TREND 10.3 Pediatric ATC Helmet Use

Nevada Traffic Research & Education Newsletter
JUNE 2021 // VOL. 10, ISSUE 03
Disponible en español

Venn Diagram of Nevada Crash Data and Nevada Trauma Data

TREND In Focus: All-Terrain Vehicle (ATV) Crashes

Helmet Use among Children < 16 years in Nevada

By Samantha A. Slinkard-Barnum, MPH, Ana Reyes, MS, Emily Carter, Merika Charupoom, Laura K. Gryder, MA, and Deborah A. Kuhls, MD

A type of off-highway vehicle (OHV) is the all-terrain vehicle (ATV), which is popular for recreational activities among all age groups. The most common ATV crashes are caused by loss of control and rollover, often resulting in head injuries. These injures are common among riders who neglect proper helmet use.[1] Children ages 16 and younger have a 12 times higher risk of injury than adult riders, accounting for 30% of all ATV-related injuries.[2] Nationally in 2020, there were a total of 11 ATV fatalities in which two (2) riders were <16 years old.[3] This TREND in Focus analysis investigates ATV crash and trauma outcomes for children less than 16 years of age by helmet use at the time of injury for years 2012 to 2017 (N=120) in Nevada.

Results

Unhelmeted Pediatric ATV Rider Demographics:

Of 940 ATV-injured patients admitted to a Nevada trauma center from 2012-2017, 120 (12.8%) were children under 16 years of age. Nearly half were not wearing a helmet at the time of their crash (45%, N=54). The majority of these unhelmeted pediatric patients were male (61%, N=73) and white (69%, N=83).

Injury Outcomes:

Unhelmeted pediatric ATV crash patients experienced greater injuries in comparison to those who wore helmets at the time of the crash. Unhelmeted children more frequently had Glasgow Coma Scale (GCS) scores ≤8, indicating a severe head injury (Fig 1). Injury Severity Scores (ISS) indicate unhelmeted children were moderately injured compared to the minor injuries of helmeted children (Fig 2). For children who did not wear helmets at the time of an ATV crash, the average hospital stay was 3.9 days versus 2.2 days for helmeted children (Fig 3). Children who did not wear a helmet incurred $71,404 in mean hospital charges versus $55,253 for helmeted children (Fig 4).

Recommendations/Conclusion:

The average age for ATV pediatric trauma patients from 2012-2017 Nevada data was 11.8 years of age; almost half of children who were ATV trauma patients did not wear a helmet at the time of injury. Requiring children <16 years old to wear a helmet while riding an off-highway vehicle will improve injury outcomes and safety of this vulnerable pediatric population.

Bar graph of the percent of patients with Gasgow Coma Scale (GCS) scores < or = 8 — Figure 1. Percent of Patients with Severe Head Injury

Bar graph of the mean severity injury score (ISS) (range 0-75) — Figure 2. Mean Injury Severity Score (ISS) (range 0-75)

Bar graph of the mean days spent in hospital. — Figure 3. Mean Days Spent in Hospital

Bar graph of the mean hospital charges. — Figure 4. Mean Hospital Charges

TREND in Focus: References

ATVs are Not For Children. American Academy of Pediatrics.
https://www.healthychildren.org/English/safety-prevention/at-play/Pages/ATV-Safety-Rules.aspx
Assessing the Emergent Public Health Concern of All-Terrain Vehicle Injuries in Rural and Agricultural Environments. JMIR Public Health and Surveillance. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7293057/
2020 ATV Fatalities Report. Consumer Product Safety Administration.
https://consumerfed.org/wp-content/uploads/2020/02/2020-OHV-Deaths-Report-Generator-ATV.pdf
Nevada ATV Traumatic Injury Data 2012-2017. Nevada Road-User Trauma Registry Database. Maintained by the Kirk Kerkorian School of Medicine at UNLV, Department of Surgery. (Accessed Jun. 11, 2021).

Spotlight

Zero Fatalities’ May 2021 Champion of Traffic Safety

By Laura K. Gryder, MA

“When it comes to your friends and family, Zero Fatalities is the only acceptable number. Each day our team works to save lives on Nevada’s roadways, through collaboration, partnership, and an ongoing commitment to achieving the goal of Zero Fatalities.” – ZeroFatalitiesNV (Facebook)

May 2021 Nevada Zero Fatalities Champion of Traffic Safety Award Certificate

The Kirk Kerkorian School of Medicine at UNLV was honored by the Zero Fatalities Program within the Nevada Office of Traffic Safety (NV-OTS) as the May Champion of Traffic Safety. In celebration of Zero Fatalities 10-year anniversary, various traffic safety partners and stakeholders will be honored this year.

The Traffic Safety Research (TSR) team has been engaged in traffic safety research since 2002, and has continued this work at UNLV when the School of Medicine was established in 2017. Dr. Deborah Kuhls, a trauma surgeon at University Medical Center, Professor of Surgery at the School of Medicine, and Principal Investigator for two NV-OTS traffic safety research grants, has a passion for injury prevention which is shared by the robust research team she has built.

Presentation of the award to Principal Investigator Dr. Deborah Kuhls (right) and Project Director Laura Gryder (left) by Nevada Office of Traffic Safety Public Information Officer Andrew Bennett (middle)

“The research we conduct has really validated what I see as a trauma surgeon every day. I have spent my entire career taking care of people. And if we can decrease deaths by 10 or 20 or 30 percent… My tears represent the tears of the families, the thousands of families I have talked to during my career.”
Dr. Deborah Kuhls, Principal Investigator
Excerpt from May Champion of Traffic Safety award video

“It’s nice to know that our work is appreciated. It’s a really great honor to work with such amazing and caring partners who all have the same goal for Nevada road users: Zero Fatalities.”
Laura Gryder, Project Director

“I am very proud of the Traffic Safety Research team for receiving the Traffic Safety Champion award. It shows that the research and community work we do has an impact on our state.”
Samantha Slinkard-Barnum, Research Assistant

“I am proud to be a part of a team dedicated to preventing injuries and saving lives in my community. Every day I am inspired by the passion and dedication our team has for traffic safety.”
Emily Carter, Student Researcher

“To me this award means that the work and dedication everyone from the TSR team has put forth is being recognized. Most importantly, having this recognition brings awareness to the issue of traffic safety in our community.”
Merika Charupoom, Student Researcher

Zero Fatalities 10 Year Anniversary: 2021 Champions of Traffic Safety (to date)
January: Kevin Moore, Zero Teen Fatalities, NV-OTS
February: Traffic Incident Management (TIM) Coalition NV
March: Loy Hixson, Nevada Highway Patrol (NHP)
April: Erin Breen, Vulnerable Road Users Project, UNLV
May: Kirk Kerkorian School of Medicine at UNLV
June: Bob Mayer, Clark County School District Police Dept

At Home with the Traffic Safety Research Team

Statewide Pedestrian Workshop

By Emily Carter and Merika Charupoom

Erin Breen, Director of the Vulnerable Road Users Project at UNLV, hosted a two-part statewide pedestrian workshop and documentary premiere of My Best Friend: A Pedestrian Story. This workshop discussed pedestrian safety issues with community stakeholders, and explored solutions with the goal of creating a safer environment for all road users. The documentary was introduced by Nevada Governor Steve Sisolak who commented on his commitment to pedestrian safety. Joining Breen on the panel were community partners such as Clark County Commissioner Mike Naft, Andrew Bennett (NV-OTS), Rebecca Kapuler (RTC Washoe), Paul McCullough (LVMPD), Bryan Zink (CCSD Police), John Penuelas (RTC Southern Nevada), and the Kirk Kerkorian School of Medicine’s own Dr. Douglas Fraser.

Left: Dr. Douglas Fraser, Chief of Trauma, (University Medical Center of SNV) spoke about the importance of pedestrian safety from the perspective of a trauma surgeon.
Right: Our student researcher Merika Charupoom presented the pedestrian fatalities dashboard based on Clark County fatal and serious injury, and survey data. — Left: Dr. Douglas Fraser, Chief of Trauma, (University Medical Center of SNV) spoke about the importance of pedestrian safety from the perspective of a trauma surgeon.

Right: Our student researcher Merika Charupoom presented the pedestrian fatalities dashboard based on Clark County fatal and serious injury, and survey data.

Legislative Fact Sheets: Informing Nevada Policy-Makers

Throughout Nevada’s 81st Legislative Session our team created and distributed legislative fact sheets with the goal of educating and informing legislators utilizing evidence-based research. Nevada traffic data (crash, trauma, and hospital discharge) maintained and analyzed by our team were used to provide analyses relevant to bills that may impact traffic safety for Nevada road users. Fact sheets also provided national best practices and comparisons to other states with similar laws.

We created a Child Passenger Safety fact sheet in response to AB118, which proposed to modify Nevada law to meet best-practice recommendations by the American Academy of Pediatrics for the safe transportation of children in motor vehicles. This bill, sponsored by Assemblywoman Bilbray-Axelrod, was signed into law by Governor Steve Sisolak; changes will go into effect on January 1, 2022. Additionally, we created a High-Occupancy Vehicle Lanes (HOV) speeds fact sheet, Off-highway Vehicle (OHV) Injuries fact sheet, and Complete Streets Policies fact sheet. You may access these materials at our online library: http://bit.ly/UNLVSOMTrend.

Legislative Fact Sheets

Complete Streets Policies- legislative fact sheet — Complete Streets Policies

Speed Injuries on 55+ MPH Roads legislative fact sheet — Speed Injuries on 55+ MPH Roads

Child Passenger Safety-legislative fact sheet — Child Passenger Safety

Staff Feature
Ana Reyes, MS

Ana Reyes is a Graduate Research Assistant in the Department of Surgery at Kirk Kerkorian School of Medicine at UNLV. In her current position, Ms. Reyes is part of the evaluation readiness assessment pilot team, conducts literature reviews, writes reports, and translates TREND newsletters, infographics and other materials produced by the UNLVSOM Traffic Safety Research Team.

Ms. Reyes received her MS in Educational Psychology in 2016 from UNLV and is currently a doctoral student in the same program (focus on methodology and motivation). Ms. Reyes’ research interests are centered on academic motivation and self-efficacy and their influence on behavior and outcomes (e.g., performance, achievement, education/career choice). Through her involvement in UNLVSOM research projects, it has become increasingly evident that individuals’ motivation and self-efficacy perceptions are important in areas of injury prevention research. For instance, parent/caregiver beliefs, motivation, and perceived self-efficacy influence behaviors such as: help/information seeking; choosing proper safety system and appropriate placement (rear/forward facing, booster seat, back seat of vehicle) for child’s weight, age; and consistency of restraint use (e.g., ensuring seatbelt is worn).