Sledding Accidents in Children: Potential for Serious Injury, Risk of Fatality

Abstract

Though a pastime rarely considered rough or dangerous, sledding is not risk-free. The presentation of several serious injuries to Rainbow Babies and Children’s Hospital in Cleveland, Ohio, led us to examine our emergency department and admitting records to determine the incidence of neurological injury among children involved in sledding accidents. We discovered 24 children who had sustained brain or spine injuries as sequelae to sledding mishaps during a 5-year period. The ages ranged from 3 months to 15 years. Injuries included multiple skull fractures, 2 epidural hematomas, 1 subdural hematoma, 1 odontoid fracture and 1 anoxic brain injury. There was 1 death. Twenty-one of 24 patients incurred their injuries by colliding with fixed objects. Both improvised crafts and models intended for sledding were involved in the injuries. Only 3 sleds possessed steering capability. Eight of the 9 children who sustained a serious neurosurgical injury were supervised by an adult. Only 2 children had received instruction before sledding. The lack of awareness of the potential for injury together with the dearth of instruction and lack of control over a vehicle dashing down a hill studded with obstacles can change a carefree pastime into a hazardous activity.

Sledding-Related Injuries Among Children Requiring Emergency Treatment

“…13,15 Collisions with a stationary object were responsible for the majority of sledding injuries in this study. This finding is consistent with previously reported data regarding sledding injuries 3,11,16,17 as well as fatal skiing and snowboarding injuries. 18 In our study, there was no significant difference in the proportion of injuries caused by collisions among age groups.…”

Emergency Department Visits for Sledding Injuries in Children in the United States in 2001/2002

“…Multiple investigators have reported major head trauma related to sledding, including skull fractures, 7,8,11,13,15,17,21 cerebral contusion, 11 and intracerebral hemorrhage. 7,9,13,17 Deaths resulting from head trauma in victims of sledding accidents have also been reported, 9,10,[12][13][14] although these are rare. As with many other types of traumatic fatalities, head trauma appears to be a major contributor to sledding-related fatalities.…”

“…The high percentage of head injuries found in this study suggests that the use of helmets could be recommended for children participating in sledding; although data on helmet use were not available for this study, investigators in the United States and Canada who have examined this issue found helmet use exceedingly rare (0-7%) among injured sledders. 1,6,8,[10][11][12]16,17 Whether standard, existing helmets (e.g., bicycle or ski helmets) would be adequate for this purpose or whether some engineering modification is required remains to be determined.…”

Sledding-Related Injuries Among Children and Adults Treated in US Emergency Departments From 2008 to 2017

“…4 Sledding-related injuries can be mild (eg, lacerations) to more severe (eg, fractures and traumatic brain injuries) and can lead to hospitalization, permanent disability, and death. 1,3,[5][6][7][8][9][10] Although many studies have examined injuries associated with snow sports, such as snowboarding and skiing, [11][12][13][14][15][16][17][18] only a few studies have exclusively examined sledding-related injuries. 1,3,7,8,[19][20][21][22][23] Although sledding-related injury studies have identified important findings regarding the characteristics of patients (eg, age and sex), types of injuries (eg, fractures), mechanism of injury (eg, collision), and a lack of safety awareness (eg, not wearing a helmet), 1,3,6,7,22 many have significant limitations.…”