Study of lawn mower trauma: opportunities for injury prevention
Chris McLaughlin loves lawn mowers. And helping people in an emergency.
When this fourth-year student at the Virginia Tech Carilion School of Medicine combined the two for his required research project that has spanned the last four years, it was a match made in heaven. McLaughlin had spent many summers in his youth operating a successful lawn mowing business and six years as an EMT and paramedic.
“I knew I would work a lot harder and do a lot more if the focus of my research was something that I was passionate about,” he said. “I found that with this project.”
Mentored by Katie Love Bower, assistant professor of surgery, McLaughlin’s research involved the use of Geographic Information System (GIS) analysis of lawn mower-inflicted trauma cases across southwest Virginia. In the multi-part project, he found that lawn mower trauma differs in this region than it does nationally. He attempted to determine why.
The process began with a confidential review of the records of adult patients who came to Carilion Roanoke Memorial’s Level I trauma center with lawn mower injuries over a five-year period. In addition to demographics, McLaughlin collected information on each patient’s injury severity, the location of the incident, and how the patient was injured. This cohort was then compared to lawn mower trauma patients using the National Trauma Databank.
“In this area, lawn mower trauma occurs more frequently than the national rate, and the most common mechanism of injury was lawn mower rollover,” he said. ”With this data, we could answer affirmatively that lawn mower trauma is different in this region. Next, I tried to determine why.”
He hypothesized there might be associations among topography where each incident occurred as well as with injury patterns and the severity of the injuries. As a geology minor in college, Mclaughlin was somewhat familiar with GIS technology.
GIS captures, stores, analyzes, and presents spatial or geographic data. Some of its common uses are in civil engineering, mining, government, and oil and gas industries.
“My project was the first time anyone had taken a serious look at trauma for topographical or geomorphic values,” McLaughlin said.
He obtained GIS software from Virginia Tech and dedicated several weeks to teaching himself some of the sophisticated functions.
McLaughlin determined the location of each of the accident sites by reading EMS and trauma reports from when injured patients were brought to the hospital. He then used spatial analysis on elevation data obtained from the National Elevation Dataset, published by the United States Geological Survey. Using these spatial analysis tools, he determined the slope and curvature of the topography at each location.
“My research was a great example of the opportunities that arise from the Virginia Tech and Carilion partnership,” he said. “The GIS software came from the university, and the patient data came from Carilion.”
The last value he wanted to capture was the ruggedness of the terrain for each accident spot. For this, he found a set of analyses called the Vector Ruggedness Model with a surprising twist. The data had been developed for the tracking of sheep in the Mojave Desert.
“That was my favorite part of this project,” he said. “Finding this methodology to determine ruggedness that came from bighorn sheep, essentially nature’s own lawn mowers, that was actually built for the exact dataset that I had. It worked perfectly.”
At this point, McLaughlin had the data he needed to start running some analyses:
Regional lawn mower trauma data? Check.
Incident locations? Check.
Elevation, slope, curvature data for each location? Check.
Bighorn sheep lowdown (a.k.a. terrain ruggedness data)? Check.
“The whole key was being able to bring the GIS data to the patient care data and compare the two,” McLaughlin said.
He found that the average slope for lawn mower rollover accidents in this region was less than the recommended safety guidelines for lawn mowers.
“We didn’t have a large enough sample population to identify with certainty the differences in the geomorphic variables and patient injury data,” he said. “There were definitely trends, but we can’t say that they were significantly different.
“Compared nationally, this region had a higher incidence of lawn mower trauma, which resulted in greater injury severity and more prevalent injuries to the head, neck, chest, abdomen, and pelvis,” McLaughlin said. “These were among the statistically significant findings.”
Of all the regional lawn mower trauma patients, a majority were rollover accidents. A smaller proportion of patients were pinned and required some kind of extrication.
“It underscores how severely a lot of these patients were injured,” he said. “It’s definitely a cause of preventable injury. So the whole point is, we take all the findings we have from this injury analysis project and develop them into an injury-prevention program.”
McLaughlin doubts he’ll have time to carry his research to the next step when he starts a seven-year residency in general surgery this summer, although there is a possibility later on.
“Chris’s success with this project is demonstrative of how our students can innovate using knowledge from another field of study to improve health care,” Bower said. “He has developed a transferrable model that can be utilized by other researchers in designing more-efficient trauma systems nationwide.”
McLaughlin presented his research at the Southeastern Surgical Congress in February and has submitted a manuscript for publication.