Craniofacial Trauma Associated with the Introduction of Electric Scooters in an Urban Setting
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With the increase in popularity of standing electric scooter (escooter) alternatives to public and automobile transit comes the potential for an added burden of traumatic injuries by unsafe, unregulated, or unconventional use of these modes of pointtopoint travel. The ergonomics and riding position of escooters make riders particularly susceptible to fall trauma, and the lessened ability to break falls can lead to an increased incidence of craniofacial trauma. When complicated by the variable laws and regulations of different urban areas utilizing rental escooters, the mass usage of this expedient form of transport exposes users to a potential public health risk. The purpose of the present study was to evaluate emergency department (ED) admissions directly linked to escooter use to assess the incidence and types of craniofacial trauma directly over the first 7 months of escooter rentals in a major urban center.A total of 90 patients (56 males, 34 females) were admitted to the ED because of escooterrelated injuries over the course of the study, ranging in age from 13 to 60 years (mean age, 31.8 years). Most (64.4%) admissions involved extremity injuries, with 18 fractures, 4 dislocations, and 10 lacerations. Eight patients (8.8%) required transfer to the intensive care unit, male patients experienced trauma at a greater rate (62.2%) of escooterrelated injuries, and 7 of the patients admitted (7.7%) were younger than 18 years. Alcohol consumption was recorded in 16 escooterrelated ED visits (17.8%), and none of the admitted patients reported the use of protective headgear. 52 (57.7%) individuals presented with craniofacial trauma related to escooter use. Of the 52 patients, 28 had trauma to the upper face, 28 to the midface, and 9 to the lower face. Soft tissue facial injuries were noted in 44 patients (80.8%) who sustained craniofacial trauma, 28 (53.8%) of whom required laceration closure. Extensive craniofacial injuries included subarachnoid/ subdural hemorrhage in 6 patients (11.5% of craniofacial patients), 1 of whom required emergency craniotomy. Le Fort fractures occurred in 3 patients, including one bilateral Le Fort II/III and leftsided Le Fort I fracture and two Le Fort I fractures.The present study found that more than one half of all trauma patients presenting to a Level I trauma ED in Dallas, Texas, for escooter injuries had injuries to the head and face. Craniofacial injuries require specialist intervention ranging from dentoalveolar splinting to extensive facial reconstruction, highlighting the implications of craniofacial trauma risk associated with escooter use that could be significantly reduced by the use of proper protective equipment and access to wellregulated bicycle lanes and cyclist/pedestrian safety policies. Special focus on the factors contributing to traumatic events involving escooters, such as helmet use, pedestrian interaction, alcohol use, and policies regarding scooter use will help establish the best practices for the mitigation and treatment of such injuries.
