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What Is Traumatic Subarachnoid Hemorrhage?

Brain injuries are a leading cause of motor vehicle accident-related deaths. According to the Centers for Disease Control and Prevention:

  • In the U.S., 1.7 million people sustain a TBI each year. Of these, 52,000 lose their lives and 275,000 require hospitalization.
  • Emergency departments treat and release around 80% of people who sustain a TBI.
  • TBI is a contributing factor in about 33% of all injury-related deaths in this country.

It’s unfortunate that so many sufferers of TBI report to the ER for treat-and-release since many symptoms of a TBI don’t fully manifest until hours or even days after the incident. An example of this is a rare but serious complication called traumatic subarachnoid hemorrhage.

What Is Traumatic Subarachnoid Hemorrhage?

A subarachnoid hemorrhage (SAH) is when there’s bleeding into the space between the surface of the brain and one of its coverings (arachnoid). This space is usually filled with cerebrospinal fluid, and bleeding usually occurs when small arteries in the area tear, causing widespread detrimental effects. Trauma is the leading cause of spontaneous SAH, though the majority of Traumatic SAH (tSAH) is due to ruptured brain aneurysm.

Though tSAHs can be devastating, they’re relatively rare. The incidence rate in North America is only about 28 in 100,000.

Risk Factors for tSAH

Any traumatic head injury will increase your risk for SAH, but there are a few other factors that play a role, including:

  • High blood pressure
  • Smoking
  • Using oral contraceptives
  • Pregnancy
  • Cocaine abuse

A SAH also occurs in 20–40% of people who sustain a moderate or severe head injury.

Symptoms of SAH

Most people with tSAH reported a headache of sudden and severe onset. These patients will describe it as “the worst headache of their lives,” and patients report this symptom in approximately 97% of cases. Other symptoms include nausea, vomiting, loss of consciousness, blurry vision, and neck stiffness.

Diagnosis and Treatment

If you or a loved one experience any of the above symptoms, seek immediate emergency medical care. Doctors will likely order a CT scan to detect the presence of bleeding in the brain. In some cases, patients may require a lumbar puncture. Once your doctors determine the cause and location of the bleeding, they’ll immediately begin treatment. This depends largely on the underlying cause of the injury, but it may include surgery to stop the bleeding and preserving vital organ health and function.

Outcomes for tSAH

Medical technology has done a lot to help patients who suffer from traumatic subarachnoid hemorrhage. Despite medical breakthroughs, however, about 33–50% of patients who sustain this type of brain bleed will die or be left with declined brain function. A patient’s prognosis depends on how bad the initial bleed was, how soon it was treated, and which complications develop.

No two head injuries are exactly the same. All patients recover at different rates and to varying degrees. Recovery from head injury follows a particular process, but the rate at which a patient progresses through the process varies by individual. Helping a loved one through a tSAH takes time and patience, as recovery from these injuries can take months or even years.

What You Can Do

If your loved one is struggling with the side effects of a subarachnoid hemorrhage, you may feel helpless. This is normal. Remember, you’re not alone. If loved ones are resting or in a coma, be by their side, hold their hand, and talk to them. Even if they’re not responding, they may be able to hear and understand you. If you have any other questions about subarachnoid treatment or rehabilitation, talk to your loved one’s health care provider.

Understanding the Signs of Sexual Abuse by a Coach

Parents trust coaches to be guides and mentors to their children. Unfortunately, there are a few individuals who take advantage of their position of authority. Sexually abusive relationships between coaches and their players aren’t uncommon and have similar warning signs. Knowing these red flags will help parents identify and intervene in inappropriate relationships. Signs of potential sexual abuse in a coach include:

Inappropriate Gifts or Attention

Molesters typically start with a “grooming” phase in which they devote extra attention to their target. This could come in the form of inappropriate gifts, extra attention, or seemingly innocuous (but still inappropriate) personal contact. Examples may include:

  • Giving one player more attention than the rest
  • Acting differently in private than in front of others
  • Attempts to control the child
  • Trying to gain your favor or trust
  • Telling your child not to talk about encounters they have
  • Giving one player gifts

Unfortunately, a child may not know the behavior is inappropriate until it crosses the line. Even then, molesters are master manipulators – they may make your child feel it’s his or her fault or that the child is to blame for their behavior. It’s essential for parents to keep an eye out for these grooming signs and keep an open dialogue with their children.

Warning Signs of Sexual Abuse

If a coach has initiated a sexually abusive relationship with your child, you may notice behavioral changes. Keep in mind, physical warning signs are rare, especially in the early days when an assailant might be grooming a child for abuse. These warning signs might not signal sexual abuse, but they should be taken seriously, no matter the circumstances. Most warning signs of sexual abuse are difficult to detect, but be cautious if your child begins acting out of character or exhibiting the following symptoms:

  • A decrease in personal hygiene
  • Anxiety or depression
  • Self-mutilation or suicidal behavior
  • Acting more distant or distracted than before
  • Mood swings
  • Sudden changes in behavior or eating habits
  • Adult-like sexual behavior
  • Drawing or writing about sexual topics or frightening images

The presence of one or several of these warning signs does not necessarily mean there is sexual abuse, which makes reporting your suspicions difficult. If you believe a coach is abusing your child, you may not have proof, but you can intervene immediately by withdrawing your child from the activity and initiating a conversation with your child about this person. It may be helpful for him or her to see a counselor. If your child admits to any inappropriate contact to you or a counselor, it’s time to report the abuse.

Reporting Child Abuse

Reporting suspected sexual abuse may be uncomfortable, but it’s vital. The law requires some professionals to report suspected abuse. These include physicians, teachers, coaches and assistant coaches, school staff, and more. Failure to report sexual abuse is a crime under “mandatory reporting” laws, and someone who fails to report sexual abuse may face fines or jail time.

The law considers parents “permissive reporters.” These are people who report sexual abuse voluntarily, and the courts cannot punish them for failing to report. It’s important to realize, however, that you won’t be punished for reporting – even if the allegations prove to be false. As a voluntary reporter, you’ll have immunity from liability as long as you make your report in good faith.

When in Doubt, Report

One of the strongest tools against sexual abuse is early reporting. By intervening as soon as possible, you may save more than a child’s innocence and mental health – you may save a life. Reporting isn’t always easy, but it’s right. This is why the state offer anonymous reporting tip lines. Find where to report abuse by county.

Remember, there’s no punishment for reporting, but certain professionals may face misdemeanor charges for failing to report. If you have any other questions about reporting sexual abuse, whether by a coach or anyone else, talk to our Oakland personal injury attorneys with experience in California family law.

Social Media And Workplace Harassment

In today’s technology-driven world, we’ve moved beyond water-cooler gossip. With email and social media, we can instantly share information with fellow employees. This also opens a world of possibilities for workplace bullying. Using Facebook messenger, Twitter, Instagram, or Snapchat, employees can send offensive messages in seconds. While many employees may just dismiss their harassment as a joke, we know there is a fine line between the point where joking ends, and harassment begins.

Types of Social Media Harassment

There are several forms of social media harassment. At work, here are some of the most common offenders:

  • Virtual harassment, such as friending a person on Facebook and sending offensive comments vis messenger.
  • Sending lewd Snapchats.
  • Cyberstalking, which is the act of obsessively following someone on their social media networks and blogs.

Employees may also erroneously believe that some forms of offensive electronic communications do not constitute workplace harassment (for example, if they send messages from their personal smartphone). It doesn’t matter whether the device is personal or if the harassment isn’t on company time – employers still have a responsibility to make sure that their workplaces are free of discrimination and intimidation.

Examples of Social Media Harassment

These legal cases highlight the importance of a social media and workplace harassment policy:

  • In 2012, an employer was ordered to pay $2.3 million to settle a lawsuit filed by the Equal Employment Opportunity Commission regarding sexual harassment. The case began when a store manager sent sexual text messages to one of his employees.
  • The courts awarded another employee $1.6 million because they were continually harassed online outside of the workplace for their disability. The employee in question reported the harassment to management, but they didn’t take action. Since management was aware of the harassment and didn’t stop it, they were liable for the damages.

As you can see, it’s essential for employers to create comprehensive social media use policies to protect both their employees and the well-being of their companies.

From a legal standpoint, electronic harassment is a form of employment discrimination that may be a violation of the Civil Rights Act of 1964, as well as the Age Discrimination in Employment Act of 1967, or the Americans With Disabilities Act of 1990. Harassment is defined as any conduct that is based on sex, religion, national origin, age, disability, or race. Employers may be liable if they are complicit in the origin or continuation of this unwelcome conduct.

Creating a Workplace Social Media Policy

Employers must take steps to articulate clear social media use policies. These policies should address electronic communication in all its forms and ensure that employees understand the scope of their responsibilities. It’s not OK for employees to harass one another under any circumstances. Employees must also understand that there is no expectation of privacy when it comes to communication between two employees.

Consider adding an addendum to your current harassment policy that includes all forms of electronic communications. Remind your employees that all forms of harassment are unlawful, and might result in termination. Consider conducting an electronic harassment prevention workshop to ensure all of your employees are on the same page.

Reporting Social Media Harassment

Above all, employees should feel comfortable reporting all forms of harassment. Make it clear to your employees that there will be no retaliation for reporting electronic harassment, either as a bystander or a victim.

Having a clear policy will go a long way in preventing social media harassment in the workplace. Despite this, employers should still be prepared to discipline harassers in a timely fashion, especially if they don’t want to be liable for damages.

The Bystander Effect of Workplace Bullying

We like to think that we leave bullying behind when we leave high school, but the reality is that most of us probably know someone who has been the victim of workplace harassment. As many as 70 percent of women and 45 percent of men have been victims of sexual harassment at some point in their careers. And surveys suggest that nearly 40 percent of all workers have experienced workplace bullying.

How Common is the Bystander Effect?

Only 12 percent of workers report seeing workplace bullying. This means that bullying in the workplace is underreported. In other words, many workers likely see bullying, but they don’t recognize it as a problem. For example, if an employee sees their supervisor demeaning another’s work, they might think, “Oh, he is just teasing her.” This is a problem.

It also is an instance of the “bystander effect,” a term used in social psychology that refers to observers who stand idly by when a person needs help. The more observers there are, the less likely they are to help, because of something known as “diffusion of responsibility.” (i.e., someone else will take care of it.)

Experts say that the vast majority of workplace bullies are bosses. Managers and supervisors are much more likely to verbally, even sexually, abuse their employees than a coworker. Bullies crave power and control, and often struggle with emotional instability.

Workplace bullies may choose their victims based on confidence or achievements outside of the workplace. At their cores, most bullies are insecure about their own performance and are threatened by independence.

According to the Workplace Bullying Institute, the targets of office bullies are most likely to be the employees who are the most competent, experienced, and popular with their coworkers. The majority of bullies, almost 70%, are men. Male bullies target women much more often (57% of the time) than other men. Female bullies target women about 70% of the time and rarely bully men.

The biggest problem with workplace bullying is often that coworkers know it exists, but do nothing to stop it. If this seems outrageous, consider this: What did you do the last time you passed by a car accident? Did you pull over and make sure everyone was OK? Or did you glance over and continue on with your day, thankful it wasn’t you? Usually, we’ll ignore it and assume the authorities are on the way, especially if helping poses a threat to our own safety.

This is the bystander effect in action. People who know about workplace bullying are often sympathetic and kind. They may offer support and listen to the victim. But they won’t go out of their way to end the harassment, because they fear for their own job security.

How Can We Stop the Bystander Effect?

The bystander effect is a part of human nature. But that doesn’t mean we can’t do something about it. The first step in addressing the problem is acknowledging its existence. If you notice someone being harassed at work, don’t disregard it as teasing or “the price of admission.” Approach them, and ask them if they need help.

Businesses must also work to adopt anti-bullying policies. Policies to address bullying are rare. While most workplaces have policies that address specific types of abuse (such as sexual harassment), a blanket policy covering threats or intimidation is not as common. Bystanders need to feel empowered to take action with the human resources department if they observe bullying in the workplace.

Having a uniform anti-bullying policy will help employees feel less intimidated about reporting. Workplaces can rid themselves of bullies if employees don’t fear retaliation from management. This will help companies retain their best and most experienced employees.

Common Medications That Can Impair Driving

Driving may seem like second nature, but it’s a complex skill that requires quick judgement, reaction time, and motor skills. Unfortunately, there are several over-the-counter and prescription drugs that may affect a driver’s ability to navigate the road effectively. Here are some of the most common medications that impair driving:


Itchy, watery eyes, and runny noses are unpleasant, which is why many Americans find relief in antihistamines during allergy season. These pills can have negative side effects. Certain classes of antihistamine – called diphenhydramine (Benadryl) – can lead to brain fog, confusion, and drowsiness. Operating a vehicle while taking this medication is nothing to sneeze at – in fact, it may lead to a traffic ticket or accident.

Nyquil and Cold Medicine

The common cold may not have a cure, but some over-the-counter medicines can temporarily alleviate symptoms. But cold medicines that contain alcohol – Nyquil is a common example – can cause drowsiness and affect your ability to drive. Save these medications for nighttime, and always use them as intended.

Cough medicines that contain a substance called dextromethorphan also cause drowsiness. Medication containing this compound is often marked “DM,” so read each label carefully.

Pain Medication and Prescription Pills

Some prescription pain pills, such as narcotics, can affect your ability to drive safely. To see if one of your prescription medications affect your ability to operate a vehicle, read the label or talk to a pharmacist or physician.

Prescription medications that impair driving include:

  • Tranquilizers
  • Some antidepressants
  • Decongestants
  • Sleep aids
  • Muscle relaxers
  • Diarrhea medications
  • Some ADD/ADHD medications

This isn’t an exhaustive list. If you’re unsure of a medication’s side effects, talk to your doctor.

What Can I Do About My Medications?

It’s important to realize that most people can drive safely while taking common medications. There are a few, like the ones outlined above, that can increase your risk of impairment. In some cases, you might not even be aware of the negative effects. If you notice drowsiness or “brain fog” as a side effect of any medication, take the following prevention steps:

  • Have an honest conversation with your doctor. When you receive a prescription a new drug, ask about its side effects. Since some medications have a synergistic effect, remember to bring a list of medications with you to every doctor’s appointment – including those you take over the counter.
  • Ask your health care provider if it’s ok to drive. Medications affect everyone in different ways, especially in the beginning. If you notice an effect on your alertness, your doctor may be able to adjust the dose or change it to a medicine that doesn’t cause drowsiness.
  • Monitor your symptoms. Learn how your body reacts to your medicine, and keep track of how each make you feel. If you notice symptoms such as drowsiness, weakness, or blurry vision, call your doctor or pharmacist.

Know the Signs

Each medication has different side effects, and drowsiness is one of the most common. Even if a medicine doesn’t list drowsiness as a known side effect, it may affect you differently. According to one clinical pharmacist, a medication’s drowsy effect can manifest within an hour of taking it, and some drugs last for up to eight hours. That’s why it’s important to keep track of which medicines affect you.

If medications play a role in a car accident, it may affect your insurance rates – or worse, make you privy to a lawsuit. If you have any questions or concerns, talk to your health care provider.

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