Alexandra Finch1, Shelley Cox2, Stephen Bernard3, Warwick Teague4, Karen Smith5. 1. Centre for Research & Evaluation, Medical Directorate, Ambulance Victoria, Victoria, Australia; University of Birmingham, Birmingham, United Kingdom. 2. Centre for Research & Evaluation, Medical Directorate, Ambulance Victoria, Victoria, Australia; Department of Epidemiology & Preventive Medicine, Monash University, Victoria, Australia. Electronic address: Shelley.Cox@ambulance.vic.gov.au. 3. Centre for Research & Evaluation, Medical Directorate, Ambulance Victoria, Victoria, Australia; Department of Epidemiology & Preventive Medicine, Monash University, Victoria, Australia; Intensive Care Unit, The Alfred Hospital, Victoria, Australia. 4. Trauma Service, The Royal Children's Hospital, Melbourne, Australia; Department of Paediatric Surgery, The Royal Children's Hospital, Melbourne, Australia; Surgical Research Group, Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Australia. 5. Centre for Research & Evaluation, Medical Directorate, Ambulance Victoria, Victoria, Australia; Department of Epidemiology & Preventive Medicine, Monash University, Victoria, Australia; Department of Community Emergency Health and Paramedic Practice, Monash University, Victoria, Australia; School of Primary, Aboriginal and Rural Health Care, University of Western Australia, Western Australia, Australia.
Abstract
BACKGROUND: Paediatric participation in competitive and recreational off-road motorcycle sports is increasing in popularity worldwide, however injuries frequently occur and the sport is associated with significant morbidity. OBJECTIVE: This study describes the profile of paediatric off-road motorcycle trauma attended by emergency medical services (EMS) in Victoria, Australia. METHODS: A retrospective review included paediatric (<16 years) competitive and recreational off-road motorcycle patients attended by EMS between 2010 and 2017 in the State of Victoria, Australia. Patient characteristics and injuries sustained were described using descriptive statistics. Predictors of EMS transport were identified using multivariable logistic regression analyses. RESULTS: There were 1,479 paediatric motocross patients attended by EMS between 2010 and 2017. This represents 1.6% of the total state-wide EMS paediatric trauma (<16 years) workload, and equates to an average incidence of 22.2 per 100,000 population. The median age of patients was 13 years (IQR: 10-14) and 89.5% were male. The most common final diagnoses recorded by paramedics were 'fractures' (25.5%, n = 377) and 'unspecified pain' (19.5%, n = 289). Administration of analgesia (76.3%) was the most common EMS management, followed by spinal immobilisation (54.7%) and splinting (33.4%). The vast majority (91.5%) of patients were transported to hospital by EMS. Following admission, 38 (2.6%) patients were confirmed to have sustained major trauma, 78.9% of which had been transported direct from scene to a major trauma centre for definitive care. Median ISS for confirmed major trauma patients was 14 (IQR: 14-22). Four (0.4%) patients received pre-hospital CPR. All four sustained injuries from recreational off-road, motorcycle activities and all four cases died, two at the scene and two in-hospital. CONCLUSION: Off-road motorcycle activities are an important cause of death and injury in Victorian children, as highlighted and demonstrated by the four deaths and high EMS transport rates borne out in this study. Riders and parents need to be aware of these risks, and organised events must have adequate on-site medical care resources.
BACKGROUND: Paediatric participation in competitive and recreational off-road motorcycle sports is increasing in popularity worldwide, however injuries frequently occur and the sport is associated with significant morbidity. OBJECTIVE: This study describes the profile of paediatric off-road motorcycle trauma attended by emergency medical services (EMS) in Victoria, Australia. METHODS: A retrospective review included paediatric (<16 years) competitive and recreational off-road motorcycle patients attended by EMS between 2010 and 2017 in the State of Victoria, Australia. Patient characteristics and injuries sustained were described using descriptive statistics. Predictors of EMS transport were identified using multivariable logistic regression analyses. RESULTS: There were 1,479 paediatric motocross patients attended by EMS between 2010 and 2017. This represents 1.6% of the total state-wide EMS paediatric trauma (<16 years) workload, and equates to an average incidence of 22.2 per 100,000 population. The median age of patients was 13 years (IQR: 10-14) and 89.5% were male. The most common final diagnoses recorded by paramedics were 'fractures' (25.5%, n = 377) and 'unspecifiedpain' (19.5%, n = 289). Administration of analgesia (76.3%) was the most common EMS management, followed by spinal immobilisation (54.7%) and splinting (33.4%). The vast majority (91.5%) of patients were transported to hospital by EMS. Following admission, 38 (2.6%) patients were confirmed to have sustained major trauma, 78.9% of which had been transported direct from scene to a major trauma centre for definitive care. Median ISS for confirmed major traumapatients was 14 (IQR: 14-22). Four (0.4%) patients received pre-hospital CPR. All four sustained injuries from recreational off-road, motorcycle activities and all four cases died, two at the scene and two in-hospital. CONCLUSION: Off-road motorcycle activities are an important cause of death and injury in Victorian children, as highlighted and demonstrated by the four deaths and high EMS transport rates borne out in this study. Riders and parents need to be aware of these risks, and organised events must have adequate on-site medical care resources.