All-terrain vehicle (ATV) sales have climbed 89% in the last 5 years. We sought to determine if pediatric ATV accidents have increased in frequency and morbidity.
Medical records of children treated in our emergency unit for ATV accidents from 1993 to 2003 were reviewed. The 11 years were divided into 2 periods, January 1993 to June 1998 and July 1998 to December 2003, to allow comparisons and analysis of trends over time.
We treated 184 children, with 90% requiring admission. Comparing the first and second halves of the study, patients treated increased from 8.7 +/- 4.8 (mean +/- SD) to 24.5 +/- 11.1 per year (P < .01), patients requiring immediate operation increased from 4 (9%) of 44 to 24 (17%) of 140, and patients with serious injuries (resulting in direct intensive care unit admission, immediate operation, or death) rose from 12 (27%) of 44 to 51 (36%) of 140. Patient age was 11.5 +/- 3.9 years. Sixty-eight percent of the children sustained multiple injuries and 50% required surgery. Only 35% of the children wore helmets.
Over the 2 periods, there was a significant increase in number of patients treated, and considerable increases in serious injuries, and need for immediate operation. Despite inherent risks with riding ATVs, helmet use and patient age were remarkably low.
"Most states have some usage restrictions involving age of driver or weight of vehicle, and 25 states require helmet and safety equipment. The challenge is to enforce these regulations, because even in states requiring helmets , usage approaches only 35% . In one study, when asked to discuss prevention issues in focus groups, children admitted to risk-taking behavior and were resistant to age-based restrictions. "
[Show abstract][Hide abstract] ABSTRACT: Despite improved education and prevention initiatives, trauma remains the leading cause of death in children. A variety of preventative measures have been developed to decrease the morbidity and mortality, and the financial burden on the health care system. This article discusses injury prevention strategies, issues in prehospital care, and key points of initial resuscitation. In addition, the major injury patterns are described with attention paid to the diagnosis and management of patients with multiple traumatic injuries.
Surgical Clinics of North America 03/2007; 87(1):207-28, viii. DOI:10.1016/j.suc.2006.09.016 · 1.88 Impact Factor
"In comparison to paediatric bicycle injuries, ATV accident victims were more likely to " sustain multiple injuries and more often required surgical intervention … [and tended to] require longer hospitalisations … " (Brown et al, 2002, p. 377). Kelleher et al (2005), also highlight the phenomenon of multiple injuries, with two thirds of child ATV accident victims receiving multiple injuries (p. 933). "
[Show abstract][Hide abstract] ABSTRACT: The agricultural sector features prominently in the rates of ATV injuries and fatalities amongst children in New Zealand. This research project assesses the nature and scope of ATV accidents to children on New Zealand farms and provides recommendations that attempt to meet the needs of all relevant stakeholders. In particular, we believe that the most effective means of reducing the rates of ATV injuries and fatalities amongst children involves a strategy which recognises the unique circumstances which give rise to practical impediments to safer farm workplace practices. We identified three distinct groups of children in the literature, each facing a different major risk category. Very young children were most at risk as passengers. As age increased the highest risks applied to bystanders, while older children and teenagers were more likely to be injured as drivers. The high risks to younger children as passengers and bystanders were indicative of underlying problems associated with childcare options – or, more particularly, the lack of childcare options. Accidents involving older children were associated more closely with practices around child supervision and involved aspects of farming culture, rather than practical barriers to safer practices.
[Show abstract][Hide abstract] ABSTRACT: Access to protection orders for women experiencing domestic violence has recently been identified as a problem in New Zealand, and ways of addressing this problem are now being developed. Police-initiated protection orders, called safety orders, have been proposed to provide immediate protection to women who experience domestic violence and to overcome some of the evidential difficulties that can arise through representation in the Family Court. This discussion paper was commissioned to provide a review of the literature relating to safety orders. The paper uses a conceptual framework to identify the implicit assumptions associated with safety orders initiated by the police, and then compares these assumptions with the relevant research findings relating to police interventions, the actions women take to protect themselves and the court's responses to breaches of protection orders. Finally, conclusions are drawn about the ongoing need for education of the police and court personnel, and the need for compassionate involvement of women and their advocates in new initiatives. Research is encouraged when new initiatives are under development in this area to detect unintended consequences.
Social Policy Journal of New Zealand 07/2008; · 0.23 Impact Factor
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