Emergency & Trauma

May 31, 2023

Pediatric trauma experts add multipassenger UTVs, golf carts to list of dangerous vehicles that includes ATVs

While ATV accidents are commonly associated with high-profiled injuries, trauma prevention advocates at Monroe Carell Jr. Children’s Hospital at Vanderbilt want the community to add UTVs and golf carts to the list of motorized vehicles that can be dangerous.


by Jessica Pasley

“Parker, stay with me. Parker stay with me. Parker…” are the words Stephanie Holmes could hear in the background when she returned a call from an unidentified number on April 11.

Her 13-year-old son had been in a utility task vehicle (UTV) accident. Parker was supposed to be across the street from their home in Dickson, Tennessee.

“He was supposed to take our side-by-side (UTV) across the street, which is all that we allow,” recalled Holmes. “He decided to be a typical preteen and take it down the road, pick up a friend, and take the long way back home.

“That long way,” exclaimed Holmes, “is a very curvy, back road with a 90-degree angled turn that he incorrectly maneuvered. He was going too fast, hit gravel, lost traction and over corrected. He slammed into a tree.

“I got a call from a state trooper while cooking dinner. He was supposed to be home at 5:30. But instead, he was at an unknown address.”

Stephanie and her husband, who had just walked in the door from work, turned right back around and rushed to their son, who was unconscious and being loaded into an ambulance that headed to a nearby ball field where LifeFlight carried him to Monroe Carell Jr. Children’s Hospital at Vanderbilt for lifesaving care.

Parker, who suffered a traumatic brain injury (TBI), is one of 30 ATV trauma cases in the first quarter of the year that required the trauma care at Monroe Carell.

The number is alarming for the trauma service.

“In the last three years, we have seen on average about 95 ATV trauma cases a year,” said Bo Lovvorn, MD, professor of Pediatric Surgery and medical director, Pediatric Trauma Program at Monroe Carell. “In the four months of 2023, we have had more than 30. This would indicate a higher volume than previous years.

While ATV accidents are commonly associated with high-profile injuries, trauma prevention advocates at Monroe Carell want the community to add UTVs and golf carts to the list of motorized vehicles that can be dangerous.

An all-terrain vehicle (ATV) is usually made for one rider to go off-roading. A UTV is a larger type of ATV designed to haul heavier loads and allow for additional passengers.

Stacey Pecenka, MPH, CPH, manager, Trauma Injury Prevention Program at Monroe Carell, said there are multiple safety measures for ATV, UTV, dirt bike, skateboard and bike riders.

Wearing a helmet is the best save-the-brain decision anyone enjoying these activities can make, said Pecenka.

In Parker’s case, wearing a seat belt was a key safety precaution that he did not follow. His family does not typically wear helmets when tooling around the farm because the vehicle only allows drivers to go a maximum speed of 15 miles an hour when not buckled in. If seat belts are being used, driving speeds can double in their motorized vehicle model. Holmes said her son buckled the safety belt behind him allowing him to reach higher speeds.

For ATV riders, helmets are the most important gear, but it is also wise to use restraints and wear long sleeves and pants, and appropriate shoes, to prevent or minimize injuries to other parts of the body in addition to the head.

According to Pecenka, Tennessee law requires ATV riders to wear helmets and limits driving to those ages 16 and up. It’s not uncommon for emergency room personnel to treat children much younger than age 16 who have suffered ATV-related injuries, she said.

Monroe Carell fully supports recommendations by the American Academy of Pediatrics and the American College of Surgeons that children 16 and under should not ride ATVs due to the high risk of serious injuries.

“ATVs are part of Middle Tennessee culture,” said Pecenka. “We strongly recommend those kids use safety equipment to best protect them.”

Other safety measures strongly recommended include:

  • Always wear protective gear — especially a helmet — when riding ATVs. Head injuries are by far the leading cause of death and disability related to ATV crashes. Helmets are known to reduce head injuries by 85%. Wear a motorcycle or motorized sports helmet and make sure it is certified by the U.S. Department of Transportation or the Snell Memorial Foundation.
  • Avoid driving ATVs with a passenger, or riding as a passenger. Most ATVs are designed to carry only one person.
  • Take a hands-on safety training course if one is available in your area.
  • Do not drive ATVs on paved roads because they are difficult to control. Collisions with cars and other vehicles can be deadly.
  • Do not permit children to drive or ride adult ATVs. Children are involved in about one-third of all ATV-related deaths and hospital emergency room injuries. Most of these deaths and injuries occur when a child is driving or riding on an adult ATV.

Holmes is thankful her son is recovering. Females and males, ages 13-16, are the least likely to use helmets.

“The most common type of injury we see is head injury due to not wearing a helmet,” said Lovvorn. “Everyone using any kind of motorized vehicle should wear a helmet.

“When a child comes into our hospital with a head injury, it requires resources that include neurosurgery and trauma teams working collaboratively to provide the highest level of care.”

For that, Holmes is very thankful.

“While we were in the hospital, nothing but blessings came,” recalled Holmes. “There was no need for any surgeries; the bleeding in his brain stopped; the fractures around his eye mended appropriately.

“He still has not attended a full week of school, but we are working on being patient. This is not something you just bounce back from. He knows he was wrong – so many lessons learned.”