to the point where halfpipe riding became really dangerous, I think riders would do something about it," Burton said. "It wouldn't be cool anymore."

His opinion is shared by many.

"There are inherent risks in everything," Judge said. "Certainly, freestyle skiing has one of the greatest safety records of almost any sport. Freestyle is a very safe sport in large part because we had to build a safe sport in order to get into the Olympics."

In 2009, Burke broke a vertebra in her back after landing awkwardly while competing in slopestyle at the X Games. It was her lobbying that helped get the X Games to include women's slopestyle -- where riders shoot down the mountain and over "features" including bumps and rails.

It wasn't her best event, but she felt compelled to compete because she pushed for it. She came to terms with her injury quickly.

"I've been doing this for long time, 11 years," she said in a 2010 interview. "I've been very lucky with the injuries I've had. It's part of the game. Everybody gets hurt. Looking back on it, I'd probably do the exact same thing again."

She returned a year after that injury and kept going at the highest level, trying the toughest tricks and winning the biggest prizes.

A native of Midland, Ontario, Burke won the ESPY in 2007 as female action sports athlete of the year.

"Sarah was a wonderful, spirited person and loved by everyone who had the pleasure of knowing her. Our thoughts and prayers go out to Sarah's husband, Rory, her mother Jan Thelan, her father Gord Burke and to the entire Burke family," ESPN said in a statement.

In 2010, she married another freestyle skier, Rory Bushfield,
and they were headliners in a documentary film project on the Ski
Channel called "Winter."

In her interview with AP two years ago, Burke reflected on the niche she'd carved in the action-sports world.

"I think we're all doing this, first off, because we love it and want to be the best," she said. "But I also think it would've been a great opportunity, huge for myself and for skiing and for everyone, if we could've gotten into the [Vancouver] Olympics. It's sad. I mean, I'm super lucky to be where I am, but that would've been pretty awesome."
Information from The Associated Press was included in this report.

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Freeskier Burke, 29, dies from crash injuries

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SALT LAKE CITY -- Canadian freeskier Sarah Burke died Thursday, nine days after crashing at the bottom of the superpipe during a training run in Utah. Burke, who lived near Whistler in British Columbia, was 29. She was injured Jan. 10 while training at a personal sponsor event at the Park City Mountain resort.

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Sarah Burke was a Canadian freestyle skier. Burke was training in Park City, Utah when she landed on her head after attempting a spin in her routine. After falling, she lost her pulse and stopped breathing.  She was rushed to the University of Utah Hospital and died 9 days later from lack of oxygen to the brain. Burke was seen as a "pioneer and a charismatic spokeswoman for a growing sport." AG

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The sport will make its Olympic debut at the 2014 Games in Sochi, Russia. Burke was expected to be one of the gold medal favorites there.

"She always asked, 'Why not?' " said Peter Judge, the chief executive officer of the Canadian Freestyle Ski Association, who knew Burke for more than a decade. "It was: 'Why not ski with the men? Why not be in the Olympics?' "

Her death will draw attention to the dangers facing those who participate in halfpipe sports, which feature soaring, high-speed moves executed on slick surfaces within immense walls.

Burke was injured Jan. 10 on the same halfpipe where Kevin Pearce, a promising snowboarder from Norwich, Vt., sustained a serious head injury in 2009.

Burke, while trying to land a trick at the base of the halfpipe, crashed and struck her head, rupturing her vertebral artery. The torn artery led to a severe intracranial hemorrhage, which in turn caused Burke to enter into cardiac arrest at the scene, her family's statement said.

As CPR was administered, Burke remained without a pulse and was not breathing. She was airlifted to the emergency department at University of Utah Hospital in Salt Lake City, where she was placed on life support. The next day, doctors performed surgery to repair the ruptured artery, though her recovery was far from assured.

"With injuries of this type, we need to observe the course of her brain function before making definitive pronouncements about Sarah's prognosis for recovery," Dr. William T. Couldwell, the surgeon who performed the operation, said the day after the procedure.

Although the operation was successful, subsequent tests revealed Burke had sustained irreversible damage to her brain as a result of the cardiac arrest, which had hindered the supply of oxygen to her brain.

Burke died "peacefully surrounded by those she loved" at 9:22 a.m., the family's statement said.

Doctors and officials at University Hospital, at the request of Burke's family, were unavailable for comment Thursday.

Burke's crash inevitably called to mind the one involving Pearce, which instigated debates on the safety of such events. Pearce was knocked unconscious after hitting his head on the edge of the halfpipe and remained in a coma for weeks.

Though he got back on a snowboard last month, his recovery from the effects of his injury continues, and he has no plans to compete again.

Burke's death could renew concerns about the sport.

Judge said Thursday that he expected that Burke's death would increase scrutiny. He said his organization considered athlete safety a "pre-eminent and predominant concern." Burke's accident, he said, was an "extraordinary" tragedy that would not ultimately require an overhaul of safety procedures.

"She was doing a trick she was well versed in, the conditions were good, and everything seemed normal," Judge said. "That mitigates a lot of that sort of introspection."

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Sarah Burke, Canadian Freestyle Skier, Dies of Injuries

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The sport will make its Olympic debut at the 2014 Games in Sochi, Russia. Burke was expected to be one of the gold medal favorites there. "She always asked, 'Why not?' " said Peter Judge, the chief executive officer of the Canadian Freestyle Ski Association, who knew Burke for more than a decade.