, 2025-05-05 06:54:00
Rental electric scooter (e-scooter) injuries among adults are increasingly common in a large Canadian city. Men and women are presenting to emergency departments (EDs) in Edmonton with multiple injuries that represent “substantial burdens” to patients and the Canadian healthcare system, a new analysis suggested.
Most e-scooter use in Edmonton involves rentals, as the use of privately owned e-scooters on city property is prohibited.
“We were surprised by the high percentage of ambulance use (20%), as well as the required post-ED visit follow-up, with 30% of patients requiring further follow-up and almost 10% of patients requiring surgery within 30 days of presenting to an ED following an e-scooter injury,” lead author Erin Bristow, MD, an emergency medicine doctor at University of Alberta Hospital, Edmonton, told Medscape Medical News.
“The incidence of head injuries was notable (17%), as was the high rate of fractures (32%) among the patients studied,” she said.
The study was published on April 17 in the Canadian Journal of Surgery.
Multiple Injuries Common
To determine the incidence and severity of injuries from rentable e-scooters among adults presenting to Edmonton EDs, researchers investigated 759 e-scooter–related injury presentations during three summer seasons (2019-2021).
The patients’ median age was 28 years. Men and women were almost equally represented. About 20% of patients presented by ambulance, and 14% were triaged as urgent.
Most patients (61.5%) had multiple injuries, and fractures (31.9%) and head injuries (17%) were common.
Helmet use was rare (2.4%), but concomitant substance use was common (26.4%). Most patients (76.3%) underwent investigations during their ED visit, and 11% required a consulting service while in the ED.
Only 5.5% of patients were admitted to the hospital, but 30% required further follow-up. This group included 9.1% of patients requiring surgery within 30 days of their primary visit to an ED, 10.3% of patients re-presenting to an ED, and 9.7% requiring a formal outpatient follow-up visit.
No deaths were documented during the study period.
The study was limited by its focus on rental e-scooter injuries among adults, which excluded pediatric injuries. Moreover, the catchment population was in a single municipality, potentially limiting the generalizability of the results. In addition, the prevalence of e-scooter injuries could have been underestimated due to missing triage text or inadequate chart coding.
“This is not a benign activity,” Bristow noted. Potential preventive strategies could include mandatory helmet regulations, e-scooter speed restrictions beyond the current local restriction of 20 km/h, and user education regarding the risks of e-scooter use while intoxicated, she suggested.
Clinicians can help by providing patient education in the ED and in the office and by advocating for injury prevention strategies to be implemented by municipalities that license the use of rentable e-scooters, she added.
‘Small, Attractive, Popular’
Donald Redelmeier, MD, the Canada Research Chair in Medical Decision Sciences and a professor of medicine at the University of Toronto, Toronto, said that the findings are typical of his experience as a physician in the trauma center at Sunnybrook Health Sciences Centre, Toronto.
More injuries are occurring, at least in part because e-scooters are a relatively new technology, he told Medscape Medical News. “In the same way that we’re seeing fewer patients with injuries from falling off a horse, we’re bound to see more injuries from patients falling off of e-scooters, especially since the wheels are small, the base of support is extremely narrow, and users are often unfamiliar with the device.”
The authors did not mention the fire hazard associated with the batteries, which have led some cities to ban all forms of e-scooters, he noted. Nor did they mention the potential collateral damage to pedestrians who are sometimes knocked over in a collision with an e-scooter.
Regarding preventive strategies, he said, “Education is super important. You just can’t outlaw these things. They’re too small and attractive and popular. And there’s inevitably a balance between safety and freedom.”
Like Bristow, Redelmeier highlighted the importance of protective gear. “The fact that less than 10% of these individuals were wearing a helmet is a solvable problem that should be enforced. So, you don’t prohibit the technology, but you do make some requirement about mandatory helmets, as is the case in other parts of Canada, like Ontario.”
Furthermore, protective gear involves more than helmets, he said. “Gloves and proper footwear help a lot. The adage says that it’s better to sweat than to bleed, and this study certainly shows that there are a lot of superficial injuries, very commonly to the elbows and the hands, that could have been prevented easily with gloves and maybe elbow guards that are quite inexpensive.”
The study did not examine why the patients fell off their scooters in the first place, and that’s common, he said. “That also applies for people who get injured on their bicycles, on their motorcycles, and in other motor vehicles.
“One of the profound lessons about motor vehicle travel is that often you don’t know why the misadventure occurred, either because of associated amnesia or because the incident occurs so quickly that you have no idea why you ended up on the ground,” he said. “Ergo, you have no real way of learning from your past experiences to prevent it from happening in the future. And that’s why proactive forms of education are so important because you just can’t learn until it’s too late.”
This research received in-kind support from the Emergency Medicine Research Group in the Department of Emergency Medicine, Faculty of Medicine and Dentistry, College of Health Sciences at the University of Alberta. It also received financial support from a Scientific Director’s Grant from the Canadian Institutes of Health Research to support data access, data extraction, database management, and statistical analysis. Finally, the project received financial support from the City of Edmonton and the Injury Prevention Centre at the University of Alberta. Bristow and Redelmeier reported having no relevant financial relationships.
Marilynn Larkin, MA, is an award-winning medical writer and editor whose work has appeared in numerous publications, including Medscape Medical News and its sister publication MDedge, The Lancet (where she was a contributing editor), and Reuters Health.
