INJURIES TO CHILDREN RELATED TO SHOPPING CARTS

Study Objective. To describe the epidemiology of shopping cart-related injuries among children and to consider targeted prevention strategie s based on these epidemiologic findings. Design. A consecutive series of patients. Setting. The emergency department of a large, academic ch ildren's hospital. Participants. Sixty-two children treated for shoppi ng cart-related injuries during a 15-month period. Results. Children r anged in age from 4 months to 10 years (mean, 2.8 years). Thirty-three children (53%) were boys. Twelve patients (19%) arrived via ambulance . Forty-nine children (79%) had injuries to the head, including one ch ild admitted to the hospital. Eleven children (18%) had fractures, inc luding 5 (8%) with skull fractures. Nine patients (14%) had laceration s, and 30 patients (48%) had superficial injuries (ecchymoses or abras ions). The most common mechanism of injury was falling out of the cart s (58% of children), followed by cart tip-overs (26% of children). Inj uries caused by falls from the carts occurred across the entire age ra nge, whereas injuries caused by cart tip-overs were most frequent amon g children 1 year of age or younger. The sitting position was associat ed with tip-over injuries, and standing in the cart basket was associa ted with falling from the cart. Conclusions. Shopping cart-related inj uries cause serious pediatric morbidity, especially among children you nger than 5 years of age, and are potentially fatal. Based on identifi ed age-specific mechanisms of injury, currently used prevention strate gies are not sufficient. The use of infant seats and restraining belts is an inadequate strategy for prevention of shopping cart-related inj uries among children 1 year of age or younger, because cart tip-over i s an important mechanism of injury in this age group. Shopping carts s hould be redesigned to decrease the tip-over hazard. Transportation of children in shopping carts of current design should be prohibited.