Watercraft and watersport injuries in children: trauma mechanisms and proposed prevention strategies.
OBJECTIVE
Watercraft-associated trauma (WAT) in children has received little attention so far, despite the potentially severe and debilitating resulting injuries. The aim of this study was to evaluate all cases of major watercraft-associated trauma admitted to the Children's of Alabama during the past 10 years, identify patterns in mechanism and injury, and propose future prevention strategies.


METHODS
We reviewed our (prospective) database for children admitted through our trauma center after major WAT. Charts were abstracted for mechanism, epidemiologic data, injury type and injury severity scale (ISS), as well as outcome.


RESULTS
We identified 15 children (6 males, 9 females, age range 7 to 15, mean 12 ± 2 years), involved in 14 accidents. Sharp trauma was inflicted by a propeller (n=4) or a rope (n=1). Towed tubing (riding an inflatable tube while being pulled by a boat) was the most prevalent mechanism (n=6). There was a trend towards higher ISS after towed tubing (24.8 ± 12.4) compared to all other mechanisms (15.1±7.7). Mean length of stay was longer after towed tubing accidents (14.2 ± 7.2 versus 4.9 ± 3.4 days). All patients survived and eventually were discharged home. In one of the incidences, involving 2 victims of this series, the driver of the boat was intoxicated with alcohol.


CONCLUSIONS
Pediatric watercraft-related accidents are infrequent, but often result in major injuries. More awareness for safety measures to prevent these injuries is warranted. Alcohol is not a major factor in pediatric watercraft-associated trauma. Tubes towed by a boat seem to be particularly dangerous, perhaps because of the rider's limited maneuverability and the fact that centrifugal force lets the tube travel well outside the wake in curves. Limiting boat speed and the use of protective gear on towed tubes when children are involved may decrease the incidence and severity of pediatric WAT.
Division of Pediatric Surgery, Children's of Alabama, UAB, Birmingham, AL, USA. richardkeijzer@gmail.com
Richard
R
Keijzer
Geni F
GF
Smith
Keith E
KE
Georgeson
Oliver J
OJ
Muensterer
D000056:Accident Prevention; D000059:Accidents / Q000706:statistics & numerical data*; D000293:Adolescent; D000407:Alabama / Q000453:epidemiology; D000428:Alcohol Drinking; D000671:Amputation, Surgical; D001265:Athletic Injuries / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control / Q000601:surgery; D002648:Child; D004867:Equipment Design; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D007902:Length of Stay; D008297:Male; D012307:Risk Factors; D012767:Ships; D014949:Wounds, Nonpenetrating / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D014950:Wounds, Penetrating / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control
Children; Prevention; Towed tube; Trauma; Watercraft