Internationally, there is a growing body of evidence relating to deaths and serious injury associated with the use of quads. [1][2][3] In Australia and New Zealand, these vehicles are widely used within the agriculture sector and for recreational purposes. Quads are fourwheeled vehicles (sometimes colloquially referred to as quad bikes or ATVs -All Terrain Vehicles), with a straddle seat and handlebars.As early as the 1980s, significant safety concerns for all-terrain vehicles (inclusive of three and four wheeled vehicles), were raised by the United States Consumer Product Safety Commission (CPSC). 4 Most recently, the CPSC identified that there were between 500-600 deaths annually on quads in the 2015-17 period, with more than 100,000 Emergency Department presentations each year. 3 Furthermore, the CPSC has maintained an ongoing register of deaths since 1982, which contains over 17,000 fatal cases, with over 20% being children. 3,5