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Bicycle Safety Hilary Suzawa Med/Peds September 2006 Phot

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Title: Bicycle Safety Hilary Suzawa Med/Peds September 2006 Phot


1
Bicycle Safety
  • Hilary Suzawa
  • Med/Peds
  • September 2006

Photo from SAFE KIDS
2
Incidence
  • Bicycle-related injuries cause per year in the
    United States
  • 900 deaths
  • gt20,000 hospital admissions
  • gt500,000 ER visits
  • gt1 million physician visits
  • Estimated cost of 8 billion annually

3
Pediatric Injuries
  • Most common cause of serious head injury in
    children
  • Bicycle injuries account for 10 of all pediatric
    traumatic deaths

4
Risk Factors
  • Peak incidence of bicycle-related injuries and
    fatalities
  • Age?
  • 9-15 years
  • Gender?
  • Male gt Female

5
Risk Factors
  • Male
  • 9-15 years old
  • Summer
  • Late afternoon or early evening
  • NO helmet
  • Motor vehicle involved
  • Unsafe riding environment
  • From an unstable family environment
  • Has a pre-existing psychiatric condition
  • Intoxicated
  • Competitive mountain-bike racing

6
Acute Trauma
  • Most injuries occur to the upper or lower
    extremities
  • In order from most common to least common site of
    injury
  • Extremity
  • Head or face
  • Abdomen or thorax
  • Neck

7
Acute Trauma
  • Superficial trauma abrasions (road rash),
    contusions, lacerations
  • Extremities Strains, fractures, dislocations
  • Abdomen or thorax Blunt injury, handlebars
  • Face Airborne objects leading to eye trauma
  • Neck associated with MVA

8
Acute Trauma
  • Head injuries
  • Occur in 20-45 of injured bicyclists
  • Usually with MVA
  • Responsible for 60 of bicycle-related deaths
  • Younger children are more at risk for head
    injuries
  • 50 of all bicycle-related injuries among
    children lt10 years occur to the head or face vs.
    20 in older children

9
Acute Trauma
  • Overall, off-road cyclists have a 40 lower
    incidence of head, facial and dental injuries
    than on-road bicyclists
  • Separation from motor vehicles
  • More frequent helmet use

10
Overuse Injuries
  • Neck ache and backache
  • Hyperextension of the neck and flexion of the
    lower back
  • Tx rest, stretching, NSAIDs, shortening the
    handlebar reach
  • Compression Neuropathy
  • Ulnar neuropathy (from handlebars)

11
Overuse Injuries
  • Buttock tenderness
  • Pressure over the ischial tuberosities
  • Saddle sores
  • From skin chafing
  • Tx powder, lubrication, seat positioning
  • GU conditions
  • Perineal folliculitis or maceration of the
    perineal skin
  • Traumatic urethritis with hematuria and mild
    dysuria
  • Nerve compression of pudendal nerve causing
    paresthesia of penis and scrotum in males
  • Femalesvulval abrasions, lacerations, contusions

12
Overuse Injuries
  • Hip pain
  • Trochanteric bursitits
  • Iliopsoas tendonitis
  • Knee pain
  • Patellofemoral syndrome
  • Foot pain
  • Metatarsalgia
  • Plantar fasciitis
  • Achilles tendonitis
  • Sun and heat

13
Injury Prevention
  • Bike helmets reduce risk for bicycle-related
    injuries to the head by 75-85 and to the nose
    and upper face by 65.
  • Cyclists who strike heads in a crash are 20 x
    more likely to sustain head trauma if NO helmet
  • Goal of Healthy People 2000 that 50 of
    bicyclists wear safety helmets (nationally 18)
  • 50 of children have bike helmets but only
    15-25 wear them consistently and correctly

14
Bike Helmet Fitting
  • Horizontal positionlevel front and back
  • Cover the top of the forehead2 fingers above
    eyebrows
  • Straps forming a V around the ears
  • Buckle fastened
  • Fit snuglywhen open mouth helmet moves down
  • Removable and extra-foam fitting pads to
    customize fit
  • Check fit by having child shake headno side to
    side or back to front movement

15
Bike Helmet Fitting
16
Bike Helmet Fitting
17
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18
Bike Helmet Standards
  • Look for sticker on the helmet
  • States it meets standards of either
  • Snell Memorial Foundation
  • American National Standards Institute (ANSI)
  • Educate patients to replace bike helmet after an
    accident

19
Barriers to Helmet Use
  • Financialdoes not own a helmet
  • Peer pressure
  • Feels uncomfortable
  • Maternal employment (noted in one study)

20
Factors Promoting Helmet Use
  • Legislation
  • 15 states have bicycle helmet laws
  • Texas as a state does not have legislation but
    cities do (eg. Austin)
  • Education
  • Parental attitudes
  • Peer attitudes

21
  • Parents consistently overestimate their
    childrens likelihood of wearing a helmet.
  • Bicycle helmet use decreases as age increases

22
Resources for Parents
  • AAP
  • National SAFE KIDS campaign
  • TMA Hard Hats for Little Heads
  • Bicycle Helmet Safety Institute
  • National Center for Bicycling and Walking
  • League of American Bicyclists

23
Resources for Parents
  • Strap and Snap Program
  • Think First Foundation
  • EN CARE Bike with Care Program
  • National Center for Injury Prevention and Control
  • American Trauma Society
  • American Automobile Association
  • Harborview Injury Prevention and Research Center
  • United States Consumer Product Safety Commission

24
Main Points
  • Bicycle-related accidents are a major cause of
    pediatric head injury and traumatic deaths
  • Peak risk group is age 9-15 years
  • Most common site of acute trauma extremity
  • Head injuries are more common in younger children
    (lt10 years)
  • Bike helmets reduce risk of head injury by 75
  • Know how to fit a bicycle helmet

25
Bike Helmets at MLK Clinic
  • Any residents interested in coordinating an event
    and a bike-helmet program?
  • Funding?
  • Resources for helmets?
  • Survey of patients
  • How many own helmets?
  • How many wear helmets?

26
Bibliography
  • Coffman, S. Bicycle Injuries and Safety Helmets
    in Children. Ortho Nurs 2003 22(1) 9-15.
  • Clements J. Promoting the Use of Bicycle Helmets
    During Primary Care Visits. Jour of the Amer
    Acad of Nurs Pract 2005 17 (9) 350-354.
  • Marsh E et al. Preventing Bicycle-Related Head
    Trauma in Children. Internat Jour of Trauma Nurs
    2000 6 117-22.
  • Rezendes, J. Bicycle Helmets Overcoming
    Barriers to Use and Increasing Effectiveness.
    Jour of Ped Nurs 2006 21 (1) 35-44.

27
Bibliography
  • Thompson, M and Rivara, F. Bicycle-Related
    Injuries. Amer Fam Phys 2001 63 (10)
    2007-2014.
  • Bicycle safety Statistics pinpoint danger
    zones. www.bcm.edu/findings/vol2/is5/04may_n4.htm
    l
  • Section VII. Profiles. Austin, Texas.
    www.nhtsa.dot.gov/people/injury/pedbimot/bike/Bike
    HelmetUseLawsWeb/pages/7ProfileAAustin

28
The End
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