Risk reduction after bicycle, scooter, and skateboard-related head injuries through helmet use and brain injury education: A trauma center quality improvement initiative.

INTRODUCTION

Helmets reduce head injury severity after bicycle, scooter, and skateboard injuries. Prevention of one head injury reduces lifetime risk of reinjuries. Our clinical care quality improvement initiative (QII) aimed to improve helmet usage, education, and safety awareness in head injury patients at a United States trauma center.

RESEARCH QUESTION: To assess QII feasibility.

MATERIAL AND

METHODS

Head injury patients presenting to emergency department (ED) after bicycle, scooter, and skateboard accidents without helmets or with lost/damaged helmets were provided helmets free-of-charge, and in-person review of traumatic brain injury education, resources, and follow-up care. Surveys on helmet use were conducted in the ED and at ≥1 telephone appointments (2-weeks to 1-year).

RESULTS

In 21 patients aged 37.7 ± 12.5-years, 71 % were male, 38 % had traumatic intracranial hemorrhage on head computed tomography (CT) scan, and 81 % were unhelmeted. Mechanisms included scooter (48 %), bicycle (38 %), and skateboard-related (14 %) injuries. All patients reported improved understanding of risk reduction strategies and helmet use at enrollment and follow-up. At follow-up, 11/21 patients were able to resume pre-injury bicycle, scooter, and/or skateboard-related activities, of which 82 % reported consistent helmet use. Of 10 patients unable to resume pre-injury activities, reasons included head injury (50 %), polytrauma (30 %), and concern for reinjury (30 %).

DISCUSSION AND

CONCLUSIONS

Costs of one head injury ED admission may exceed $6000, compared with $60 for one helmet. In-person provision of helmets, education, and resources is an adoptable, cost-effective intervention for improving safety awareness and reducing reinjury risk. Next steps include expanding QII implementation and refining evaluation metrics.