FIGURE 1: Helmet use by year, age 1 year to 17 years
120 100 80 60 40 20
60.0 % 50.0 % 40.0 % 30.0 % 20.0 % 10.0 %
0 0.0 %
2008 2009 2010 2011 2012 2013 2014 2015 2017 2016 2018 2019 2020
n Helmet %
FIGURE 2: Number of trauma center visits and helmet use by age from 2008-2020
120 100 80 60 40 20
70.0 % 60.0 % 50.0 % 40.0 % 30.0 % 20.0 % 10.0 %
0 0.0 % 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17
n Helmet %
to 17 years of age, of which 520( 70.4 %) were the drivers of the vehicle. Of the 2,299 crash victims aged 18 years and older, 2,009( 87.3 %) were identified as the driver. There were 43 crash victims that came to our emergency department on two or more occasions.
Helmet Use in the Pediatric Population
Of the 738 crash victims aged 1 year to 17 years seen in our trauma center, there were 41.7 % who were wearing helmets. Between 2008-2020 the range of helmet usage in crash victims was 26.2-56.3 %. There were three years when helmet use reached 50 %, and one year when it was < 30 %( Figure 1). The least likely to wear a helmet were the
32 patients under 4 years of age( 6.2 %)( Figure 2). Of the 205 female crash victims, 58( 28 %) were wearing helmets, compared to 244 of 533( 46 %) male crash victims who were wearing helmets( p-value =. 000015).
Helmet use in children aged 1 year to 17 years had a protective effect. Using admission to the intensive care unit( ICU) as a surrogate for injury severity, the patients wearing helmets were significantly less likely to require an ICU stay compared to those not wearing helmets. Of the 308 children wearing a helmet, 45( 14.6 %) required ICU admission versus 109 of the 430( 25.3 %) who were not wearing a helmet( p-value = 0.0004; relative risk 0.58; Odds Ratio 0.5). There were four fatalities in this age group, all males aged 9, 10, 12, and 17 years. All were reported to be drivers of the ATV, and only the 10-year-old was wearing a helmet.
Substance Use in the Pediatric Population
A total of 53 children, all aged 12-17 years, were positive for substance use. THC was the most common drug found in the urine drug screen, in 34 of the 738( 4.6 %) patients. The youngest patient in which THC was found was aged 13 years, and the average age of patients with THC use was 15.9 years. Of the patients in which THC was detected, 24( 70.5 %) were drivers of the vehicle.
West Virginia Medical Journal • June 2025 • 15