Paediatric Driveway Injuries in Auckland
1998 - 2001
A Preventable Tragedy

Background
• Child deaths in transport accidents - NZ 3rd highest of OECD
• Pedestrian fatalities 2X > Britain/USA 3X > Australia
• 25% of pedestrian injuries in Auckland occur in residential driveways

• Typical scenario is a 2 year old child reversed over in their home driveway by a family member
• Severe injuries, PICU
• 2 patients per month at Starship
• Incidence unchanged over 15 years

Aims
• Incidence
• Injuries
• Demographics - at-risk families - targeted public campaign
Method
• Retrospective review of all children under 15 years injured on Auckland driveways from January 1998 to October 2001 Chart review Parent Interviews Driveway inspection Coroner’s files

Results
• 77 cases from 76 accidents
• 5 fatalities
• Incidence 8 cases/100,000 children/year
• Age median 23 months range 1-12 years

Gender Bias
Location
Vehicle Driver
Vehicles involved
Time of Accident
Season
Patient Ethnicity
Mean Number of Children per Family by Ethnicity

Home Ownership amongst affected families

Type of Trauma

Results
• Presentation of Patients 29% via GP 48% use Ambulance
• PICU admissions 22%
• Patient management 16% Operative 84% Non-operative
Length of Stay

Results of Study

• Long-term complication rate: 11%

• Place of discharge: Home 92% Rehab 3% Died 6%

Conclusions
• Incidence unchanged at 8/100,000/year
• Predictable patterns of injury
• Severe injuries common 57% Head Chest Lower Limb
Conclusions
• Risk Factors Children 1-4 years Low SES Ethnic group Large families Vans

Recommendations
• Education is critical ?
• fencing - cost-benefit analysis
- legislation
• NB: success of Swimming Pools Act
• “difficult driveways” - better design needed
• mirrors, reversal alarms & proximity alarms inconsequential
• provision adequate play areas in community

Final Conclusion
• Education targeted to those at
highest risk
• Physical barriers to driveway access
• Better driveway design

...will reduce paediatric pedestrian trauma in New Zealand