Paediatric and adolescent horse-related injuries: Does the mechanism of injury justify a trauma response?


  • John A Craven, BSc(Hons), BMBS, Paediatric Emergency Registrar.

Dr John Craven, Paediatric Emergency Department, National Children's Hospital, Tallaght, Dublin 24, Ireland. Email:


Objective:  To identify the frequency, variety and disposition of horse-related injury presentations to the ED and to use this information to evaluate the existing institutional trauma team activation criteria following horse-related injuries.

Methods:  A retrospective case analysis was performed of all horse-related injury presentations to the ED of Women's and Children's Hospital, Adelaide, Australia, in the 5 year period between January 1999 and December 2003.

Results:  A total of 186 children presented with horse-related injuries during the 5 year study period. The median age of injury was 9 years (range 1–17 years), with 81% of presentations female and 60% of patients hospitalized. The mechanism of injury was divided into four groups: 148 falls (79%), 28 kicks (15%), 7 tramples (4%) and 5 bites (3%). There was one death. Seven presentations rated an Injury Severity Score >15, with full trauma team activation occurring for two of these presentations.

Conclusion:  Although horse-related injury presentations are uncommon, severe injuries do occur. Patients presenting with severe horse-related injuries do not always activate a full trauma team response based on current trauma team activation criteria. These severe injury presentations are supported by a limited trauma team response, which activates on the mechanism of injury. The effectiveness of this as a contingency system needs to be evaluated.