Key takeaways

  • The CDC calls motor vehicle crashes a leading cause of death for teens. Most teen crashes are not that. But a first crash deserves more than a look at the bumper.
  • Teens under-report pain, especially to a parent who is already upset about the car.
  • Watch the head that night and the neck and back that week.
  • If an exam is needed, call the office yourself, say it is a minor, and ask what the office needs from a parent or guardian at the first visit.

Chesterfield and the rest of West County put a lot of new drivers on the road every fall. Students from Marquette, Parkway Central, Parkway West and Lafayette share the school lots, Clarkson Road, Olive and the 64 ramps with everyone else's commute. Most first crashes are small: a slow bump at a stop sign, a misjudged left turn, a curb. The phone rings, a parent drives over, and the first question is about the car. This article is about the second question.

Why teens say "I'm fine"

Three reasons, and a parent should assume all of them. Adrenaline really does mask pain for a few hours, which is why adults say the same thing. Teens are embarrassed and worried about the car, the insurance and losing the keys, so admitting they are hurt feels like making it worse. And a teen who plays a fall sport may not want anything that could take them off the field. None of that means they are hiding an injury. It means their first report is not the last word.

The CDC's teen driver page is blunt that crash risk is higher for drivers ages 16 to 19 than for any other age group. That is a reason to take the aftermath seriously, not a reason to lecture tonight. The lecture can wait until everyone has slept.

Tonight: the head

A head does not have to hit anything to be jarred, and a concussion does not require a knockout. The CDC's HEADS UP program lists the danger signs that mean 911 or an emergency department right away: a headache that gets worse and does not go away, repeated vomiting, slurred speech or unusual behavior, and being very drowsy or hard to wake. The emergency list at the bottom of this page is the same idea.

Short of those, watch for the everyday signs HEADS UP describes: headache, nausea, dizziness or balance trouble, bothered by light or noise, feeling foggy or slowed down, trouble concentrating or remembering, and changes in mood or sleep. Some can show up hours or days later. A teen who is unusually irritable, goes to bed at eight, or cannot focus on homework the next night is telling you something.

If your teen plays a sport, tell the coach and the athletic trainer about the crash, even if nothing seems wrong. HEADS UP guidance is that an athlete with a possible concussion should not return to play until checked by a health care provider. This desk wrote more about the fields in weekend athletes.

This week: the neck and back

Crash stiffness tends to arrive late, often on the second morning, which this desk explained in two days later. For teens, the tells are practical. Turning stiffly to look over a shoulder. Carrying a backpack on one side. Skipping practice with a vague excuse. Complaining about the car seat or the desk at school. Ask on day two and day three, casually, and ask specific questions: can you turn your head all the way to check a blind spot? Does your back hurt getting out of bed?

Booking the first visit

If the answer is yes, book an exam that week. Some practical steps for the call:

  1. Make the call yourself. Say it was a car crash, give the date, and say the patient is a minor.
  2. Ask what they need from a parent. Ask whether a parent or guardian needs to attend, and what forms and insurance information to bring. This desk does not publish the clinic's policies on minors because the clinic does not publish them, so ask.
  3. Mention the head if there was any bump, fog or headache, so the office knows before you arrive. The clinic has a TBI and concussion rehab lane.
  4. Pick a time around school. The offices close daily from 12 to 2. A 3:30 or 4:00 slot Monday, Tuesday or Thursday in O'Fallon usually fits after the last bell.

At the visit

The first visit is a history, an exam, findings written down, a diagnosis if the findings support one, and a plan. The desk's first visit from Chesterfield page has the fuller version and the route. For a teen, the useful thing a parent can do in the office is let the teen answer first. Clinicians need to hear where it hurts in the patient's own words, and a teen will often tell a clinician what they would not tell a parent in the car. Add facts after, like the date the headaches started. Take notes on the plan.

And the car

The bumper will get fixed. The keys can come back on whatever schedule your family decides. The exam is the part with a clock on it, because an exam in the first week describes an injury more clearly than one a month later.

The near office. Say it was a crash, say the patient is a minor, and ask what a parent needs to bring. O'Fallon, 2163 West Terra Lane, (636) 280-0990: Mon, Tue, Thu 9am to 6pm, Wed and Fri by appointment, closed daily 12 to 2. Book the exam this week

Everything on this desk is educational reading. It is not medical advice, and reading it is not an exam.