Abstract
Introduction
Light electric vehicles (electric bikes and scooters) are becoming increasingly accessible as a transportation method for children. Despite their high attainable speeds, there are no age, weight, training, or protective equipment requirements. Current literature on pediatric injuries associated with light electric vehicles is quite limited. This study sought to compare injury patterns and clinical characteristics of pediatric patients injured while riding light electric versus manual vehicles (manual bikes and scooters).
Methods
A retrospective review was conducted of 262 pediatric patients treated at Children's Hospital of The King's Daughters following injuries involving light electric vehicles or manual vehicles from May 1st, 2018 to May 1st, 2025. Demographics, injury severity score (ISS), prehospital transport, trauma activation, protective equipment use, injury type, operative management, intensive care unit (ICU) admission, and hospital length-of-stay (LOS) were collected for each patient and compared between light electric and manual vehicle groups.
Results
A smaller proportion of riders injured on light electric vehicles were female compared to male (13% female vs 28% male, p = 0.035). Overall, mean ISS was similar between light electric and manual vehicle groups (6 electric vs 6 manual). Light electric vehicle injuries, however, were significantly more likely to result in trauma activation (71% electric vs 46% manual, p = 0.008), head or facial injury (74% electric vs 50% manual, p = 0.006), and extremity injury (73% electric vs 52% manual, p = 0.02). Protective equipment use was low for both groups (9.7% electric vs 15.7% manual). Prehospital transport by emergency medical services (EMS) (74% electric vs 77.6% manual), ICU admission (6% electric vs 8% manual), and LOS in the hospital (1.5 days electric vs 1.9 days manual) were comparable between light electric and manual vehicle groups. Operative management was required in 22.6% of light electric vehicle injuries and 37.4% of manual vehicle injuries (p = 0.08).
Conclusion
Despite similar overall injury severity, pediatric light electric vehicle injuries exhibited a distinct, worrisome injury pattern that included significantly higher rates of trauma activation, head or facial injury, and extremity injury when compared to manual vehicles. Of particular interest was the high rate of head and facial injury with very low rates of protective equipment use. These findings highlight the importance of pediatric-specific safety regulations for electric bicycles and scooters, including minimum age recommendations, helmet use, speed limitation, and rider education, to help prevent avoidable injuries in children as light electric vehicles continue to become more accessible.