Reversing motor vehicle injuries: A preventable tragedy

Head injury is the most common cause of death, accounting for 25% of deaths in the 5–15 age group.¹ There are 4011 attendees to accident and emergency department, 400 admissions and 5.3 deaths per 100,000 children per year.² These data encourage us to initiate appropriate preventive measures.

The father of two-year-old child reversed his car while the child was playing in the driveway. As a result, the child was crushed between two cars. CT scan of the head (Figure 1) demonstrated multiple skull fractures, extensive intracerebral bleeding and marked cerebral damage. In spite of extensive treatment, the child died two days later.

Figure 1

CT brain scan: axial images showing several skull fractures with significant displacement of a large parietal bone fragment. There is evidence of significant cerebral oedema and raised intracranial pressure, with swelling of the brain beyond the margins of the skull vault and appearances consistent with coning in the posterior fossa. Extensive extra axial haemorrhage is also noted

The mother of an eight-year-old boy reversed her car down in the driveway and hit her son on the right side of the head. The boy sustained a depressed skull fracture with large parietal scalp laceration (Figure 2). The boy underwent elevation of the compound depressed fracture and repair of the lacerated scalp wound.

Figure 2

CT brain scan showing depressed skull fracture

To our knowledge, there are no significant numbers of studies done in Britain about driveway motor vehicle injuries. Within a short period of six months, we encountered two children with serious head injuries, of which one resulted in death.

Implementation of certain environmental modifications such as fencing the driveways is one form of preventive measure.^3,4 Other ways include reversing sensor systems, alarms, and cameras⁵ which allows the driver to see objects behind the vehicle in a small screen placed in the dashboard.

Vehicle manufacturers are offering all the above-mentioned provisions, but usually only in luxury cars. We recommend that these optional upgrades be made compulsory in each and every new vehicle.

Road safety research shows that a combined camera and proximity sensor system would be a very effective countermeasure. This letter highlights the real danger of driveway reversing injuries and the need to implement compulsory modifications for motor vehicles. We strongly advocate that vehicle manufacturers include these safety accessories as standard in all types of motor vehicle.