Driveway motor vehicle injuries in children

Objectives: To describe the frequency, nature and outcome of driveway injur ies in children. Design: Retrospective case series of driveway-related injuries in children under 16 years of age admitted to the New Children's Hospital (NCH), New So uth Wales, from November 1995 to February 2000, and deaths reported to the New South Wales Paediatric Trauma Death (NPTD) Registry from January 1988 t o December 1999. Main outcome measures: Circumstances of injury; type and number of injuries identified. Results: 42 children were admitted to our institution with driveway-related injuries over four years and four months. These represent 12% of all child ren admitted with pedestrian motor vehicle injuries. Fourteen deaths (inclu ding one of the children admitted to NCH) were reported to the NPTD Registr y over 12 years, accounting for 8% of all paediatric pedestrian motor vehic le deaths reported to the registry. Typically, the injury involved a parent or relative reversing a motor vehicle in the home driveway over a toddler or preschool-age child in the late afternoon or early evening. Four-wheel-d rive or light commercial vehicles were involved in 42% of all injuries, alt hough they accounted for just 30.4% of registered vehicles in NSW. These ve hicles were associated with a 2.5-times increased risk of fatality. In 13 o f the 14 deaths, the cause was a severe head injury not amenable to medical intervention. Conclusions: Driveway injuries in children account for a significant propor tion of paediatric pedestrian motor vehicle injuries and deaths in NSW. Pre vention represents the only effective approach to reducing deaths from this cause.