BACKGROUND AND OBJECTIVE: Trampoline parks, indoor recreational facilities with wall-to-wall trampolines, are increasing in number and popularity. The objective was to identify trends in emergency department visits for trampoline park injuries (TPIs) and compare TPI characteristics with home trampoline injuries (HTIs). METHODS: Data on trampoline injuries from the National Electronic Injury Surveillance System from 2010 to 2014 were analyzed. Sample weights were applied to estimate yearly national injury trends; unweighted cases were used for comparison of injury patterns. RESULTS: Estimated US emergency department visits for TPI increased significantly, from 581 in 2010 to 6932 in 2014 (P = .045), whereas HTIs did not increase (P = .13). Patients with TPI (n = 330) were older than patients with HTI (n = 7933) (mean 13.3 vs 9.5 years, respectively, P < .001) and predominantly male. Sprains and fractures were the most common injuries at trampoline parks and homes. Compared with HTIs, TPIs were less likely to involve head injury (odds ratio [OR] 0.64; 95% confidence interval [CI], 0.46–0.89), more likely to involve lower extremity injury (OR 2.39; 95% CI, 1.91–2.98), more likely to be a dislocation (OR 2.12; 95% CI, 1.10–4.09), and more likely to warrant admission (OR 1.76; 95% CI, 1.19–2.61). TPIs necessitating hospital admission included open fractures and spinal cord injuries. TPI mechanisms included falls, contact with other jumpers, and flips. CONCLUSIONS: TPI patterns differed significantly from HTIs. TPIs are an emerging concern; additional investigation and strategies are needed to prevent injury at trampoline parks.

1 page article about trampoline injuries, including statistics and key messages.

Factsheet contains latest accident figures (2002) and provides some simple safety advice for parents and children. Also lists further information available.

This article provides some injury statistics associated with trampoline use as well as some important safety advice.

This report is an evaluation of a small campaign to promote trampoline safety organised by Jocelyn Scott, Health Promoter with Health South Canterbury. The main focus of the campaign was to send out the Otago IPRU trampoline safety factsheets through local schools. The campaign was held during September and October 1995.

This report details a study which was undertaken to assess the extent of injuries associated with trampoline use, types of equipment available and the general level of safety precautions taken in New Zealand. Most importantly, recommendations are outlined for safety in trampolining.

Trampoline-associated injuries are common among children in New Zealand. This study has shown that many of these injuries occur in the spring, when New Zealand clocks change to daylight savings time. Most of these injuries, at least those that present to hospital, are broken bones of the arm or forearm. Public safety messages to decrease injuries associated with playing on trampolines should be targeted around spring when clocks in New Zealand change to daylight savings time.

INTRODUCTION: The sales of recreational trampolines have increased during the past few years. Severe injuries are associated in part with trampoline sport in the domestic setting. Therefore, this study was conducted to confirm the hypothesis of an increase in trampoline-related injuries in conjunction with the increasing sales of recreational trampolines and to find out what kind of injuries are most frequent in this context. METHODS: Between 01/1999 and 09/2013 all trampoline-related injuries of children (0-16 years of age) were assessed retrospectively. Only those cases were evaluated which described with certainty a trampoline-associated trauma. The fractures were considered separately and assigned to specific localisations. Additionally, accidents at home were differentiated from institutional accidents. RESULTS: Within the past 13 years and 9 months trampoline-related injuries were seen in 195 infants. Fractures were present in 83 cases (42 %). The average age was 10 ± 3.4 years (range: 2-16 years). Within first half of the observed time period (7½ years; 01/1999 to 06/2006) 73 cases were detected with a significantly increasing number of injuries up to 122 cases between 07/2006 and 09/2013 (7 years, 3 months), which corresponds to an increase of 67 % (p = 0,028). The vast majority of these injuries happened in the domestic setting (90 %, n = 175), whereas only 10 % (n = 20) of the traumas occurred in public institutions. In 102 children (52 %) the lower extremity was affected and in 51 patients (26 %) the upper extremity was involved (head/spine/pelvis: n = 42, 22 %). The upper extremity was primarily affected by fractures and dislocations (n = 38, 76 %). At the upper extremity there were more injuries requiring surgery in contrast to the lower extremity (n = 11) or cervical spine (n = 1). CONCLUSION: The underlying data show a significant increase of trampoline-related injuries within the past years. The upper extremity is the second most affected after the lower extremity, but is more associated with fractures in contrast to other localisations and had to be operated on the most. Because of the increase of recreational trampolines within past years an increase of trampoline-associated injuries has to be expected in the future. The security guidelines should be followed exactly and the infants should be under supervision.

The objective of this research was to describe the epidemiological features of trampoline-related injuries among children treated in an urban pediatric emergency department. This was a descriptive study of a consecutive series of patients. The setting was an emergency department of a large, urban, academic children's hospital. Participants were children treated for trampoline-related injuries from May 1, 1995, through April 30, 1997. Results showed that two hundred and fourteen children were treated for trampoline-related injuries during the study period, representing, on average, 1 child treated approximately every 3 days. Children ranged in age from 1 to 16 years (mean [SD], 9.4 [3.6] years). The area of the body most commonly injured was a lower extremity (36.0%), followed by an upper extremity (31.8%), the head (14.5%), the trunk (9.8%), and the neck (7.9%). The most common type of injury was a soft tissue injury (51.9%), followed by fracture (34.6%) and laceration (11.7%). Several patterns of trampoline-related injury were identified. Extremity fractures were more common in the upper extremities; however, soft tissue injuries were more common in the lower extremities. Lacerations were associated with injury to the head region and were more common among children younger than 6 years. Soft tissue injuries were more common among children 6 years of age and older. Four patients (1.9%) with fractures were admitted to the hospital. The trampoline was located in the backyard in 96% (119/124) of cases. Adult supervision was present at the time of injury for 55.6% (65/117) of children, including 73.3% (22/30) of children younger than 6 years. Parents reported that they had been aware of the potential dangers of trampolines before the injury event (73% [81/111]), that their child had previously attempted a flip on a trampoline (56.9% [66/116]), that this was not the child's first injury on a trampoline (10% [12/120]), and that their child continued to use a trampoline after the current injury event (54.8% [63/115]). In conclusion, trampoline-related injuries to children treated in the emergency department are almost exclusively associated with the use of backyard trampolines. The prevention strategies of warning labels, public education, and adult supervision are inadequate to prevent these injuries. Children should not use backyard trampolines, and the sale of trampolines for private recreational use should be halted.

Email re proposed ban on the use of the trampoline

This fact sheet provides key facts regarding injuries from trampolines in New Zealand over the ten years 1979-88 and includes common sense rules for safer trampoline use.

Report on data from 81 documented cases of trampoline injury. Gives recommendations to reduce safety hazards.

This updated trampoline factsheet from Kidsafe NSW has sections on: Safety guidelines, In ground installation, Maintenance and Child safe practices. PDF available at: http://www.kidsafensw.org/factsheets/playground-safety/

The latest available data indicate that an estimated 83 400 trampoline-related injuries occurred in 1996 in the United States. This represents an annual rate 140% higher than was reported in 1990. Most injuries were sustained on home trampolines. In addition, 30% of trampoline-related injuries treated in an emergency department were fractures often resulting in hospitalization and surgery. These data support the American Academy of Pediatrics’ reaffirmation of its recommendation that trampolines should never be used in the home environment, in routine physical education classes, or in outdoor playgrounds. Design and behavioral recommendations are made for the limited use of trampolines in supervised training programs.

A descriptive epidemiological study of trampoline related injury in New Zealand was undertaken. National hospitalisation and mortality data was searched. The commonest injury was a fracture and the body site most frequently involved was the upper limb. There was no evidence of a high incidence of severe head and neck injury. It was concluded that although existing trampoline standards addressed many of the issues raised by this research, measures to reduce the impact of falls from trampolines to the ground surface and to prohibit the provision of trampolines as 'play equipment' are required.

The Consumer NZ website offers this advice, the "... New Zealand standard for trampolines gives these safety tips for trampoliners: - Stop your bounce by flexing your knees as your feet come in contact with the trampoline mat. Learn this skill before you attempt others. - Learn fundamental bounces and body positions thoroughly before trying more advanced skills. - Climb on and off the trampoline – do not jump. - Avoid bouncing too high. Stay low until you can control your bounce and repeatedly land in the centre of the trampoline. - Focus your eyes on the end of the trampoline to help control your bounce. - Avoid bouncing for too long and don't bounce when tired. - Don't use the trampoline as a springboard to other objects. - Don't attempt somersaults without proper instructions and coaching (this is the cause of most serious injuries on trampolines). As well, make sure children are supervised by an adult – and allow only one child at a time on the trampoline. Setting up your trampoline A trampoline must always: - be on a level surface with a clear space of at least two metres around it – make sure it’s far enough away from fences and outdoor furniture - have a minimum overhead clearance of 7.3 metres from the ground – watch out for wires and tree limbs - have no “obstructions” underneath it (for instance, don’t store things under it or allow kids to play underneath) - be in a well-lit area - be secured against unsupervised use (for instance, remove the ladder so young kids can't climb on to the mat) - be used only when the mat’s surface is dry. Accident waiting to happen? Here’s what to watch out for, particularly if you have an older trampoline: - punctures or holes worn in the mat - deterioration in the mat’s stitching - a bent or broken frame - ruptured springs - missing or insecurely attached frame pads - a sagging mat - sharp protrusions on the frame or suspension system - holes or tears in the safety net – if there’s one fitted. Get problems like these fixed before the trampoline’s next used. The New Zealand Standard for trampolines NZS 5855:1997 was used as the basis for our advice on setting up, maintaining and using a trampoline." See also record # 9953. For more see: http://www.consumer.org.nz/reports/trampolines

The increasing popularity of indoor trampoline parks is leading to a rise in children's injuries, research reveals.

Mandatory product safety standards for children's nightclothes, bicycles and toys for children under 3 years of age in New Zealand and Australia are different. See: http://www.consumeraffairs.govt.nz/productsafety/consumerinfo/index.html

Transanal suction from a swimming pool drain can result in intestinal evisceration. A report on the eighth such case, followed by a literature review, description of the mechanism, and management guidelines. This bizarre injury, which has devastating consequences for the children involved, is completely preventable by installation of semi-permanent, anti-vortex grates.

This 'Transition/ Discharge planning' item from the 'Policy & procedure manual', Starship Children's Health - Auckland District Health Board (ADHB) includes this advice on page 7: "When a [child] patient is discharged out of hospital it is prudent of the service to ensure that travel will be safe and comfortable for the child. It may be timely to mention child care restraints and also to consider the length of time that the travel may be in conjunction with the child’s essential cares."

Injuries continue to be the most important cause of morbidity, disability and mortality during childhood and adolescence. One of the key issues in injury control is the translation of the knowledge gained from rigorous research studies into programmes in the community which make a difference. This conference and proceedings were important steps in disseminating information on how to accomplish this task. These conference proceedings can help provide a road map for the successful implementation of injury control programmes in the community. The conference was based around three papers/topic areas: -Bicycle helmet promotion -Graduated driver licensing -Safe firearm storage Each of the three topics has their own set of circumstances and parameters in which an intervention or policy is pursued.

A leading article advocating for the development of better public transport systems in New Zealand and pointing out the disadvantages of car-oriented systems especially in terms of pedestrian injury and other health costs. These costs are particularly high for children, the elderly and socioeconomically disadvantaged people.

An outline of the Northern Ireland Strategic transportation Model (NISTM) and the Belfast Trasnsportation Model (BTM). Both schemes have resulted from unique co-operation between roads, planning and public transport authorities in the interests of integrated tranpsort planning.

The New Zealand Ministry of Transport has a: "Transport Monitoring Indicator Framework (TMIF)' which provides a national, and where possible regional, framework for the monitoring of the New Zealand transport system. Led by the Ministry of Transport in collaboration with the wider transport sector, the framework is also a tool for informing and evaluating transport-related policies and other work. The TMIF contains a large set of transport sector-related head-line indicators. The Ministry updates indicator data on an on-going basis and publishes annual reports based on the information provided within the framework." The focus of this part of the Transport Monitoring Indicator Framework is cycle helmet use. Available at: http://www.transport.govt.nz/ourwork/TMIF/SS020/

These results are based upon questions included in an omnibus telephone survey of a nationally representative sample of 750 New Zealanders 18 years old or older. Survey was of perceived safety of ways children travel between home and school.

OBJECTIVE: Children regularly imitate behavior from movies. The authors assessed injury risk behaviors in top-grossing children's films. METHODS: The 5 top-grossing G- or PG-rated movies annually from 2008 to 2013 were included, including animated movies and those set in the past/future. Researchers coded transportation scenes for risk taking in 3 domains: protection/equipment, unsafe behaviors, and distraction/attention. RESULTS: Safe and risky behaviors were recorded across the 3 domains. With regard to protection and equipment, 20% of motor vehicle scenes showed characters riding without seat belts and 27% of scenes with motorcycles showed characters riding without helmets. Eighty-nine percent of scenes with horses showed riders without helmets and 67% of boat operators failed to wear personal flotation devices. The most common unsafe behaviors were speeding and unsafe street-crossing. Twenty-one percent of scenes with motor vehicles showed drivers speeding and 90% of pedestrians in films failed to wait for signal changes. Distracted and inattentive behaviors were rare, with distracted driving of motor vehicles occurring in only approximately 2% of total driving scenes. CONCLUSION: Although many safe transportation behaviors were portrayed, the film industry continues to depict unsafe behaviors in movies designed for pediatric audiences. There is a need for the film industry to continue to balance entertainment and art with modeling of safe behavior for children.

This printout of a policy from the ADHB intranet provide guidelines for staff who utilise ADHB fleet and private vehicles to provide transport for child and family clients who have difficulty accessing health services. It includes details on the law, appropriate child restraint use and links to relevant organisations such as: the New Zealand Transport Agency (NZTA), Safe2go, Plunket and Safekids NZ.

This printout of a policy from the ADHB intranet provide guidelines for staff who utilise ADHB fleet and private vehicles to provide transport for child and family clients who have difficulty accessing health services. It includes details on the law, appropriate child restraint use and links to relevant organisations such as: the New Zealand Transport Agency (NZTA), Safe2go, Plunket and Safekids NZ.

OBJECTIVE: To evaluate the transport of children in automobiles and the use of child restraints systems (CRS). METHODS: This is a transversal descriptive study which included 200 vehicle drivers who carried 0-10 year old children in the city of São Luis, MA, Brazil. The drivers' passengers' and children's features were properly identified. The children's transportation using CRS were analyzed according to the Resolution 277/8 of the Brazilian National Traffic Department. RESULTS: The transportation of children was classified as inappropriate in 70.5% of the vehicles analyzed. The most common way for children transportation was free on the back seats (47%) or on the lap of passengers/drivers (17%). The main reasons to justify the improper transportation were either not understanding the importance of CRS use (64.5%) or not having financial resources to buy the devices. The child safety seat was the most used CRS (50.8 %) among vehicles with proper child transportation system. CONCLUSION: The transportation of children was inappropriate in most of the vehicles analyzed, reflecting the need for creating awareness among automobile drivers, including education, supervision and improvement of policies for health improvement and prevention of accidents involving children transportation. Level of Evidence III, Cross Sectional Study.

Children with special health care needs should have access to proper resources for safe transportation. This statement reviews important considerations for transporting children with special health care needs and provides current guidelines for the protection of children with specific health care needs, including those with a tracheostomy, a spica cast, challenging behaviors, or muscle tone abnormalities as well as those transported in wheelchairs.

Factsheet for healthcare providers about the safe transportation of newborn infants.

Pre-school children grow and develop rapidly with age and their changing capabilities are reflected in the ways in which they are injured. Using coded and textual descriptions of transport-related injuries in children under five years of age from the Queensland Injury Surveillance Unit (QISU) this paper profiles the modes of such injuries by single year of age. The QISU collects information on all injury presentations to emergency department in hospitals throughout Queensland using both coded information and textual description. Almost all transport-related injuries in children under one year are due to motor vehicle crashes but these become proportionately less common thereafter, while injuries while cycling become proportionately more common with age. Slow-speed vehicle runovers peak at age one year but occur at all ages in the range. Bicyclerelated fatalities are rare in this age group. If bicycle-related injuries are excluded, the profiles of fatal and non-fatal injuries are broadly similar. Comparison with a Queensland hospital series suggests that these results are broadly representative.

Background: Injuries resulting in admission to hospital provide an important basis for determining priorities, emerging issues, and trends in injury. There are, however, a number of important issues to be considered in estimating person based injury incidence using such data. Failure to consider these could result in significant overestimates of incidence and incorrect conclusions about trends. Aim: To demonstrate the degree to which estimates of the incidence of person based injury requiring hospital inpatient treatment vary depending on how one operationally defines an injury, and whether or not day patients, readmissions, and injury due to medical procedures are included. Method: The source of data for this study was New Zealand’s National Minimum Dataset. The primary analyses were of a dataset of all 1989–98 discharges from public hospital who had an external cause of injury and poisoning code assigned to them. Results: The results show that estimates of the incidence of person based injury vary significantly depending on how one operationally defines an injury, and whether day patients, readmissions, and injury due to medical procedures are included. Moreover the effects vary significantly by pathology and over time. Conclusions: (1) Those using New Zealand hospital discharge data for determining the incidence of injury should: (a) select cases which meet the following criteria: principal diagnosis injury only cases, patients with day stay of one day or more, and first admissions only, (b) note in their reporting that the measure is an estimate and could be as high as a 3% overestimate. (2) Other countries with similar data should investigate the merit of adopting a similar approach. (3) That the International Collaborative Effort on Injury Statistics review all diagnoses within International Classification of Diseases 9th and 10th revisions with a view to reaching consensus on an operational definition of an injury.

All-Terrain Vehicle (ATV) accidents cause 7000 injuries and 20 deaths per month. In this prospective multicentre study comparing three- and four-wheelers, data were obtained on all ATV accident victims treated at 33 participating institutions in West Michigan from July-November 1986 (n=143) and on 51 accidents from the preceding 18 months. Analysis of the data showed the following: 1) the three-wheeled ATV design is significantly more unstable than that of the four-wheeler; 2) though more stable, the four-wheeled ATV was still associated with frequent accidents as severe as those involving three-wheelers; 3) riders under age 16 were more likely to be using their ATV improperly and had more severe injuries with a higher hospitalisation rate, and 4) these ATV riders had inadequate training and protective gear. Lastly, recommendations are made that ATVs need their design flaws corrected for safer use, and that mandatory minimum age requirements, rider education, and helmet use should reduce injuries.

Contains: Guidelines for essential trauma servcies; WHA resolution 60.22; Additional resources; Burns prevention; Mass casualty management; Strengthening care for injured...; Prehospital trauma care systems; Guidelines for trauma quality improvement programmes; Guidelines for medico legal care for victims of sexual violence.

Concludes that data from local and out of area referred patients at trauma centers should be analyzed and presented separately in studies if an accurate representation is to be provided of the role of injury in the population at large of the community.

Abstract of a paper presented to the World Injury conference held in London in October 2010: "Objective: Every year in the US, thousands of young children are injured by passenger vehicles in driveways or parking areas. Little is known about risk factors, and incidence rates are difficult to estimate because ascertainment using police collision reports or media sources is incomplete. This study used surveillance at trauma centres to identify incidents and parent interviews to obtain detailed information on incidents, vehicles and children. Methods: Eight California trauma centres conducted surveillance of non-traffic pedestrian collision injury to children aged 14 years or younger from January 2005 to July 2007. Three of these centres conducted follow up interviews with family members. Results: Ninety-four injured children were identified. Nine children (10%) suffered fatal injury. Seventy children (74%) were 4 years old or younger. Family members of 21 victims from this study (23%) completed an interview. Of these 21 interviewed victims, 17 (81%) were male and 13 (62%) were 1 or 2 years old. In 13 cases (62%), the child was backed over, and the driver was the mother or father in 11 cases (52%). Fifteen cases (71%) involved a sport utility vehicle, pick-up truck or van. Most collisions occurred in a residential driveway. Conclusions: Trauma centre surveillance can be used for case ascertainment and for collecting information on circumstances of non-traffic pedestrian injuries. Adoption of a specific external cause of injury code would allow passive surveillance of these injuries. Case–control studies are needed to understand the contributions of family, vehicular and environmental characteristics and injury risk to inform prevention efforts." doi:10.1136/ip.2010.029215.358

AIM: The aim of this study was to describe trauma in children secondary to the use of wheeled recreational devices (WRDs). METHODS: This study retrospectively described trauma secondary to use of WRDs sustained by children 16 years or younger over a period of 12 months at two tertiary paediatric hospitals in Brisbane, Queensland. Data were analysed from the Paediatric Trauma Registry at these two facilities. Data were also retrieved from The Commission for Children and Young People and Child Guardian to provide information regarding deaths in Queensland from the use of WRDs for the period January 2004 to September 2013. Outcome measures included age, gender, types of injuries, Injury Severity Scores, admission to Intensive Care, and length of hospital stay for all hospital admissions greater than 24 h. RESULTS: A total number of 45 children were admitted with trauma relating to WRDs during the 12 months, representing 5.3% of all trauma admissions of greater than 24 h during this time period. Of these, 34 were male with a median age of 11.0 years (IQR = 9-13). Limbs accounted for the majority (54.5%) of injuries, with other common injuries being spine/cranial fractures (14.5%), lacerations (12.7%), internal organ injuries (9.1%), and intracranial bleeds (9.1%). There were six admissions to the Paediatric Intensive Care Unit and one death. CONCLUSIONS: WRDs contribute significantly to injuries sustained by children. A large proportion of these injuries may be preventable, suggesting that mandating the use of protective equipment in Queensland may be of great benefit.

We evaluated the characteristics of traumatic injury and risk for subsequent trauma in infants less than three months of age. injury was due to abuse/neglect in 28% whereas 72% were accidentally injured. Falls were the most common mechanism of accidental injury- 67% The abuse/neglect group tended to have a greater number of subsequent traumatic injuries than those accidentally injured. Abuse/neglect should be considered in any seriously injured infant less than three months of age because of the likelihood of subsequent trauma.

The objective of this study was to evaluate the frequency, severity, exact patterns and mechanisms of burn injuries in children. The patient records of children with acute burns admitted to the University Children's Hospital of Zurich were retrospectively reviewed over an 11year period. The age group with the highest risk, were children under the age of five (69%). Boys were overrepresented in all age groups, but the gender imbalance increased with age. Infants and toddlers were mainly injured by scalds and contact burns. Conversely, almost three quarters of injuries over the age of 9 were caused by flame. The majority of scald injuries was a result of pulling down hot liquids. The typical distribution of this accident scenario involved mainly the face, trunk and arms. More than half of all flame injuries occurred due to fire accelerants. 55% of children were passively involved while other children throwing flammable substances into a fire. Most of these injuries involved the face and arms. This study shows that burn etiology is age dependent. Additionally, our results demonstrate the diversity of burn accidents and their resulting injuries. These findings may help better specify target groups and subjects for prevention.

The pressure is on the health system to improve the salvage rate from road trauma by establishing high tech, hospital based, high profile, highly trained and immediately available trauma surgical units in 5 New Zealand hospitals. This article looks at the pros and cons of such units.

One of the leading causes of death and disability among young children is motor vehicle accidents. Although current child restraint systems (car seats) have significantly reduced mortality and morbidity, deaths and injuries still occur. Since it is not possible to correlate human child injury potential with the biomechanical devices used for high level impact testing using experimental methods, the acquisition and analysis of specific child injury data identifiable with real world automobile crashes is critical for input to biomechanical research, anthropometric test device (ATD) development and safety standard revisions. The purpose of this study was to analyse vehicular-related trauma that had occurred to children in known crash environments based on accident configuration and care seat design.

This article is based on data from the Starship Trauma System and focuses on all trauma in February-May 2008. Main cases are: falls, caught in or between, pedal cyclists, cutting and piercing and pedestrian injuries. Includes a section 'Are motorbikes safe for children?' which describes the high number of admissions from this cause and sorts of serious injuries which result.