Citation

Manson J, Cooper S, West A, Foster E, Cole E, Tai NR. Emerg. Med. J. 2013; 30(1): 32-37.

Affiliation

Trauma Sciences, The Blizard Institute, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, London, UK.

Copyright

(Copyright © 2013, BMJ Publishing Group)

DOI

10.1136/emermed-2011-200966

PMID

22362649

Abstract

Introduction Pedal cycling in cities has the potential to deliver significant health and economic benefits for individuals and society. Safety is the main concern for potential cyclists although the statistical risk of death is low. Little is known about the severity of injuries sustained by city cyclists and their outcome. Aim The aim of this study was to characterize the physiological status and injury profile of cyclists admitted to our urban major trauma centre (MTC). Methods Database analysis of cyclist casualties between 2004 and 2009. The physiological parameters examined were admission systolic blood pressure (SBP), admission base deficit and prehospital Glasgow Coma Scale.Results265 cyclists required full trauma-team activation. 82% were injured during a collision with a motorized vehicle. The majority (73%) had collided with a car or a heavy goods vehicle (HGV). These casualties formed the cohort for further analysis. Cyclists who collided with an HGV were more severely injured and had a higher mortality rate. Low SBP and high base deficit indicate that hemorrhagic shock is a key feature of HGV casualties. Conclusion Collision with any vehicle can result in death or serious injury to a cyclist. Injury patterns vary with the type of vehicle involved. HGVs were associated with severe injuries and death as a result of uncontrollable hemorrhage. Awareness of this injury profile may aid prehospital management and expedite transfer to MTC care. Rapid hemorrhage control may salvage some, but not all, of these casualties. The need for continued collision prevention strategies and long-term outcome data collection in trauma patients is highlighted.

Language: en