Critical injuries in paediatric pedestrians.

Data are presented on all sixty-four children who were injured as pedestrians and admitted to the department of critical care medicine, Auckland Hospital over a four year period. Median age was six years, with a male:female ratio of 1.6:1.0. Admission rates were 3.1 and 3.0 times higher for Maori and Pacific Island children, respectively, than for children of European origin. Fifty-two percent of injuries occurred between 3 pm and 7 pm. Median injury severity score (ISS) was 29, and 95% of patients had an ISS of 16 or more. Life threatening injuries were most commonly to the head, whilst less severe injuries, commonly fractures, were to the limbs. The combination of head and lower limb injury was seen in 53% of patients. Twenty-nine patients had 34 operative procedures: 16 orthopaedic, six neurosurgical, four laparotomies and eight wound debridement and closure. Eighty-one percent of the patients received ventilatory support and nine patients (14%) died, all from brain injuries. Pedestrian injury is an important child health problem in New Zealand and studies aimed at the identification of factors that place children at risk for these injuries are needed.