The Children’s Wisconsin Emergency Department team recently cared for a child who suffered a skull fracture with multiple brain bleeds after an electric scooter crash. What started as a fun afternoon with friends ended in a crowded trauma bay, where emergency medicine physicians and nurses, trauma surgeons and neurosurgeons worked together to treat a traumatic brain injury. The child was not wearing a helmet.

Unfortunately, this story isn’t unique. As e-bikes and e-scooters become more common, more powerful and increasingly accessible to children, our Emergency Department and emergency departments across the country are seeing a growing number of serious injuries. Higher speeds turn small mistakes into serious injuries. Between 2017 and 2022, U.S. emergency departments treated more than 235,000 e-bike and e-scooter related injuries. This is a 30-fold increase in e-bike injuries and 7-fold increase in e-scooter injuries in just four years.

Behind these statistics are children with broken teeth and broken bones, internal bleeding, concussions and traumatic brain injuries, requiring surgery and intensive care. As pediatric specialists, it’s not uncommon for us to care for at least one child with an e-bike or e-scooter-related injury during a single shift. What makes these injuries especially difficult to witness and care for is that most could have been prevented, or their severity reduced, with simple discussions about e-scooter and e-bike safety. Or, even more simply, by wearing a properly rated helmet.

As pediatricians, it's our job to prevent injuries and create safe environments so children can grow up protected and healthy. We have seen how simple, consistent safety practices, like wearing seat belts in cars or life jackets on boats, save lives. Yet, today, more and more children and teens are riding e-bikes and e-scooters capable of speeds up to 28 miles per hour, that mix with traffic in neighborhoods and busy roads, often without the most basic protection: a helmet.

Unlike traditional bikes, e-bikes and e-scooters experience higher speeds and greater forces in a crash. That increased speed means the potential for serious injury, especially a head injury, is significantly increased. Research shows that wearing a helmet can reduce the risk of serious head injury by up to 60% and cut the risk of traumatic brain injury nearly in half. When the consequence of a crash can be in a life-altering brain injury or even death, choosing not to wear a helmet carries risks that are simply too high.

Many parents and e-bike users may not realize that helmet recommendations surrounding e-bikes differ from those of traditional bicycles. Motorized bikes and scooters can exceed speeds of 20 mph. Because of this, they require helmets rated for higher speeds, like those designed for motorcycles. Not using a properly rated helmet approved by the Consumer Product Safety Commission (look for the CPSC label on the inside) greatly increases the risk of head injuries for children and adolescents involved in these crashes.

We know that these devices have opened up new freedom and independence for kids and teens, but this popularity is outpacing safe riding habits. This is where parents, caregivers and the broader community play a critical role. Just as we would never allow a child to ride in a car without a seat belt, we should not allow a child to ride an e-bike or e-scooter without a helmet rated for the speed and use. A properly fitted, well-certified helmet should be a non-negotiable part of every ride. And we urge parents to talk with their pediatrician on safety expectations and ensure your kid is ready before they are allowed on an e-bike or e-scooter. Lastly, we ask parents to teach their children about road safety and enforce helmet use.

No single measure can prevent every injury, but we know from decades of public health experience that consistent safety practices save lives. Helmets are one of the simplest and most effective tools we have to protect children from devastating head injuries. Let’s commit to reinforcing expectations, supporting safety information and normalizing helmet use so that it becomes as routine as putting on a seat belt. 

Co-authored by Emma Strode, DO, Pediatric Emergency Medicine Fellow Physician, and Shelby Terrell, DO, Pediatric Resident