Nurses can help reduce child trampoline injuries
Parents and young people need safety advice to help curb the number of emergency presentations
In recent years, trampolining has become a common recreational activity for children and young people.
Its popularity in the UK has been on the increase since 2005, reflected in the sale of almost 250,000 trampolines in 2014 (RoSPA 2015) and the emergence of indoor trampoline parks and trampolining as a competitive sport (Council on Sports Medicine and Fitness 2012).
Trampolines, however, can be a source of injury if used inappropriately and are a common cause of emergency department (ED) attendances. More than 13,000 trampoline-related injuries are treated in EDs in England every year, costing the NHS an estimated £1.5 million (RoSPA 2015).
A UK study, between January 2012 and March 2014, found that 1.8% (372) of 20,883 injury presentations at EDs (from young people aged 0 to 19) had injuries linked to the trampoline (RoSPA 2015).
Ankles and bones
The most common injury sustained is an ankle sprain, but younger children are prone to serious bone injuries (Council on Sports Medicine and Fitness 2012). Injuries are usually sustained in the lower extremities, but upper extremity injuries are more common when the injury involves falling off a trampoline (Council on Sports Medicine and Fitness 2012).
The most common serious trampolining injuries are fractures sustained to the upper limbs including the elbow, wrist, forearm, hand and collar bone (RoSPA 2015). And 19% of trampolining injuries were deemed by clinicians to be among the most serious triage codes requiring urgent medical attention (RoSPA 2015).
It is important to obtain information from a witness about the injury as it may raise suspicion about severity. Head injuries often occur after a fall from a trampoline, while cervical spine injuries are often seen after failed attempts at somersaults.
Cervical spine injuries are caused by hyperflexion or hyperextension and can be the most catastrophic of injuries sustained while trampolining (Council on Sports Medicine and Fitness 2012).
Injuries more likely to be attributed to trampoline use include proximal tibial fracture, manubriosternal dislocations/sternal injuries, atlanto-axial subluxation and vertebral artery dissection, which can occur 12 to 24 hours after a neck injury producing lasting neurological complications.
Trampolining injuries occur when basic safety advice is not followed. A study conducted in Dundee in 2009 showed that multiple users were involved in 60% of trampoline injuries (RoSPA 2015), and falls account for 27% to 39% of all trampoline-associated injuries (Council on Sports Medicine and Fitness 2012).
There is a need for stronger legislation and adherence to key safety recommendations but, in the meantime, nurses working in EDs can provide safety advice and parental education when managing children with trampolining injuries (RoSPA 2015).
This includes advising that only 1 person should use a trampoline, limiting a trampoline’s use to children over 6, using netting, constant supervision of children, ensuring the trampoline is on a flat, soft surface with a clear safe fall zone, and that children receive proper instruction before making complex moves, including somersaults (RoSPA 2015).
Jessica Calf is a fifth-year medical student at Peninsula College of Medicine and Dentistry, Plymouth University
Rachel Wilkinson is advanced paediatric nurse practitioner at St Richard’s Hospital, Chichester
Siba Prosad Paul is consultant paediatrician at Torbay Hospital, Torquay
Council on Sports Medicine and Fitness (2012) Trampoline safety in childhood and adolescence. Pediatrics. 130, 4, 774-779.
Royal Society for the Prevention of Accidents (2015) Briefing Paper: Garden Trampolining. RoSPA, London.