Children in Motor Vehicle Collisions: Analysis of Injury by Restraint Use and Seat Location

Abstract

This study was a retrospective chart review of hospital records and autopsy reports of 499 children nine years old or younger in-volved in motor vehicle collisions from 1994 to 1998. The objective was to evaluate the frequency and severity of injuries as a function of age, re-straint use, and seat position. We found that 33% of the children were unrestrained and 20% were improperly restrained. Unrestrained children had the highest mean Maximum Abbreviated Injury Scores (MAIS) and Injury Severity Scores (ISS), accounted for 70% of the fatalities, and had the highest incidence of head in-juries. Although most of the head injuries were superficial, 80% of the fatalities were the result of a head injury. Improperly restrained children had the highest frequency of abdominal injuries. Regardless of restraint use, the back seat was associated with fewer head injuries and lower mean MAIS and ISS scores compared to the front seat. Also, properly restrained children in the front seat had lower mean MAIS and ISS scores than unrestrained children in the back seat, suggesting that restraint use is more beneficial than seat position.

Motor Vehicle Collisions and Their Demographics: A 5‐Year Retrospective Study of the Hamilton‐Wentworth Niagara Region*

“…Motor vehicle collisions with resultant fatalities can involve numerous contributing factors. These fatalities have been reported in the literature often in the context of particular areas of interest such as gender, age (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13), site of injury (14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26), and toxicology (8,(27)(28)(29)(30)(31)(32)(33)(34)(35)(36). Results are limited to certain populations and various study criteria limiting generalization.…”

Prehospital pediatric trauma classification (PHPTC) as a tool for optimizing trauma care resources in the city of São Paulo, Brazil

“…Besides, a constant work must be carried out in analyzing results, so that the necessary modifications are incorporated. 5 Deficiencies in registries such as the ones we detected in the present study, including the absence of height for falls, lack of information about the position of the child in the car and the use of safety tools, were also detected in most series. 8,[26][27][28][29][30] Classifying a type of event can be difficult, so that a good protocol with proper codification and adequately trained personnel is of essence.…”

“…Prehospital trauma care in children remains a significant problem worldwide. 1,[2][3][4][5][6][7] Although health personnel are used to dealing with bizarre situations at the trauma scene, whenever the victim is a child, emotional involvement and reactions may be quite different than those involving adults. Moreover, a frightened child will hardly cooperate with the team; vital signs are more difficult to obtain and normal values vary according to age.…”

An Unusual Case of Impalement of the Cranium in a Child

“…3 Proper restraint use has been shown to reduce morbidity and mortality in numerous studies. 1,[3][4][5][6][7] In addition, passengers in the back seat are at less risk than front-seat passengers of sustaining a severe injury. 3 Head injuries sustained in motor vehicle collisions tend to be diffuse, blunt trauma with or without skull fractures.…”

“…1,[3][4][5][6][7] In addition, passengers in the back seat are at less risk than front-seat passengers of sustaining a severe injury. 3 Head injuries sustained in motor vehicle collisions tend to be diffuse, blunt trauma with or without skull fractures. 4,7-9 Less common, although clearly not unique to our case, are penetrating head injuries, with the offending objects ranging from devices within the automobile to objects outside the vehicle.…”