Pediatric "off-road vehicle" trauma: determinants of injury severity and type.

OBJECTIVES: This study aimed to describe the determinants of the severity and type of injuries sustained by children hurt in off-road vehicle (ORV) accidents. METHODS: This was a retrospective clinical study for which data were obtained from the trauma database at the Children's Hospital at Westmead covering the 10-year period between January 1, 1998, and December 31, 2007. Data points collected included age, sex, Injury Severity Score (ISS), body region injured, type of vehicle, accident setting, mechanism of injury, estimated speed, position of the rider, use of a helmet and/or protective clothing, and hospital length of stay. The study end points were determinants of injury severity and type. Statistical analysis of the collected data was done with the standard statistical software package, SPSS. RESULTS: A total of 288 children (242 male [84%] and 46 female [16%] patients) presented for ORV-related trauma. Helmets significantly diminished the chance of sustaining a head injury occasioning a skull fracture. Jumping was associated with increased ISS and a higher chance of sustaining an abdominal and/or thoracic injury. Older children were more likely to sustain pelvic and spinal injures, be injured while traveling at high speed, and be injured while going over a jump. Mean ISS was significantly lower if trauma was sustained while riding a mini motorcyle in any setting and any ORV at home. CONCLUSIONS: Further research (prospective, federal, and multi-institutional) is needed with a view to optimizing training schedules, rules, regulations, and licensing requirements for pediatric ORV riders.

Comparison of severe injuries between powered and nonpowered scooters among children aged 2 to 12 in the United States.

OBJECTIVE: A substantial increase in the number of nonpowered and powered scooter injuries since 2000 has occurred in the United States. Because of differences in weight and operational speed between scooter types, it is possible that the type and severity of injuries may differ. The purpose of the current study is to compare demographics and injury characteristics between scooter types, focusing on differences in injury severity. METHODS: The 2002-2006 National Electronic Injury Surveillance System provided information about individuals aged 2 to 12 years who sought treatment at an emergency department due to powered or nonpowered scooter-related injury in the United States. We defined severe injury as an injury resulting in the hospitalization, staying in the hospital for observation, or transfer of the injured patient. Logistic regression analysis, adjusted for sex, age, and geographic location in which the injury occurred, estimated odds ratios (ORs) and 95% confidence intervals (CI) for the association between scooter type and severe injury. RESULTS: There were an estimated 15 752 and 185 007 injuries related to powered and nonpowered scooters, respectively. Powered scooter-related injuries were over 3 times as likely to be severe (OR 3.57, 95% CI, 1.91-6.65). This association was more prominent among females (OR 5.80, 95% CI, 2.02-16.63) than males (OR 2.90, 95% CI, 1.44-5.82). CONCLUSION: Data suggest that, compared with nonpowered scooter-related injuries, powered scooter-related injuries are more often severe. This association is stronger among females than males. The higher risk of severe injury due to powered scooter use could result from increases in concussions and hip and lower extremity injuries.

The characteristics and use patterns of all-terrain vehicle drivers in the United States.

The consent decrees between the US Consumer Product Safety Commission and the major distributors of all-terrain vehicles (ATV), which were designed to address ATV-related injuries and deaths, expired in April, 1998. While national estimates of nonfatal and fatal injuries involving ATVs declined after the consent decrees went into effect 10 years ago, the injury estimates have stabilized in recent years. To gain a better understanding of current ATV use patterns, the CPSC sponsored a national probability survey of ATV drivers in the fall of 1997. The survey was designed to collect information about the characteristics and use patterns of ATV drivers and to quantify the numbers and types of ATVs in use. It employed a single stage list-assisted random-digit-dial sample design. This article describes the results of the survey, and discusses long term ATV usage trends.