By Susan Schmunk, CAISS, CSTR, Senior Trauma Registry Consultant, MedPartners
Summer is here, and with it the potential for increased injury to children due to a variety of factors. The American Academy of Pediatrics (AAP) has several tips on their website for keeping your family safe this summer. (American Academy of Pediatrics, 2017)
As of 2012, according to the Centers for Disease Control (CDC), the most common causes of pediatric injury are
- Motor vehicle accidents
(National Institutes of Health – Eunice Kennedy Shriver National Institute of Child Health and Human Development, n.d.)
These account for approximately 8,000 emergency room visits per day. Couple that with the recent (2015) information that nearly 49 children, ages 0-19, visited an emergency department (ED) every hour due to a wheeled sports-related injury with 3% of these visits resulting in admission to the hospital. These include injuries from riding bikes, scooters, skates and skateboards. While bicycle injuries have been declining, other wheeled sports, such as scootering (non-motorized), have seen an increase. (Safe Kids Worldwide, 2017)
A survey of 1,600 parents revealed that their children do not always wear a helmet while riding. Reasons cited for non-helmet use included
- Parents think area is safe/View child as experienced/Don’t see helmets as necessary (47%)
- Child finds helmet uncomfortable (27%) (American Academy of Pediatrics, 2017)
- Other kids don’t wear one (24%)
- Child thinks helmets aren’t cool 22%)
Among parents who say they always wear a helmet when riding a bike, 86% say their child also does. Among parents who say they never wear a helmet, 38% say their child always does. Helmet use varied from 68% for bicycling down to 57% for scootering. Overall parents didn’t enforce wearing a helmet most often when children were scootering (51%), followed by bicycling (47%), skateboarding (46%) and skating (39%). (Safe Kids Worldwide, 2017)
In states where there is a bicycle helmet law parents surveyed indicated compliance with helmet use at 75% versus 60% in states without a bicycle helmet law. Just 21 states and the District of Columbia require children ranging from 17 and under (California and New Mexico), to 11 and under (Pennsylvania) to wear a helmet. There has been no proactive bike helmet legislation that has become law for at least 10 years. The trend toward “bike sharing” programs, in which riders can borrow a bike for a short period of time at kiosks without any people-to-people contact, may also be slowing passage of new laws requiring bike helmets. A successful solution for borrowing a bike helmet with a shared bike has not been developed. (The League of American Bicyclists, 2015) (Insurance Institute for Highway Safety – Highway Loss Data Institute, 2017)
Serious head injuries (defined as concussions, internal head injuries and head fractures) made up 11% of ED visits across wheeled sports, although the proportion varied by activity. Fractures were the most frequent injury diagnosis for all activities except bicycling, making up 25% of ED visits across the four wheeled sports.
Fractures were the most frequent diagnosis making up hospital admissions for all four wheeled sports, especially to the shoulder, arm, elbow, wrist or hand. The second most frequent diagnosis was head injury ranging from 1 in 10 hospitalizations for skating to nearly 4 in 10 for biking and skateboarding combined.
Safety equipment does not just include helmets. Other protective equipment such as elbow and knee pads as well as wrist guards are important pieces of protective equipment to protect limbs in case of a fall. The majority of ED visits in 2015 were for fractures, contusions and abrasions; most often to upper and lower limbs. Approximately 16% of parents report the use of some additional protective equipment for their children who scooter, while for skating the use of other protective equipment ranges from 18-36%, and for skateboarding the range is 17-32% based on type.
While it is important to keep our children active it is also important to protect them while they are keeping fit. Protective gear is not just for wearing on the street, but also in the driveway, on the sidewalk and in the skate park. This summer remember the many ways to protect your children while they (and hopefully you) are enjoying more time outdoors.
American Academy of Pediatrics. (2017, May 4). Summer Safety Tips: Sun and Water Safety. Retrieved from healthychildren.org: https://www.healthychildren.org/English/news/Pages/Summer-Safety-Tips-Sun-and-Water-Safety.aspx
Insurance Institute for Highway Safety – Highway Loss Data Institute. (2017, July). Pedestrians and bicyclists. Retrieved from Highway Safety Research and Communications: http://www.iihs.org/iihs/topics/laws/bicycle-laws/table-bicycle-helmet-use?topicName=pedestrians-and-bicyclists
National Institues of Health – Eunice Kennedy Shriver National Institute of Child Health and Human Development. (n.d.). What causes pediatric injury? Retrieved from US Department of Health and Human Services: https://www.nichd.nih.gov/health/topics/pediatric/conditioninfo/Pages/causes.aspx
Safe Kids Worldwide. (2017, May). Ready for the Ride – Keeping Kids Safe on Wheels. Retrieved from safekids.org: https://www.safekids.org/sites/default/files/wheels_safety_study_2017-for_web.pdf
The League of American Bicyclists. (2015). State Bike Laws. Retrieved from About the League Bicycle Friendly American National Bike Summit Leadership Institute Smart Cycling: http://bikeleague.org/StateBikeLaws