Sat., 10/15/11 Peds, Ger, Hip, Femur & IP, Paper #68, 10:06 am OTA-2011
Does Following the AAOS and AAP Guidelines for Trampoline Use Decrease the Severity of Pediatric Trampoline Injuries? A Prospective Study
James R. Phelps, MD, MPT1; Christine A. Ho, MD2; Neil Evans, MD3; Pam Okada, MD2;
1University of Texas Southwestern Medical School, Dallas, Texas, USA;
2Children’s Medical Center–Texas Scottish Rite Hospital, Dallas, Texas, USA;
3Cook Children’s Medical Center, Fort Worth, Texas, USA
Purpose: As the popularity of recreational trampoline use continues to increase, the number of pediatric trampoline injuries has also followed this trend, despite both AAOS (American Academy of Orthopaedic Surgeons) and AAP (American Academy of Pediatrics) policy statements detailing guidelines to improve the safety of these devices. The purpose of this study was to prospectively analyze all patients seen in the pediatric emergency department (ED) or orthopaedic clinic who sustained a trampoline-related injury and evaluate the risk factors affecting the severity of their injury, with special attention to the recommendations issued by the AAOS and AAP.
Methods: 300 consecutive patients that sustained a trampoline-related injury were evaluated in the ED or orthopaedic clinic and consented to participate in the study. Measures of severity included the Abbreviated Injury Scale (AIS), Glascow Coma Score (GCS), need for surgical intervention, and need for a sedated closed manipulation of the patient’s fracture. Risk factors included presence of adult supervision, number of participants, trampoline height, use of protective safety devices, age of the patient (recommendation is to prohibit use in children younger than 6 years old), and whether a high-risk maneuver was performed at the time of injury. These data were analyzed to identify any statistically significant correlation between risk factors and measures of severity of injury.
Results: Of the 300 patients, over 99% (299/300) were found to have severe/serious or moderate severity of injury according to the AIS. Of these injuries, 91% (273/300) were fractures, and 1% were visceral injuries (3/300). 49% (147/300) required an intervention; of these, 31% (93/300) required an operation and 18% (54/300) required a procedure with conscious sedation. An adult was present during 71% (214/300) of the injuries, and protective safety devices were used in 55% (164/300) of injuries. 58% (174/300) of injuries occurred in children 6 years of age and older, and a high risk maneuver was attempted in only 23% (70/300) of the injuries. There were no correlations found between risk factors and measures of severity.
Conclusion: Trampoline recreation can result in severe injuries consisting of not only fractures but visceral injuries that often lead to surgery or a need for reduction under conscious sedation. Also, children are at risk of an injury on a trampoline regardless of age, adult supervision, trampoline height, use of protective devices, performance of high-risk maneuvers, and number of participants, and following the guidelines set by the AAP and AAOS does not necessarily correlate to less severe injuries. Our results demonstrate that despite following the AAP and AAOS recommended guidelines, there is no such thing as “safe” trampolining, and severe injuries can occur despite the best vigilance of parents.
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• The FDA has not cleared this drug and/or medical device for the use described in this presentation (i.e., the drug or medical device is being discussed for an “off label” use). ◆FDA information not available at time of printing. Δ OTA Grant.