All-terrain vehicle injuries on the rise;
St. John’s encourages proper use
By Pam Holt, RN, BSN

In the last three years, emergency trauma center staff at St. John’s Regional Health Center have seen a significant rise in the number of all-terrain vehicle-related trauma patients. ATV-related emergency room visits in the U.S. more than doubled from 1997 to 2001.

Roger Huckfeldt, M.D., St. John’s chief trauma surgeon, has studied the problem and says one factor contributing to the rising number of accidents is the increasing weight and power of ATVs. Nationwide, 95 percent of all children injured in ATV accidents crashed while riding adult-sized ATVs. Experts say children younger than 16 do not have the physical size, strength, coordination or motor skills to operate an ATV, especially adult-sized ATVs that reach speeds over 60 miles per hour. ATV manufacturers recommend that no one under the age of 12 operate an ATV and children under the age of 16 should not drive an ATV with an engine size greater than 90 cc. Drivers aged 12 to 15 operating an adult-sized ATV have more than twice the average risk of injury.

“Children riding adult-sized ATVs, inadequate driver training and not enough helmet use are contributing factors to many ATV crashes. Anyone who operates an ATV should wear a helmet, receive specialized training and should operate an ATV of the appropriate size,” Huckfeldt says.

Nearly 80 percent of all ATV crash patients treated at St. John’s in the last three years did not wear a helmet and nearly half of those sustained head injuries. Helmets that provide face protection reduce the risk of fatal head injury by 42 percent and the risk of non-fatal head injury by 64 percent.

In a recent study, St. John’s Assistant Trauma Program Manager Monta Rae Glaser, R.N., and Huckfeldt compared the health care costs of non-helmeted riders involved in ATV crashes to those of helmeted riders who had crashed.

“The cost of treatment for non-helmeted riders is twice the cost of treatment for helmeted riders. The most common injuries sustained are orthopedic injuries and head injuries,” Glaser says.

The study shows that the average length of stay in the hospital for ATV-related crash patients is 3.7 days. The average length of stay for helmeted ATV riders who have crashed is lower by nearly two days than the hospital stay of non-helmeted riders.
Surprisingly, there is no national legislation to ensure that all riders have the proper training and gear. Forty-two states do not require a license to drive an ATV, 24 states have no minimum age to drive an ATV and 19 more states allow children as young as 8 to operate ATVs. Thirty-five states do not require any safety training or testing to drive an ATV.

In Missouri, the minimum age to operate an ATV is 16, unless supervised by an adult, and riders younger than 18 must wear helmets. There are no laws regarding ATV size for children and the law does not require an operator’s license or safety courses either.

“Parents and adults should use their best judgment and err on the side of safety when allowing a child to operate an ATV or operating an ATV themselves, since the law does not provide the maximum safety standards for ATV operators,” Huckfeldt says.

Pam Holt, RN, BSN is a trauma prevention education coordinator for St. John’s.