• Alexandra Finch, Shelley Cox, Stephen Bernard, Warwick Teague, and Karen Smith.
• Centre for Research & Evaluation, Medical Directorate, Ambulance Victoria, Victoria, Australia; University of Birmingham, Birmingham, United Kingdom.
• Injury. 2020 Sep 1; 51 (9): 2016-2024.

BackgroundPaediatric participation in competitive and recreational off-road motorcycle sports is increasing in popularity worldwide, however injuries frequently occur and the sport is associated with significant morbidity.ObjectiveThis study describes the profile of paediatric off-road motorcycle trauma attended by emergency medical services (EMS) in Victoria, Australia.MethodsA retrospective review included paediatric (<16 years) competitive and recreational off-road motorcycle patients attended by EMS between 2010 and 2017 in the State of Victoria, Australia. Patient characteristics and injuries sustained were described using descriptive statistics. Predictors of EMS transport were identified using multivariable logistic regression analyses.ResultsThere were 1,479 paediatric motocross patients attended by EMS between 2010 and 2017. This represents 1.6% of the total state-wide EMS paediatric trauma (<16 years) workload, and equates to an average incidence of 22.2 per 100,000 population. The median age of patients was 13 years (IQR: 10-14) and 89.5% were male. The most common final diagnoses recorded by paramedics were 'fractures' (25.5%, n = 377) and 'unspecified pain' (19.5%, n = 289). Administration of analgesia (76.3%) was the most common EMS management, followed by spinal immobilisation (54.7%) and splinting (33.4%). The vast majority (91.5%) of patients were transported to hospital by EMS. Following admission, 38 (2.6%) patients were confirmed to have sustained major trauma, 78.9% of which had been transported direct from scene to a major trauma centre for definitive care. Median ISS for confirmed major trauma patients was 14 (IQR: 14-22). Four (0.4%) patients received pre-hospital CPR. All four sustained injuries from recreational off-road, motorcycle activities and all four cases died, two at the scene and two in-hospital.ConclusionOff-road motorcycle activities are an important cause of death and injury in Victorian children, as highlighted and demonstrated by the four deaths and high EMS transport rates borne out in this study. Riders and parents need to be aware of these risks, and organised events must have adequate on-site medical care resources.Copyright © 2020. Published by Elsevier Ltd.

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