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Paediatric recreational vehicle‐related head injuries presenting to the emergency department of a major paediatric trauma centre in Australia: Is there room for improvement?
Author(s) -
Bressan Silvia,
Daverio Marco,
Barker Ruth,
Molesworth Charlotte,
Babl Franz E
Publication year - 2016
Publication title -
emergency medicine australasia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.602
H-Index - 52
eISSN - 1742-6723
pISSN - 1742-6731
DOI - 10.1111/1742-6723.12617
Subject(s) - medicine , emergency department , logistic regression , neurosurgery , head trauma , observational study , retrospective cohort study , emergency medicine , head injury , pediatrics , surgery , psychiatry
Abstract Objective This study examines clinical characteristics and helmet use of children presenting to the ED with a recreational vehicle (RV)‐related head injury (HI). Methods Observational retrospective study of children <18 years presenting with a RV‐related HI to the ED of a state‐wide paediatric trauma centre in Australia between April 2011 and January 2014. Results In the 647 presentations identified, corresponding to 7.5% (95% CI 7.0–8.1) of all HI presentations, RVs involved were bicycles (36.3%), push scooters (18.5%), motorcycles (18.4%), horses (11.7%), skateboards (11.6%), quadbikes (2.8%) and go‐karts (0.6%). Recorded helmet use was the highest in motorcycle, horse and bicycle riders (83.2%, 82.9% and 65.1%, respectively), and the lowest for push scooter (25.8%) and skateboard riders (17.3%). Overall 23% underwent a CT scan, 8.8% had intracranial injuries on CT, 30.6% were admitted, and 2.2% underwent neurosurgery. Push scooter‐related HIs were the least severe. Age (in years), riding a motorised vehicle and not wearing a helmet were independently associated with intracranial injuries on CT on multiple logistic regression (OR 1.1, 95% CI 1.0–1.2; OR 2.4, 95% CI 1.3–4.6 and OR 6.0, 95% CI 3.2–11.2, respectively). Conclusions RV‐related HIs accounted for a non‐negligible proportion of paediatric HIs presenting to the ED and for significant morbidity and use of hospital resources. Interventions such as introduction of mandatory helmet use for off‐road motorised vehicle riding and skateboard riding in children, enhanced injury prevention campaigns, and strict adult supervision during motorised vehicle riding may reduce the morbidity and health care costs associated with paediatric RV‐related HIs.