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Not Just Little Adults: Differences in Injury Patterns Among Children and Adults Following ATV Crashes
*Alia Whitehead, *Alicia Privette, *Armin Kiankhooy, Kennith Sartorelli
UVM/Fletcher Allen Health Care, Burlington, VT

Objective: To determine differences in injury profiles and helmet usage between adult and pediatric ATV crash victims and whether these differences warrant independent evaluation.
Design: Retrospective review of prospectively collected trauma database
Setting: Rural Level I Trauma Center
Patients: All patients evaluated by Trauma Service (2000-2009) following ATV crash with AIS>2
Interventions: None
Main Outcome Measures: Isolated and multisystem injury type (head, thorax, abdomen/pelvis, spine, orthopedic), helmet usage, state helmet laws, ISS, GCS, ICU, hospital LOS.
Results: 261 patients (62 children (age <16) and 199 adults). 17 patients excluded for inadequate ISS. Adults had significantly worse injuries (ISS: 16.8 vs. 13.1, p = 0.005). Presence of multi-system vs. single system injuries was similar. Abdominal injuries significantly more likely in children (33.9% vs. 15.4%, p=0.004). Thoracic and spine injuries significantly more common in adults (30.3% vs. 8.9%, p < 0.001; 21.8% vs. 8.9%, p=0.03). Head and orthopedic injuries were similar. Similar documentation of helmet use (78.6% children and 79.8% adults). Children were significantly more likely to use helmets (63.6% vs. 43.3%, p=0.03). Helmet usage was protective (p=0.009) against head injury (41.9% with helmet vs. 61.4% without helmet), but didn’t affect incidence multisystem injury. Non-helmeted vs. helmeted adults had significantly worse (12.2 vs. 13.8, p=0.003) GCS. Helmeted adults vs. helmeted children had significantly worse ISS scores (17.6 vs. 13.6, p=0.01). Helmet laws did not affect helmet usage.
ATV crashes impart a significant injury burden in both children and adults, but injury patterns are significantly different. Identification of these patterns may help guide patient evaluation and development of safety gear. Helmet use is protective, but documentation of helmet behavior and compliance with helmet laws needs improvement.

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