Pediatric Traumatic Injuries Due to Agrarian Hay-Hole Falls

TL;DR

This study examines injuries in children from falling through barn hay-holes, finding they often involve young kids and face injuries but are rarely fatal.

Contribution

The study provides new insights into the specific injury patterns and prognostic factors of pediatric hay-hole falls.

Findings

Hay-hole falls frequently involve younger children and craniofacial injuries.

Greater fall height correlates with longer hospital stays but not severe head injuries.

Fatalities from hay-hole falls are rare despite significant injuries.

Abstract

Hay-holes are a design feature in many traditionally built barns that serve as a portal through which stored hay is passed to the lower level where animals are fed. Unfortunately, children sometimes fall through the hay-hole to the concrete or packed earth below. Available data on the frequency and types of hay-hole injuries is limited. The purpose of this study was to better characterize the resultant injuries and identify prognostic factors that predict outcomes from them. We performed a retrospective review of 53 children admitted to the Penn State Hershey Children's Hospital at the Penn State Hershey Medical Center with injuries due to a fall through a hay-hole over 15 years. Compared to urban trauma, hay-hole falls more frequently involve younger children and craniofacial injuries. Although they may result in significant injuries, they are rarely fatal. Greater fall height is associated with longer length of stay (LOS) but not with a greater frequency of intubation, intracranial hemorrhage, or skull fracture. A re-examination of barn design may help to reduce the frequency of this injury type.