PEDIATRIC EQUESTRIAN INJURIES - ASSESSING THE IMPACT OF HELMET USE

Objective. To assess the impact of helmet use on the pattern, and seve rity of pediatric equestrian injuries. Design. A prospective observati onal study of all children less than 15 years of age who were brought to the University of Virginia children's Emergency Department with hor se-related injuries. Results. During the two-year period of the study, 32 children were evaluated. Two children were injured when a horse st epped on them. Thirty children fell from or were thrown from a horse. Of these, 20 were wearing a helmet. Head injuries were more frequent i n those patients not wearing helmets. The mean Modified Injury Severit y Scale (MISS) score for riders without a helmet (12.9) was significan tly higher (more severe) than that for helmeted riders (2.8). All thre e patients with a Glascow Coma Score < 15 on arrival were not wearing a helmet at the time of injury. The frequency of hospitalization was s ignificantly higher for those not wearing a helmet. Compared with othe r common mechanisms of childhood injury the mean Modified Injury Sever ity Scale score of injured riders was exceeded only by that of pedestr ians struck by a ear. Conclusion. Equestrian injuries are more severe than those suffered from other common pediatric mechanisms. Helmet use is associated with decreased frequency and severity of central nervou s system injury.