hide abstract details

Skylar Faul, MD
Rebecca Spegele, MD
Michelle Recto, MD
Yin Zhang, MS
Wendy J. Pomerantz, MD, MS

There is limited literature on the incidence and types of injuries associated with amusement park ride use, particularly among pediatric populations. Prior work by Thompson et al. used National Electronic Injury Surveillance System (NEISS) data from 1990-2010 to characterize amusement park-related injuries. Given changes in ride design, safety regulations, and utilization patterns over the last fifteen years, updated analyses are needed. This study evaluates more recent NEISS data to assess contemporary injury patterns.

This retrospective cohort study utilized the NEISS database, a stratified probability sample of approximately 100 U.S. emergency departments. Children and adolescents aged ≥18 years presenting with amusement park ride-related injuries from 2013 to 2024 were included and identified using NEISS product code 1293 and case narratives. Demographic characteristics, injury diagnoses, body regions, mechanisms, ride types, and ED dispositions were analyzed. Sample weights and survey procedures were applied to generate nationally representative estimates accounting for the complex survey design. Descriptive statistics and temporal trend analyses were performed.

An estimated 41,796 amusement park ride-related ED visits occurred nationally among patients aged ≥18 years from 2013-2024, averaging ~3,483 injuries per year. Most injured children were female (59.6%), aged 6–12 years (47.5%), White (46.1%), and non-Hispanic (54.2%). The head and neck were the most injured body region (30.9%), with strains and sprains the most frequent injury type (24.5%), followed by soft tissue injuries (19.1%) and concussion/closed head injuries (14.5%). Falls in, off, or against a ride, or while boarding/exiting, caused 30.7% of injuries. Among cases in which the ride was clearly identified, roller coasters were most often involved (17.4%), although the type of ride was unknown or classified as “other” in 66.6% of cases. Most injuries occurred from June to August, likely correlating with summertime and peak visitation at amusement parks. Carousel/merry-go-round injuries were associated with increased odds of fracture (OR 4.16, 95% CI 2.80–6.18), concussion/closed head injury (OR 2.07, 95% CI 1.33–3.22), and hospital admission (OR 4.46, 95% CI 1.69–11.73), while roller coaster injuries demonstrated lower odds of fracture (OR 0.08, 95% CI 0.03–0.21).

This study provides updated national estimates and injury patterns among children and adolescents, highlighting ongoing risks from amusement park rides, and aims to inform future safety guidelines, injury prevention efforts, and parental education

Amusement park ride-related injuries continue to result in thousands of pediatric emergency department visits annually in the United States despite advancements in ride technology and safety measures.

Head and neck injuries remain among the most common injury patterns associated with amusement park rides in children and adolescents.

Falls during riding, boarding, or exiting rides represent a major mechanism of injury, highlighting potentially modifiable targets for safety interventions and rider education.

hide abstract details

Lorrie Lynn, MA, CPSTI

In 2025, Rady Children's Hospital Trauma Center treated 262 children 11-14 years of age who were riding e-bikes. Slowing the Wave is an e-bike education and bike skills program meant to address this growing trend. This program is a three-pronged wrap around approach to reducing the rising e-bike injuries in San Diego County. Through an online e-bike safety curriculum, school-based bike skills experience and workshops for youth and their caregivers we will inform, educate, train, and engage children, youth, and families to increase safety on e-bikes.

This project combines safety education and bike skills to increase the knowledge of risks and benefits of e-bikes. By increasing knowledge about e-bikes for adults/parents, children, and teens in communities and schools. E-bikes provide exercise and allow teens freedom to ride without family; we want to provide injury prevention strategies and skills education to ensure safe handling of the e-bikes reducing injuries. The school program for education and skills is critical to ensuring that bike riders and e-bike riders know the classification of e-bikes, the rules of the road, and the risks. Students complete a standardized e-bike training curriculum. Students must pass a knowledge assessment to earn a certificate of completion before advancing to the bike skills training. Parent and Teen Workshops create space to bring both into e-bike education. Workshops educate caregivers and teens while providing separate, targeted learning. Guidance on e?bike purchasing decisions, local laws, and supervision strategies; teens participate in interactive activities including helmet fitting and reaction?time challenges. Finally, a Parent–Teen Riding Agreement to reinforces shared responsibility.

Slowing the Wave addresses a growing and preventable public health issue with a scalable, data?driven solution. By combining education, skills training, and parent engagement, the program moves beyond awareness to real behavior change, helping youth ride safely, supporting families in making informed decisions, and giving schools a practical tool to reduce risk and injury. The primary audience is children and teens ages 11–14, with secondary reach to parents and caregivers. Annually, the program is designed to reach: • 4,000 students through school?based programs • 100+ teens and caregivers through workshops With adoption across multiple school districts, the program has the potential to reach thousands more students each year.

Slowing the Wave addresses a growing and preventable public health issue with a scalable, data?driven solution. By combining education, skills training, and parent engagement, the program moves beyond awareness to real behavior change, helping youth ride safely, supporting families in making informed decisions, and giving schools a practical tool to reduce risk and injury.

1. Big problems need visionary approaches to change behavior
2. Train-the-trainer models create champions who can expand their reach into their communities
3. Engaging students as leaders gives them the status and respect to influence peers

hide abstract details

Alyssa Joachim, MD
John Schomberg, PhD
Romeo Ignacio, MD
Yigit Guner, MD, MS
Amy Lawrence, MD
Laura Goodman, MD, MPH

With growing electric bike (e-bike) ridership, pediatric e-bike crashes are becoming increasingly common and are often more severe than traditional bicycle injuries because of the higher speeds these bikes can achieve. Legislative and manufacturer-based interventions have been implemented to limit e-bikes speeds. One such intervention was Super73’s January 1, 2025, app restriction, which disabled “off-road” mode allowing speeds above 28 mph; without this app, Super73s are a class 2 or 3 e-bike depending on the model, allowing speeds up to 20-28 mph with a throttle, or even higher with pedal assistance or modification. This study assessed whether the change was associated with differences in pediatric crash frequency or characteristics.

We performed a retrospective analysis of police-reported e-bike collisions involving riders ?18 years recorded in the Statewide Integrated Traffic Records System (SWITRS) between 2021-2025. Demographic characteristics, roadway conditions, injury severity, collision factors, and the proportion of crashes involving Super73 e-bikes were compared before and after implementation of the Super73 app restriction.

A total of 115 pediatric crashes involving Super73 e-bikes were identified, 71 (61.7%) of which occurred before the app restrictions and 44 (38.3%) after the app restriction. Median rider age was similar before and after the restriction, at 14 years (interquartile range [IQR] 13-15) prior to the app restriction and 13 years (IQR 12-14) after the app restriction. No significant differences were observed in helmet use, injury severity, roadway conditions, or unsafe riding behaviors before and after the app restriction was implemented. Prior to the app restriction, Super73 e-bikes accounted for as low as 9.0% of e-bike crashes annually in 2022 and up to 17.0% of e-bike crashes in 2024, compared with 12.1% following implementation of the app restriction in 2025.

Super73’s app-based speed restriction limited speeds above 28 mph as of 2025, with pediatric Super73 e-bike crashes showing no significant change in injury severity or crash characteristics following this change. The reduction in proportion of crashes attributable to Super73 e-bikes seen in 2025 requires longer-term study to determine whether it reflects improved safety or reduced ridership.

1. Understand the impact of e-bike app restrictions on Super73 crash characteristics and demographics
2. Understand how implementation of a Super73 speed restriction impacted proportion of crashes that occurred on Super73 e-bikes
3. Understand how e-bike app and/or speed restrictions may be a legislative policy that can help reduce e-bike crashes

hide abstract details

Lily Den Hartog, BS
Zachary Ballinger, MD, MSCI
Jeremy Aidlen, MD
Muriel Cleary, MD
Kaitlyn Wong, MD, PhD
Jonathan Green, MD, MSCI

Despite longstanding evidence that helmets decrease brain injury severity, rates for helmet use among children and adolescents remain low, particularly in males, residents of lower income neighborhoods, those with public insurance, racial minorities, and adolescents. A 5-year review of helmet use at our institution found that nearly 2/3 of bicycle-related pediatric trauma patients were unhelmeted. This led to the creation of our institution’s Helmet Distribution Program, which aims to improve access to helmets and educate adolescents about their benefits, thereby improving habitual helmet use. This study’s goal is to analyze demographic and socioeconomic trends, as well as clinical characteristics, of participants in the Helmet Distribution Program.

Cross-sectional analysis was performed of patients who received helmets through the Helmet Distribution Program from 06/01/24-05/21/26 at our Level 1 Trauma Center. Patients qualified for a helmet if they presented to the Pediatric Emergency Department after a traumatic incident where they should have been helmeted, but were unhelmeted or damaged their helmet during the event. Demographic data was collected and socioeconomic status was assessed via calculations of the CDC’s Social Vulnerability Index (SVI) and the University of Wisconsin’s Area Deprivation Index (ADI). Descriptive statistics were used.

106 patients received helmets. The mean age was 12.2 years, 86% were male, 57% White, and 36% identified as Hispanic or Latino. 75% primarily spoke English, followed by Portuguese (12%) and Spanish (9%). The majority (75%) were publicly insured. Average MA State Decile ADI was 8.07, and 88% of patients lived in a community with a Medium-High SVI. The overwhelming majority (94%) were unhelmeted at the time of injury. Most commonly, patients were riding bicycles (61%), of which 36% involved a vehicle collision, followed by scooters (21%) and motorized bicycles (15%) (Figure 1). 28 patients had no associated injuries, 48 had a single injury, and 30 had multiple injuries. Head trauma and extremity fractures constituted the majority of injuries (77% combined) (Figure 2). Most patients (56.6%) did not require admission, though 34% required admission to the floor and 8.5% required ICU admission. Only 17 patients required operative intervention.

Patients receiving helmets via our institution’s Helmet Distribution Program are mostly of early adolescent age, male, and publicly insured. They are from more disadvantaged communities, as illustrated by elevated ADI and SVI scores. Most sustain head trauma or extremity injuries in bicycle-related incidents, though most do not require hospital admission or surgery. Characterizing these patients validates program utility and identifies populations to target for further helmet education and distribution, ultimately informing a more focused effort to prevent injury related to a common cause of pediatric head trauma.

1. Discuss the utility of a helmet distribution program at a Level 1 trauma center.
2. Describe demographic trends and clinical characteristics of patients receiving helmets via a helmet distribution program.
3. Identify populations at greatest risk for injury due to helmet disuse.

hide abstract details

AnnaMarie Fjeld, BS
Brianna Iverson, MD
Kareem Shoukih, BS
Parker Sternhagen, BS
Sarah Nichols, BS
Taeuk Kang, MBiotech, MSc
Kristel Wetjen, RN, BSN
Brenda Vergara
Pam Hoogerwerf, BA
Charles Jennissen, MD

Bicycling is a common activity among children and adolescents but remains an important source of preventable injury. Head injuries account for the majority of bicycle-related fatalities, and prior research demonstrates that bicycle helmets substantially reduce the risk of head injury and fatal head injury. Despite this evidence, helmet use remains low among youth, particularly adolescents, who may be influenced by peer norms, reduced parental supervision, and low perceived injury risk. Most studies of youth bicycle helmet use have focused on urban or general pediatric populations, with limited data addressing rural adolescents. This study evaluated bicycle helmet use, attitudes toward helmet use and helmet laws, and factors associated with helmet use among rural adolescents.

A convenience sample of attendees at the 2025 National FFA Convention & Expo completed an anonymous survey at the University of Iowa Stead Family Children’s Hospital injury prevention booth. Responses were collected in Qualtrics and analyzed using SAS 9.4. Descriptive statistics were calculated. Bivariate analyses were performed using chi-square, Fisher’s exact, Kruskal-Wallis, and Wilcoxon rank sum tests. Multivariable logistic regression was used to assess factors associated with helmet use and support for helmet laws.

2,516 respondents aged 13–18 years participated. Most respondents were female (56%), ages 16–18 years (56%), and non-Hispanic White (91%). Thirty-eight percent lived on a farm, 38% lived in the country but not on a farm, and 14% lived in towns. Most participants (86%) reported having at least one bicycle in their household. Two-thirds (67%) had ridden a bicycle in the past year with those from farms and the South having lower ridership, both p<0.008. Overall helmet use was low: 15% always, 12% mostly, 12% sometimes, 18% rarely, and 43% never wore a helmet while riding. The mean helmet-use importance rating was 5.5 out of 10, and only 26% supported bicycle helmet laws. Compared with adolescents from other regions, Midwest respondents had lower proportions supporting helmet laws (23% vs 30%) and always/mostly wearing a helmet (23% vs 32%), both p?0.001. Farm respondents had approximately half the odds of supporting helmet laws compared with town dwellers, and reported lower helmet importance ratings and lower helmet use than those living elsewhere, both p<0.008. Respondents from states with youth bicycle helmet laws had higher helmet importance ratings (6 vs 5) and higher percentages always/mostly wearing helmets (33% vs 24%) than those from states without such laws, both p<0.001. Adolescents with a strict parental “no helmet, no riding” rule had 22 times greater odds of supporting helmet laws and nearly 5 times greater odds of always/mostly wearing helmets.

Rural adolescents, particularly those living on farms and in the Midwest, reported infrequent bicycle helmet use and limited support for helmet laws. State helmet laws and strict parental helmet rules were associated with more favorable helmet attitudes and greater helmet use. Injury prevention efforts should target both rural adolescents and parents by addressing social norms, parental rule-setting, and policy-level strategies to increase helmet use and reduce bicycle-related head injuries.

Attendees will be able to:
1. State the frequency of rural adolescent’s use of bicycles and bicycle helmets, and which youth might be at greater risk for not wearing a helmet while riding bicycles.
2. Identify at least three rural adolescent demographic groups who ascribe lower importance to helmet use.
3. Discuss how a strict parental “no helmet, no bike riding rule” might influence bike helmet use and attitudes.

hide abstract details

John Drey, BS
Parker Sternhagen, BS
Sarah Nichols, BS
Brianna Iverson, MD
Kareem Shoukih, BS
Taeuk Kang, MBiotech, MSc
Kristel Wetjen, RN, BSN
Brenda Vergara
Pam Hoogerwerf, BA
Charles Jennissen, MD

Dirt bikes are common in rural areas, especially on farms and ranches. Mishaps can result in serious injury with head injuries being the most common cause of death. Helmet use can significantly reduce the risk. Our objective was to determine rural adolescents’ attitudes regarding helmets, their frequency of helmet use while riding dirt bikes, and to identify demographic and other factors affecting helmet use and the support of helmet laws.

A convenience sample of 2025 National FFA (formerly Future Farmers of America) Convention & Expo attendees in Indianapolis, Indiana, completed an anonymous survey. After compilation, data were imported into SAS version 9.4. Descriptive, bivariate (Chi-square, Fisher’s exact test) and logistic regression analyses were performed. The Wilcoxon rank sum or Kruskal-Wallis test was used to determine differences in helmet importance score distributions.

2,516 adolescents (13-18 years) participated. Almost two-fifths (38%) lived on a farm, 38% lived in the country/not on a farm, and 24% were from towns. Nearly one-third (31%) stated their family owned a dirt bike with those from farms having a higher ownership percentage (39%) than those living elsewhere, p<0.0001. Over one-third (36%) had ridden dirt bikes in the past year. Males, dirt bike owners, those from farms or from the country/not a farm, and individuals from rural Rural Urban Commuting Area (RUCA) codes all had higher proportions having ridden dirt bikes. Respondents from the Northeast and West census regions had higher proportions having ridden a dirt bike in the past year versus the Midwest and South. Average helmet importance rating (1-10, 10 high) was 8.9 (SD1.9). Those with lower median helmet importance included males, those from farms, and those that had ridden dirt bikes, all p<0.0001. Helmet use was: Always 51%, Mostly 21%, Sometimes 11%, Rarely 8%, Never 10%. Midwesterners had about twice the odds of wearing helmet always/mostly as compared to those from the South and West. Overall, 70% supported laws requiring dirt bike helmet use with those from farms with lower endorsement percentages, p<0.0001. Those living in states with universal helmet laws had odds 2.7x higher, and those in states with helmet laws covering younger drivers had odds 1.8x higher of supporting helmet laws than those without laws. Over three-fifths (61%) reported their family had a “no helmet, no riding” rule; these respondents had a 10.6x higher odds of always/mostly wearing a helmet compared to those without a rule.

Dirt bike ownership and use by study adolescents was common, especially those from farms. Respondents rated wearing a helmet while riding dirt bikes as being very important, but much lower by farm residents. Farm youth also had lower proportions wearing helmets. The safety culture surrounding dirt bike helmet use is poor among farm adolescents and deserves targeted interventions. However, families with “no helmet, no riding” rules had a much higher likelihood of supporting helmet laws and always/mostly wearing helmets.

Attendees will be able to:
1. List at least three youth demographic factors associated with higher proportions having ridden dirt bikes in the past year.
2. Describe rural youth’s attitudes related to dirt bike helmet use and how it differs among motorized vehicles.
3. State which rural adolescents might be at greater risk for lack of helmet use on dirt bikes.

hide abstract details

Mary Beth Vassy, MPH, CPST-I
Callista Lamb, MPH
Kalyani Sonawane, PhD

Golf carts are becoming more popular as a means of transportation outside of their intended use. From this increase of use, pediatric and adult golf cart injuries are on the rise in Charleston County and surrounding areas. When 100 databases were evaluated, it showed that children were more susceptible to head and neck injuries in comparison to adults that had a golf cart related injury (Miller, et al., 2016). South Carolina amended their golf cart laws (H. 3292) in 2025 to require children 12 and under be wearing a seat belt while in a golf cart. The American Academy of Pediatrics recommendation is that children under the age of 6 should not ride in a golf cart (Watson, et al., 2008). Previous research is limited on pediatric golf cart injuries and shows these injuries are most likely to be under reported (Simpson, et al., 2019).

A retrospective quantitative study method was used to evaluate 101 pediatric injuries that presented to SJCH from 2015-2025. This data was pulled from the emergency department (ED) and then put into a database that was de-identified. The data was then cleaned in Excel to be suitable for coding in R statistics. The data was grouped by sex, age, year of injury, days in ICU, location in golf cart vehicle, injury mechanism, primary injury location (superficial or not superficial), secondary injury location (superficial or not superficial), tertiary injury location (superficial or not superficial), and the injury severity score. Injury mechanisms included car accident, ejection, fell off, rollover, and run over. Once the data was cleaned quantitatively, it was then put into R statistics for coding to see correlation between injury location, golf cart position, superficial or non-superficial, and other characteristics of the injuries.

Data Analysis: 49.98% of primary injuries were located on the child’s head, with 9 of these being superficial and 38 of these injuries being non-superficial. Of children’s whose position in the golf cart were listed in their ED chart, the most common golf cart seating position across all injuries was being a passenger not in the front seat. In 2015, there was only one pediatric golf cart injury, but in 2021 and 2023 there were 19 and 17 in 2024. 42 children fell out of the golf cart and 31 of those kids that fell out obtained a primary head injury.

The most common type of injury occurred in the children’s head, with majority of them being non-superficial. Knowing that head injuries were the most common injury type, it would be wise for future research efforts to evaluate safety mechanisms and items to protect children’s heads such as helmets or other devices. Knowing that head injuries were the most common injury type, it would be wise for future research efforts to evaluate safety mechanisms and items to protect children’s heads such as helmets or other devices.

1. Analyze pediatric golf cart–related injury data to identify common injury patterns, including mechanism, body region affected, and injury severity.
2. Examine trends and contributing risk factors, such as passenger position and temporal changes, to determine factors associated with increased injury risk.
3. Discuss evidence-based injury prevention and community outreach strategies aimed at reducing pediatric golf cart injuries, particularly head injuries.

**requesting poster session if possible**