How to Not Accidentally Die
AND OTHER ADVICE FOR A LONGER, HEALTHIER LIFE
ONE SLIP ON THE STAIRS, A MOMENT OF DISTRACTION BEHIND THE WHEEL, OR A MISSTEP ON THE FIELD — INJURIES CAN HAPPEN IN AN INSTANT AND THEY CAN HAVE LASTING PHYSICAL AND PSYCHOLOGICAL CONSEQUENCES.
The Injury Prevention Research Center at Emory (IPRCE) works to mitigate the staggering impact of injury in Georgia and the Southeast.
The center focuses on the most significant injury concerns of the region, which include drug overdoses, violence, falls, traumatic brain injuries, and traffic accidents. These threats tend to overlap.
“There’s a reason we don’t just have an overdose prevention center or a motor vehicle crash prevention center,” says Jonathan Rupp, director of IPRCE. “We know some of the things we can do to prevent an overdose are going to have an impact on motor vehicle crashes. Similarly, the things we do to prevent bullying have an effect on overdoses. That’s the reason we have an injury prevention center—all these things end up being interrelated.”
IPRCE experts shared tips with Emory Health Digest for how to stay one step ahead of injury and keep yourself and your loved ones out of harm’s way.
Don’t fall
Falls are the leading cause of unintentional injuries for children and older adults. While tikes can typically bounce right back up, folks aged 65 and older can suffer life-changing damages, resulting in limited mobility, loss of independence, and even death.
“Many people consider falls to be a natural part of aging, but they are not,” says Elizabeth Head, deputy director of the injury prevention program at the Georgia Department of Public Health and co-leader of the Fall Prevention Task Force. “If you fall, there is a reason you fell, and much can be done to help prevent it. And it behooves you to prevent falls because if you have fallen once, you are more than twice as likely to fall again.”
Here are a few tips to help you remain vertical:
Talk with your doctor. Be sure to tell your doctor if you have fallen, worry about falling, or feel unsteady on your feet. Review your medications with your doctor once a year, even the over-the-counter drugs you are taking. As you get older, the way medicines work in your body can change, perhaps making you sleepy or dizzy. “People who take more than four prescription medications are more at risk to have a fall,” says Head. “That’s generally because of the interactions of those medications.”
Get your eyes and feet checked once a year. Age can bring vision changes, such as cataracts and glaucoma, making it easier to trip over things. It’s also a good idea to have your feet checked annually, and to wear proper footwear. Choose shoes that have a textured sole to prevent slipping, grip your foot well so you don’t slide out of them, and provide adequate support.
Make your home safer. Simple adjustments can lessen the risk of falling in your home. Keep floors and stairs free of clutter, and reconsider throw rugs, which can be a trip hazard. Install grab bars, use non-slip mats, and use motion-sensor nightlights, especially in bedrooms and bathrooms. Have a sturdy step stool available in case you need to reach something from a high shelf—never climb up onto a chair or table.
Exercise to improve your balance and strength. Many senior centers, YMCAs, and other locations offer evidence-based falls prevention exercise programs, such as tai chi, Moving for Better Balance, the Otago Exercise Program, Matter of Balance, and more. “The newest and coolest offering I’ve seen is Bingocize,” says Head. “It’s Bingo, which everybody loves, with questions about fall risk, fall prevention, and the like. In addition, they also do some exercises that can be done seated or standing.”
Even if you can’t make it to a specific class, there are many things you can do on your own to improve your odds of avoiding falls. Walking whenever you can improves balance and confidence. When watching TV, stand and lift your legs up and down and side to side, perhaps while holding on to the back of a chair. Turn your ankle in slow circles in one direction then the other. “All of these things can improve strength and balance,” says Head.
The Fall Prevention Task Force serves as Georgia’s statewide falls prevention coalition and is working to expand falls prevention in rural areas. It also has created a virtual fall prevention series, “Falls Free Friday,” available on YouTube.
Drive smarter
Jonathan Rupp doesn’t use the term car accident. “An accident is not preventable,” says Rupp, the co-lead of the Transportation Safety Task Force. “Crashes, on the other hand, are preventable. That’s why we always say car crash.”
In Georgia, transportation has yielded its spot as the number one cause of injury to violence and overdose in recent years, but it still claims many victims. In 2022, 1,797 people lost their lives in traffic fatalities in Georgia. In the entire country, that number was more than 42,500.
The biggest culprit in all crashes, from fender-benders to fatalities, is distracted driving, accounting for more than 90 percent of all incidents. According to Georgia Traffic Safety Facts, at any point during daylight hours, about 15 percent of drivers in Georgia are engaging in risky behaviors such as texting, making hand-held phone calls, eating, or drinking. Even if you are paying complete attention to the road, the driver in the car coming toward you may not be.
Rupp advises all drivers to avoid distractions while driving. If you must talk on the phone, use the Bluetooth hands-free option or, even better, wait until you are done driving to have that conversation. Consider putting your phone in “Do Not Disturb” mode and store it out of reach. Along the same lines, driving is not the time to touch up your makeup, eat your meal, or try to retrieve items that have spilled. Keep your eyes, hands, and mind on the task at hand—driving.
Rupp’s other pieces of advice for avoiding transportation injuries are well-known but bear repeating:
Never get behind the wheel if you’ve been drinking. About 30 percent of fatal crashes involve an impaired driver.
Always wear your seat belt. Not using a seat belt in a crash increases your risk of death by up to 60 percent.
Obey speed limits. More than 20 percent of fatal crashes are related to excessive speed.
Maintain a safe distance between you and other cars on the road to allow for time to react to sudden changes.
Be patient.
Be patient.
Be patient.
Of course, you don’t have to actually be in a car to be injured by one. Each year, pedestrian and bicyclist fatalities comprise about 19 percent of all traffic fatalities, according to the US Department of Transportation. For bicyclists, wearing a helmet is the best line of defense. According to the National Institutes of Health, helmets provide a 69 percent reduction in the risk of head and brain injuries for bicyclists involved in motor vehicle crashes.
Bicyclists and pedestrians should not expect drivers to see them, says Rupp. “Wear highly visible clothing. If it’s dusk, have a light. Stay in the areas where you are supposed to be. Most pedestrian injuries happen because the pedestrian is in a place the driver does not expect.”
Admittedly, cars are getting safer. Today they come with features such as lane departure warnings, automatic braking systems, and blind spot detection. But those features are only in newer cars and there are plenty of older models still on the road. And if you are driving too fast or recklessly, you may be injured despite multiple safety features.
The Transportation Safety Task Force provided advocacy work that led to the passage of the hands-free phone law in Georgia, as well as giving feedback and input to the Governor’s Office of Highway Safety on safety fact sheets and measurements of seat belt use and driver distraction.
Watch your noggin
Traumatic brain injuries (TBIs) are caused by a bump, blow, or jolt to the head that disrupts the normal function of the brain. TBIs can result from car crashes, falls, physical assault, and sports-related injuries, to name a few of the most common culprits, and they range from mild to moderate to severe.
Moderate to severe TBIs require immediate attention. “If you’ve had an accident or fall or banged your head in some way, and you then lose consciousness, have nausea and vomiting, or vision disturbances, you need to go to the emergency room,” says Jonathan Ratcliff, associate professor of emergency medicine and neurology and a member of the Traumatic Brain Injury Task Force.
Mild TBIs, often called concussions, pose a different problem. Many people aren’t aware they have one. “If I break my arm, it’s readily visible and I lose function in my arm,” says Ratcliff. “But if I get a concussion, I might just have headaches or dizziness. People are used to pushing through symptoms like those.”
Pushing through, however, is the wrong thing to do. “For an athlete, every minute he or she continues to play after having the concussion is associated with a prolongation of symptoms,” says Ratcliff. “The same goes for someone working at his computer who gets a bad headache after suffering a mild TBI—if he keeps working with that headache instead of resting, healing will be delayed.”
People with a mild TBI can recover safely at home, but it’s a good idea to go to your primary care doctor for a check-up. Most people are fine within seven to 10 days and don't require therapy or intervention.
But if symptoms persist beyond 10 days or start to get worse, you should go back to your doctor. It’s also important to realize TBIs can be cumulative. So if you suffer another injury before your first one is completely healed, the damage will be compounded, leaving you to struggle with long-term effects of the concussion. But if your original injury has healed completely, experts now believe a second injury may not be cumulative, according to Ratcliff. “It’s almost like your brain gets a full reset,” he says.
For moderate or severe TBIs, the primary injury kicks off a cascade of events that creates inflammation, leading to the death of brain cells. No known intervention can stop the cascade. There are no effective therapies specific to TBIs, although Emory physicians have had good results with aggressive care aimed at getting all markers back to the normal range. “We make sure the blood pressure stays in a good range,” says Ratcliff. “If pressure is building somewhere in the brain, we relieve it. We make sure glucose stays in the normal range. We’ve been getting better and better outcomes over time.”
Preventing TBI depends on your exposure. Athletes should make sure they use quality protective equipment and practice safe techniques. “There are ways to make a tackle in football, for example, that are safer than other ways,” says Ratcliff.
If an athlete suffers a blow to the head, he or she should stop playing immediately and be evaluated.
Drivers and passengers should always wear their seat belts in cars. Automobiles have become safer with the addition of multiple airbags and improved restraint systems. That has actually resulted in more concussions, but for a good reason. “These are people who might have experienced severe TBIs in the past,” Ratcliff says, “but now in a crash they are experiencing a milder form of concussion.”
Bike riders should always wear a helmet and make sure it’s in good shape. Unlike football helmets, which are designed to withstand multiple blows, bike helmets should be replaced after a crash—or even after being dropped from a height. The foam compression in bike helmets is not made to withstand multiple blows.
Drug dangers
For the first time in decades, public health data shows a sudden drop in overdose deaths. The CDC reports a decline of more than 22 percent from August 2023 to August 2024. That’s a huge reversal from the double-digit percentage increases in recent years.
Experts aren’t sure why. “We certainly have increased access to medication-based treatment for addiction,” says Joseph Carpenter, associate professor of emergency medicine and co-leader of the Drug Safety Task Force. “We’ve seen increased knowledge and availability of naloxone, which reverses most opioid overdoses. And some are theorizing there’s been a shift in the drug supply, making it a bit less lethal. But it’s conjecture at this point.”
Still, roughly 100,000 people die of overdoses each year. “In this epidemic, everyone is affected,” says Carpenter. More than 40 percent of Americans know someone who has overdosed. The best line of defense is to avoid becoming dependent on opioids. But if you are recovering from surgery or an injury, says Nicholas Giodano, assistant professor of nursing and co-leader of the Drug Safety Task Force, be honest with yourself and your provider about your pain. “Patients who have poorly managed post-operative pain are at greater risk for prolonged opioid use. Try other approaches, such as over-the-counter drugs like Aleve, topical solutions like Tiger Balm or lidocaine patches, even mindfulness exercises.” If you do get an opioid prescription, Sarah Febres-Cordero recommends you also get naloxone (brand name Narcan) and keep it at your bedside. The assistant professor of nursing says, “You’ve just had surgery and are probably groggy. You might take your opioid, then forget and take another pill.”
If you or a loved one has developed an opioid use disorder, the Substance Abuse and Mental Health Services Administration (SAMHSA) can suggest treatment centers near you. When using opioids, harm reduction strategies save lives. Fentanyl test strips are available at drug stores as well as online at sites such as Aniz Inc., Dancesafe.org, and Georgia Harm Reduction Coalition. Drug checking is underused, says Febres-Cordero. “Studies have shown that the more informed consumers are about drugs they buy from the unregulated drug market, the more likely they are to change behaviors.” Many harm reduction sites also offer sterile syringes and Narcan.
Three-quarters of people who die from a drug overdose die at home alone. People who use drugs should have someone with them who can call 911 and give Narcan if they become unresponsive. Hotlines such as Safe Spot (1-800-972-0590) have a trained operator who will stay on the line and call for help if needed.
If you are willing, carry Narcan in your car or pack. If you
encounter someone who may have overdosed—who is unresponsive and breathing abnormally—administer Narcan. “You will not cause any harm to someone if you give them Narcan and they are not overdosing,” says Febres-Cordero. “It won’t hurt them at all, so if in doubt, use it."
Normalize safety
FIREARM SAFETY - Violence, unfortunately, pervades our society. It cuts across ages, backgrounds and ethnicities. It can take the form of assault, intimate partner violence, suicide, and elder or child abuse. All forms can be interconnected. And people who experience one form of violence are more likely to experience others.
The Violence Prevention Task Force works on violence prevention in multiple ways. One focus is the common denominator in many forms of violence: firearms. Firearm injuries were the leading cause of death in the US among children and teens ages 1 to 19 in 2022, and among the five leading causes of death for people ages 1 to 44. More people suffer nonfatal firearm-related injuries than die, and survivors are often left with physical disabilities, chronic pain, and trauma-induced psychological issues.
About one in three Americans have guns in their homes. In Georgia it’s one in two. It’s critical, say gun safety advocates, to store your firearm securely in the home. That means more than putting a gun out of sight and out of reach. All firearms should be stored—unloaded—in a container that locks. Ammunition should be stored separately and locked.
Parents should talk to their children about guns. “We did a study and found it’s not easy for kids to tell the difference between toy guns and real guns,” says Sofia Chaudhary, assistant professor of pediatrics and emergency medicine and a co-leader of the Violence Prevention Task Force. “Parents need to talk to children about that. Tell them never to touch or pick up a gun, and if they see one, tell a grown up.”
If your child is going to someone else’s house—even a relative’s—you should ask in advance if they have a gun in the house and if so, if it is locked up. You should also ask about guns in cars, since many people store firearms in their vehicles. If you don’t like the answers you get, suggest the children gather at your house instead. “Asking these types of questions can feel invasive, but they can be lifesaving,” says Chaudhary.
Safe gun storage is important in youth suicide prevention. The time between suicidal ideation and acting upon it is typically brief in young people. If they can’t get to a gun immediately, the desire to act may well pass. Toward that end, Chaudhary has piloted a program to give out lock boxes to families of youth who come into pediatric emergency departments for acute mental health concerns, as well as counseling parents about the risks of having an accessible firearm. These families report increased rates of locking up their firearms afterward.
INTIMATE PARTNER VIOLENCE - Sangmi Kim, assistant professor in the Nell Hodgson Woodruff School of Nursing and co-leader of the Violence Prevention Task Force, focuses on intimate partner violence. About 41 percent of women and 26 percent of men in the US have experienced intimate partner violence in their lifetime.
It can seem like an easy problem to solve—just leave the abusive partner. But that can seem impossible. “Many victims are financially dependent on their partner,” says Kim. “And often, children are involved, which complicates things. Women may not even be aware that what they’re experiencing is abuse. Some may experience isolation from family and friends and face barriers to accessing resources. These challenges can stem from limited knowledge about available services, partner monitoring and control, lack of transportation or childcare.”
Kim says prevention efforts need to move beyond the individual. “Violence prevention requires changes at the community and societal levels,” says Kim. “We need consistent policies nationwide to protect and support victims along with trauma-informed services to meet their health and societal needs. Intimate partner violence cannot be normalized.” EHD
Written by Martha Nolan; Design by Peta Westmaas
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