It’s a busy Friday afternoon in the emergency department. The waiting room hums with end-of-school energy — sports injuries, fevers, and worried parents. In Bay 3, 14-year-old Vinh lies on the stretcher, pale and tearful. His right arm is grotesquely swollen, held protectively across his chest. He’s just come in after coming off an e-scooter — fast.
He wasn’t wearing a helmet. He’d been “doubling” with a mate, both riding a single scooter, when they hit a raised section of footpath at what he estimates was over 30 km/h. The scooter jackknifed. He went over the handlebars and struck his head on the kerb — hard.
There was a moment of silence after the crash, and then vomiting. He can’t recall the impact. On arrival, his GCS is 14, and he’s confused about what day it is. A large occipital haematoma is blooming beneath his hairline. His parents are shaken — they didn’t know the rules. They thought the scooter, a Christmas present, was just a fun way to get to the skatepark.
A CT head is ordered to rule out an intracranial injury. Fortunately, there’s no bleed. But this is more than just a broken wrist — it’s a serious head injury in a child whose brain is still developing.
The arm will need casting under sedation, and in a week or two, he’ll be back in the fracture clinic. But today, like many others across Queensland, his story is a near miss. Not all are so lucky.
E-scooters have glided rapidly from novelty to norm across Australian cities and suburbs. Marketed as convenient, low-emission, and fun, they’re increasingly popular with teens, many of whom aren’t old enough to drive but are more than old enough to want speed, independence, and adventure.
Originally designed for adults, these devices are now routinely used by children and adolescents, often without adequate supervision or understanding of the rules. Queensland, uniquely among Australian states, permits e-scooter use from 12, provided children are supervised by an adult on a separate scooter or bike. In practice, this rule is patchily understood, inconsistently enforced, and frequently ignored.
Clinicians across emergency departments are witnessing the consequences. Broken bones, facial injuries, and concussions are becoming part of the landscape. What was once rare is now a daily presentation in some hospitals. And while e-scooters promise freedom, they also bring significant risk, particularly to paediatric users, whose physical and developmental readiness to operate such devices safely is questionable.
Until recently, however, there was little Queensland-specific data to describe just how dangerous these rides can be. A new audit from Sunshine Coast University Hospital changes that, offering the first detailed look at paediatric e-scooter trauma in the state. The findings are sobering and demand attention from clinicians, caregivers, educators, and policymakers alike.
Why Now? The Rise of E-Scooters
Over the past five years, e-scooters have become a defining feature of modern transport — zipping through laneways, parked outside train stations, and rattling along footpaths from Fremantle to Fitzroy. Originally intended as a green alternative for short-distance adult commuting, e-scooters are now widely used for recreation, particularly among young people.
For adolescents, the appeal is obvious. E-scooters are fast, fun, and easy to operate. There’s no need for a licence. You can buy one outright or hire one with a smartphone. There’s a whiff of rebellion in the ride — and for many teens, that’s part of the attraction.
And it’s not just anecdotal. Data from across Australia show a steep increase in injury rates associated with personal mobility devices, particularly among adolescents. In Queensland, the Injury Surveillance Unit reported a jump in e-scooter-related presentations from 279 cases in 2019 to 877 by 2022, with over 800 already recorded by September 2023. Children under 15 accounted for a significant proportion of these injuries.
On the Sunshine Coast, one hospital alone recorded 118 e-scooter-related ED presentations in 12 months, with over half involving patients under 18. Alarmingly, 61% of those cases involved fractures, and some included intracranial injuries and loss of consciousness — injuries more akin to those seen in motor vehicle trauma than recreational mishaps.
A Monash University study released in early 2025 confirmed these trends in Victoria, noting that young people aged 15–24 made up most of e-micromobility injury cases. Fractures and head injuries were the most common, with over 23% involving the face, skull, or neck. Meanwhile, an audit from Royal Brisbane and Women’s Hospital found that e-scooter injuries were presenting at a rate of 1.5 patients per day, often at night and often involving high speeds or alcohol.
These figures echo findings from a 2023 ABC News investigation, which reported a six-fold increase in paediatric presentations due to e-scooter, e-bike, and e-skateboard injuries across Queensland. Over just 12 months, 88 children were treated for related head, neck, and limb trauma — some requiring surgery, some sustaining lasting neurological symptoms.
Despite their adult design, e-scooters are increasingly used by younger riders, some as young as primary school age. Many are inexperienced in road use, have limited hazard perception, and ride without helmets. Some share scooters with friends. Others treat them like toys, unaware that the speeds involved can exceed 25 km/h and that a momentary lapse in attention can cause serious harm.
The clinical community has started to take notice. But until recently, much of the research has focused on adult injury patterns. The specific risks to children—anatomically, developmentally, and behaviourally—have been underexplored. As paediatricians, emergency clinicians, and health advocates, this matters. What we’re seeing is not just a transport trend—it’s an emerging injury epidemic, and we’re only just beginning to understand its scope.
The Rules of the Road – and Where Queensland Stands Alone
Australia doesn’t have a uniform approach to e-scooter legislation, and the patchwork becomes even more apparent regarding children.
In most states and territories, the legal minimum age for riding an e-scooter ranges from 16 to 18. These laws typically include mandatory helmet use, speed restrictions (usually 25 km/h on roads, 10–12 km/h on footpaths), and rules about where and how e-scooters can be used. Importantly, in many jurisdictions, privately owned scooters remain illegal for public use, with rental fleets governed by tighter regulation and in-built speed controls.
But Queensland is an outlier. Under current legislation, children as young as 12 can ride e-scooters legally, so long as an adult accompanies them on a separate personal mobility device (such as another scooter or bicycle). Once they turn 16, they can ride independently. In practice, however, enforcement is light, and awareness of these rules among families is limited. Many parents are surprised to learn that their child’s e-scooter use — solo, fast, unhelmeted — is not just unsafe, but unlawful.
Only the ACT shares a similar age threshold, while other states have taken a more conservative stance:
- Victoria: 16+, helmet mandatory, footpaths prohibited.
- NSW: Trials only, age 16+, private scooters still banned on public roads.
- SA: 18+ unless part of a designated trial.
- WA, NT, TAS: 16+, with local variations on speed and helmet compliance.
These disparities matter. Children in Queensland are legally permitted to ride faster, younger, and in more places than their peers interstate, despite being no more physically or cognitively prepared to manage the risks.
While legislation mandates helmet use and a 25 km/h speed limit, a significant proportion of paediatric riders either don’t know the rules or choose not to follow them. In the Sunshine Coast audit, 42% of injured children weren’t wearing a helmet, and over a third were travelling above the legal speed limit at the time of their crash.
The current regulatory environment fails to protect children, not because the rules don’t exist, but because they aren’t aligned with developmental realities or actively enforced. This gap leaves clinicians picking up the pieces after preventable injuries.
The Sunshine Coast Study
Amid rising concern but sparse local data, a Sunshine Coast University Hospital team undertook a two-year retrospective audit of paediatric e-scooter trauma. Their goal was to quantify what clinicians were increasingly seeing — more kids injured, more seriously, and often while breaking the rules.
Between January 2023 and December 2024, 176 children aged 5 to 15 presented to the emergency department with e-scooter-related injuries. That’s approximately 1% of all paediatric ED presentations, with a disproportionate spike among 14 and 15-year-olds, where e-scooter trauma made up around 1 in every 30 visits.
- 71% of patients were male, with a median age of 14.
- Falls or collisions with stationary objects accounted for 78% of injuries.
- 13% involved a motor vehicle, and 8% collided with another scooter or mobility device.
- 42% weren’t wearing a helmet, despite legal requirements.
- 12% were doubling, riding with a second passenger.
- 36% were travelling above 25 km/h — the maximum allowed speed.
Injury severity varied, but was far from trivial:
- 38% sustained at least one fracture, some requiring surgical intervention.
- 18% underwent CT imaging, most commonly for head trauma.
- Based on Paediatric Trauma Scores, 11% of cases were categorised as potentially life-threatening or life-threatening.
Even among those not classified as severely injured, the burden was significant: three-quarters required some form of imaging, and many needed follow-up with orthopaedics, neurosurgery, or community care.
A Critical Look: What This Study Tells Us — and What It Doesn’t
The Sunshine Coast audit is an important piece of work. It represents Queensland’s first paediatric-specific e-scooter trauma dataset, offering real-world insights from a busy regional emergency department.
Strengths
- Paediatric focus: Unlike previous audits, which lumped adolescents into adult data, this study restricts its scope to patients under 16 — a meaningful and developmentally relevant cut-off.
- Structured trauma scoring: The authors move beyond descriptive data to give a semi-objective sense of injury severity by applying the Paediatric Trauma Score.
- Granular detail: Helmet use, doubling, and speed estimates were recorded, offering valuable insights into modifiable risk factors.
- Policy relevance: The authors explicitly link their findings to Queensland’s legislative context, making this study descriptive and advocacy-oriented.
Limitations
- No linkage to longer-term outcomes: The study captures initial presentation only. We don’t know how many children needed surgery, had lasting impairment, or re-presented later.
- Single-centre, retrospective design: As with all audits, this limits generalisability. Other Queensland centres — particularly metropolitan or remote services — may see different patterns.
- Keyword-dependent case capture: Inclusion relied on the word scooter appearing in triage notes, which risks missing relevant cases (e.g. those simply labelled “fall” or “RTC”).
- Ambiguity in scooter type: The audit excludes push scooters where documented, but it’s likely some misclassification remains, particularly in less detailed notes.
- No supervision data: Queensland law requires adult accompaniment for 12–15-year-olds, yet the audit couldn’t determine if this occurred.
E-Scooters as a Paediatric Public Health Challenge
The Sunshine Coast audit highlights what many of us working in paediatric emergency care have already noticed: e-scooter injuries in children are becoming more common, more complex, and more resource-intensive. With a third of riders sustaining fractures, a significant proportion requiring imaging, and helmet compliance sitting well below 60%, these aren’t just isolated incidents — they’re part of a broader pattern.
The Hidden Costs of Injury
For children and adolescents, the impact of trauma extends far beyond the emergency department:
- School absenteeism following orthopaedic or neurological injury is common, especially when follow-up appointments, pain, or post-concussion symptoms are involved.
- Mental health effects such as anxiety, irritability, or sleep disruption may linger long after the wounds have healed.
- Parental burden — time off work, travel for imaging or clinic review, and the emotional toll of “what could have happened” — compounds the stress.
What’s not captured in the trauma score is the knock-on effect on a family’s stability, a child’s confidence, or their participation in sport, education, and social life.
Health System Strain
The burden on the healthcare system is measurable and growing:
- Imaging demand: Over 75% of patients in the Sunshine Coast audit required X-rays or CT scans.
- Theatre time and bed days: While not captured in this audit, anecdotal experience suggests that fracture reductions and surgical fixations are increasingly common.
- Workforce impact: Each injury presentation draws in nurses, radiographers, orthopaedic and ED teams, often for injuries that, with better upstream prevention, might never have occurred.
And yet, e-scooters remain largely unaddressed in hospital injury prevention strategies.
The Missed Moment for Intervention
Emergency departments are not just treatment spaces — they can be teachable moments. For clinicians, the moment a young person presents with a preventable injury is an opportunity to shift behaviour:
- Brief safety counselling (helmet use, speed, riding alone) could be modelled on existing interventions for seatbelt or smoking discussions.
- Helmet provision schemes, similar to those used for bike injuries, could offer immediate harm reduction and reinforce safer habits.
- Injury-response cards or school referral letters could prompt ongoing discussion in more trusted spaces, like classrooms or GP consults. We have a PARTY program to discuss drugs and alcohol, why not other risky activities?
Yet currently, there’s no formal structure to support this. We patch kids up — and then send them back into the same environment that injured them.
Reducing the burden of e-scooter injuries in children will likely require a combination of approaches. Legislative reform is one part of the picture, but there are also opportunities for health services, schools, local councils, and families to play a role. Programs that have worked in other areas of paediatric injury prevention — like bicycle safety, pool fencing, and car restraint use — could offer useful frameworks. A coordinated approach across sectors could help reduce risk and improve outcomes, particularly as personal mobility devices become more common.
Where to From Here? Policy and Practice Implications
While the Sunshine Coast audit stops short of recommending specific reforms, it clearly signals the need for a more robust and coordinated response to paediatric e-scooter injuries. There’s no single solution, but several practical, evidence-informed steps could help reduce risk and support safer use.
1. Reconsider Age Limits in Queensland
Queensland’s legal minimum age of 12 — the lowest in the country — warrants review. Aligning with other states and territories that set the threshold at 16 or older would reflect the physical and cognitive maturity needed to ride safely, particularly on shared paths or near traffic.
2. Improve Enforcement and Awareness of Existing Laws
Many families are unaware of key rules: that children must wear helmets, that footpath speeds are capped at 12 km/h, or that doubling is prohibited. Clearer public messaging — through schools, councils, or point-of-sale regulation — may help close the gap between policy and practice.
3. Explore Helmet Distribution Programs
Several hospitals have successfully trialled “injury-response” interventions, offering free bike helmets to children who present after riding unhelmeted. Adapting this model to e-scooter trauma could be a practical, low-cost way to reduce future risk, especially when paired with a brief safety discussion in the ED.
4. Use the ED Visit as a Teaching Moment
Emergency presentations offer a unique opportunity for brief, targeted intervention — especially with adolescents. Short conversations around helmet use, speed, and road rules could be normalised in paediatric assessments, similar to existing frameworks like HEADSS. Ideally, these messages would be reinforced by GPs and schools.
5. Consider Safety Requirements for E-Scooter Design
Private scooters often lack the inbuilt safety features seen in commercial fleets, such as speed limiters, geofencing, or visibility aids. Policymakers may wish to explore whether a national safety standard or child-specific product labelling could reduce the risk of serious injury.
6. Support Further Research and Surveillance
This audit is a strong starting point, but more data are needed, particularly around long-term outcomes, compliance with supervision laws, and injury patterns in metropolitan or remote areas. A multicentre prospective study could help guide both clinical practice and public policy.
Whose Responsibility Is It?
E-scooters aren’t going away. They’re affordable, accessible, and increasingly embedded in how young people move around their communities. But as clinicians, we’re now seeing the consequences of a technology that has outpaced the safeguards around it.
This isn’t a call to ban e-scooters, but it is a prompt to ask whether we’re doing enough to make them safe for children. Legislation sets the rules, but those rules must reflect real-world use and developmental readiness. Parents need clear guidance. Schools need support. And health services have a role to play — not just in treating injuries, but in helping prevent them.
For now, most of the young people who come through our EDs with e-scooter injuries recover well. But some don’t. And even when the outcome is “good,” the injury still matters — to the child, to their family, and to the system.
We have the data. We have the stories. What comes next is up to all of us.
References
Queensland Injury Surveillance Unit. E-scooter riders still not taking safety seriously. RACQ News. 2023 Dec. Available from: https://www.racq.com.au/latest-news/news/2023/12/ns191223-data-shows-e-scooter-riders-still-not-taking-safety-seriously
Sunshine Coast Health. E-scooter injuries on the rise in young people. Sunshine Coast University Hospital; 2023. Available from: https://www.sunshinecoast.health.qld.gov.au
Monash University. E-micromobility is booming — but so are injuries. Monash Lens. 2025 Feb 19. Available from: https://lens.monash.edu/@politics-society/2025/02/19/1387291/e-micromobility-is-booming-but-so-are-injuries
Royal Brisbane and Women’s Hospital. Emergency Department Audit: Personal mobility device trauma trends. Metro North Health; 2021 Aug. Available from: https://metronorth.health.qld.gov.au/rbwh/wp-content/uploads/sites/2/2021/08/clin-0039.pdf
Dwan K. Surge in child injuries linked to e-scooters prompts hospital warnings. ABC News. 2023 Sep 26. Available from: https://www.abc.net.au/news/2023-09-26/escooter-accidents-with-children-increase-in-hospital-admissions/102820648
