Summer’s here. School’s out. Kids are getting into trouble. One form is an activity called “car surfing.”
Climbing onto the roof of a moving car is car surfing. This activity caused 58 deaths between 1990 and 2008, all preventable. Though the numbers are small, we continue to see teenagers in the hospital for traumatic brain injury due to car surfing every year. It is an uncommon but significant cause of brain injury and death. And it is 100 percent preventable.
Car surfing in New Mexico even made the national news. A Washington Post article told the story of a 21-year-old woman from Nageezi (near Farmington) who decided to climb on top of her car while her friend was driving over rough dirt roads. She was flung from the car and fatally wounded. This was a preventable death due to car surfing.
There are reports from other states as well. A 19-year-old Colorado boy died from traumatic brain injury after falling while car surfing. A 17 -year-old Minnesota teen suffered severe traumatic brain injury after a car surfing accident. He spent a month in a medically induced coma and had part of his skull removed. He now suffers from chronic headaches.
Closer to home, an 11-year-old Albuquerque boy died after falling from the back of a Jeep. A 14-year-old student at Clovis High School suffered severe traumatic brain injury while car surfing in her high school parking lot. She didn’t wake up for 3 days, and when she did doctors were concerned about her ability to regain her speech and language abilities. This teen was in the hospital for a month, and then needed ongoing rehabilitation. Her mother told the newspaper that she wants the students at Clovis High School and elsewhere to stop car surfing. “I’m hoping my daughter’s story and this accident will open some eyes and show kids that even though this might look kinda fun and cool, it’s not. It’s not at all. My daughter … I don’t know what her future holds. I hope kids will make smarter choices.”
There are papers in medical journals about car surfing. In 2008 a group of neurosurgeons reviewed 7 children with car surfing injuries and found that all 7 suffered traumatic brain injury. Three children fell from the back of a moving vehicle, 2 from the hood, 1 from the side of the vehicle, and 1 intentionally jumped off. All 7 suffered intracranial bleeding, 4 had skull fractures and 4 had permanent neurological problems.
Jumping off a moving vehicle can cause injuries to many body parts. But the injuries that most affect quality and quantity of life are traumatic brain injuries (TBI). The Centers for Disease Control reports that between the years of 2001 and 2010, there were 278 TBI related deaths in children aged 0- 4 years, 488 in the 5-14 year age group and 3,670 in the 15-24 year age group. Deaths due to car surfing are usually due to the resulting TBI, and would be included in this category. We still see these injuries occurring today.
Long term outcome after Traumatic Brain Injury depends on the severity of the injury. Children with mild TBI may suffer a concussion, have some nausea, vomiting, headaches and miss some school. But they should recover. Kids with moderate TBI have more significant injury, usually with abnormal head imaging and the potential for long-term sequelae such as attention, memory and learning deficits, chronic headaches, sleep disturbance and behavior issues. Severe TBI has a significant risk of permanent brain injury or death. However, with quick medical attention, aggressive care and diligent rehabilitation, some children can recover. A 2014 article in the journal Brain Injury looked at 77 children with moderate-severe TBI who were followed for 10 years. They found that 61 percent of children were able to function within their normative age peers. This was a higher number than expected, perhaps due to the very fact that they were being followed so closely.
All this leads me back to the original message of this article.
Summer’s here. School’s out. It’s really fun to hang out in cars and get goofy with friends. But please advise your teens that riding on the hood, side or in the bed of a moving vehicle is a seriously bad idea, and they should never do it. Not for a few seconds. Not even at very slow speeds. Traumatic Brain Injury related to car surfing is completely preventable.
Anjali Subbaswamy is a Pediatric Intensive Care Physician at UNM. Please send your questions to her at firstname.lastname@example.org