Automobile-child pedestrian accidents more common outside parental supervision

LAS VEGAS — The majority of child pedestrian injuries relating to a motor vehicle occurred while children were unsupervised, near schools and bus stops, and during the afternoon and evening hours of spring, according to data presented at the American Academy of Orthopaedic Surgeons Annual Meeting.

“Automobile vs. pedestrian accidents in the urban setting are among the most common causes of polytrauma and isolated long bone fractures in children and adolescents,” Alexa J. Karkenny, MD, from Montefiore Medical Center/Albert Einstein College of Medicine in New York, and colleagues wrote. “While general details about injury scenes have been delineated by some researchers, fine details, such as proximity to bus stops or playgrounds, are not commonly included in auto vs. pedestrian injury analyses.”

To isolate the circumstances at the scene of the accident and the injury types presented in a consecutive series of patients struck by motor vehicles, Karkenny and colleagues reviewed the electronic medical record of all patients (n = 100) who presented to the ED via ambulance after an automobile vs. pedestrian accident and were assessed by the trauma surgical service from January through December 2012.

The researchers recorded ambulance dispatch data, patient demographics, chief complaint, procedures, diagnoses and length of hospital stay. In addition, they reviewed descriptions from first responders and health care providers for further accident details, including the bystanders and the type of intersection or property where the accident occurred.

Among the patients surveyed, 61 patients were evaluated in the ED only or were admitted for less than 24 hours, and 39 patients were admitted for 24 hours or more with a mean length of stay of 1.98 days. In addition, 11 patients were admitted to the ICU for at least 1 day and the orthopaedic surgery service was consulted on 46 patients.

At the time of the accidents, 40% of children were accompanied by a parent or guardian, 34% were in the company of friends or peers, 13% were with older siblings, and 13% were alone. Most accidents coincided with the time of school dismissal or occurred during the evening, including 71% of injuries happening from 2 p.m. to 9 p.m. The highest number of accidents occurred during June (13%).

The researchers identified clusters of injuries occurring near schools and public bus stops used by students.

“Keeping these spatial, temporal and behavioral predictors of pediatric orthopaedic trauma in mind, we can help guide prevention strategies in urban settings,” Karkenny said in a press release. “Knowledge of the high-risk injuries in this subset of patients can help the trauma team to prioritize patient evaluations, which is especially important in complicated cases involving multiple injuries.” – by Bob Stott

Reference:

Karkenny AJ, et al. Abstract P246. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 24-28, 2015; Las Vegas.

Disclosure: The researchers report no relevant financial disclosures.