Paediatric and adolescent horse-related injuries: does the mechanism of injury justify a trauma response?
OBJECTIVE
To identify the frequency, variety and disposition of horse-related injury presentations to the ED and to use this information to evaluate the existing institutional trauma team activation criteria following horse-related injuries.


METHODS
A retrospective case analysis was performed of all horse-related injury presentations to the ED of Women's and Children's Hospital, Adelaide, Australia, in the 5 year period between January 1999 and December 2003.


RESULTS
A total of 186 children presented with horse-related injuries during the 5 year study period. The median age of injury was 9 years (range 1-17 years), with 81% of presentations female and 60% of patients hospitalized. The mechanism of injury was divided into four groups: 148 falls (79%), 28 kicks (15%), 7 tramples (4%) and 5 bites (3%). There was one death. Seven presentations rated an Injury Severity Score >15, with full trauma team activation occurring for two of these presentations.


CONCLUSIONS
Although horse-related injury presentations are uncommon, severe injuries do occur. Patients presenting with severe horse-related injuries do not always activate a full trauma team response based on current trauma team activation criteria. These severe injury presentations are supported by a limited trauma team response, which activates on the mechanism of injury. The effectiveness of this as a contingency system needs to be evaluated.
Craven
John A
JA
Department of Paediatric Emergency Medicine, Women's and Children's Hospital, Adelaide, South Australia, Australia. jcraven@ausdoctors.net
D000293:Adolescent; D017677:Age Distribution; D000818:Animals; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003131:Combined Modality Therapy; D004636:Emergency Service, Hospital; D004638:Emergency Treatment / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D050723:Fractures, Bone / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D006736:Horses / Q000293:injuries*; D006801:Humans; D015994:Incidence; D015601:Injury Severity Score; D022125:Lacerations / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D008297:Male; D009104:Multiple Trauma / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D010348:Patient Care Team / Q000458:organization & administration*; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D017678:Sex Distribution; D013997:Time Factors; D017749:Total Quality Management; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*