Helmet use in preventing acute concussive symptoms in recreational vehicle related head trauma

ABSTRACT

Objectives: Helmets use has proved effective in reducing head trauma (HT) severity in children riding non-motorised recreational vehicles. Scant data are available on their role in reducing concussive symptoms in children with HT while riding non-motorised recreational vehicles such as bicycles, push scooters and skateboards (BSS). We aimed to investigate whether helmet use is associated with a reduction in acute concussive symptoms in children with BSS-related-HT.

Methods: Prospective study of children <18 years who presented with a BSS related-HT between April 2011 and January 2014 at a tertiary Paediatric Emergency Department (ED).

Results: We included 190 patients. Median age 9.4 years (IQR 4.8–13.8). 66% were riding a bicycle, 23% a push scooter, and 11% a skateboard. 62% were wearing a helmet and 62% had at least one concussive symptom. Multivariate logistic regression analysis adjusting for age, gender, and type of vehicle showed that patients without a helmet presented more likely with headache (adjusted odds-ratio (aOR) 2.54, 95% CI 1.27–5.06), vomiting (aOR 2.16, 95% CI 1.00–4.66), abnormal behaviour (aOR 2.34, 95% CI 1.08–5.06), or the presence of at least one concussive symptom (aOR 2.39, 95% CI 1.20–4.80).

Conclusions: In children presenting to the ED following a wheeled BSS-related HT helmet use was associated with less acute concussive symptoms.

ABBREVIATIONS: aOR, adjusted odds ratio; APHIRST, Australasian Paediatric Head Injury Rules Study; BSS, bicycles, push scooters and skateboards; CI, confidence interval; CT, computed tomography; ED, emergency department; HT, head trauma; IQR, interquartile range; OR, odds ratio; RCH, Royal Children’s Hospital; RV, recreational vehicle.

KEYWORDS:

• Head trauma
• traumatic brain injury
• paediatric
• concussion
• helmet

Contributor’s statement

Dr. Daverio conceived and designed the study, undertook the data collection, analysed the data and drafted the manuscript.

A/Prof. Babl, Prof. Da Dalt, and Dr. Barker provided advice on study design and revised the manuscript.

A/Prof. Gregori undertook statistical analysis and revised the manuscript.

Dr. Bressan conceived and designed the study, supervised data collection, drafted and revised the manuscript.

Declaration of interest

The authors have no conflicts of interest relevant to this article to disclose.

Additional information

Funding

The study was funded by grants from the National Health and Medical Research Council (project grant GNT1046727, Centre of Research Excellence for Paediatric Emergency Medicine GNT1058560), Canberra, ACT, Australia and the Victorian Government’s Infrastructure Support Program, Melbourne, Australia.