ED visits due to trampoline-related injuries jump up among SG children

Singapore has seen a rise in the existence of trampoline parks and with it an increase in emergency department (ED) visits for trampoline-related injuries (TRIs), according to a study. Most of these injuries however are mild, with no deaths or severe neurological sequelae.

“[T]rampolining is an engaging indoor activity that helps to improve motor control in children, and there are risks of falls and injuries as with all forms of physical activity,” the researchers said.

“Instead of a ban, we would recommend that additional safety measures be taken, such as adequate education when selling trampolines, ensuring adult supervision, mandatory placement of mats around the periphery of all trampolines and restricting trampoline use to one person,” they added.

This study utilized the National Trauma Registry to identify patients aged <16 years who presented to the ED at KK Women’s and Children’s Hospital in Singapore from March 2012 to June 2016 with a TRI. The researchers retrospectively collated data on age, location of the trampoline, mechanism and location of injury, treatment, disposition, and follow-up treatment.

During the study period, 137 children had an ED visit due to TRI, with an even representation across age groups (<6 years, 6–11 years and 11–16 years). Majority (60.6 percent) of the TRIs occurred in a public trampoline park, and a smaller proportion occurred in the home or school. [Singapore Med J 2019;doi:10.11622/smedj.2019168]

Of the TRIs, 61.3 percent occurred on the trampoline, 25.5 percent involved a fall off it, while the rest were incurred by hitting the trampoline frame. Soft tissue injury was the most common, followed by fractures and dislocations. A few of these injuries (16.7 percent) required surgical intervention.

Most patients were discharged to an outpatient clinic. Of all patients, 14.6 percent were admitted to the hospital and 9.5 percent eventually had to undergo surgery. Three stable head injuries and no cervical spine injuries or deaths were recorded.

Previous studies have identified several causes of TRI, including double bouncing or having multiple users on a trampoline. [Inj Prev 2017;23:352-354; Acad Emerg Med 2007;14:539-544; Curr Sports Med Rep 2009;8:273-277; Inj Prev 2006;12:133-134; J Pediatr Orthop 2007;27:729-732; World J Pediatr 2013;9:169-174]

“Consistent with the aforementioned studies, the injuries [in this study] in which multiple users were on the trampoline happened more often in younger children, with six out of 10 of them occurring in children aged below 6 years and none in the 11–16 years group,” the researchers said. “All the injuries from double bouncing were minor and did not require any long-term follow-up.”

Several studies have also assessed the effectiveness of safety measures in trampoline use, most of which reported that these measures have minimal impact on the frequency of TRIs. [Br J Sports Med 2006;40:984-987; Pediatr Emerg Care 2006;22:644-646; Injury Prevention 2012;18(Suppl 1):A87-A; Inj Prev 2015;21:314-319; Inj Prev 2002;8:27-31; Inj Prev 2010;16:185-189]

“In Singapore, safety rules and features have been put in place in public trampoline parks,” the researchers said. “The safety nets surrounding the periphery of public trampolines may have served their purpose, as only a minority of falls off trampolines occurred in public trampoline parks.”