Last month, a six-year-old boy was run over by a bus. He died. In April, an e-scooter hit an 11-year-old girl. She needed several stitches to her gums and suffered abrasions on her head, face, elbow and knees.

On the same day, a six-year-old boy was also hit by an e-scooter.

These are not isolated cases. Children – who are sometimes restless on the roads and sometimes hidden from the view of drivers, given their small size – are at high risk of being involved in traffic accidents.

Given the fact that many of them do not wear restraints or protective headgear, such accidents can often leave them seriously injured.

Last year, three children aged 12 and younger died in road accidents.

Hardly a day passes without a child victim of road accidents taken to the emergency department of KK Women’s and Children’s Hospital (KKH). Many are also sent to other hospitals.

The majority of these children, defined as 16 years or younger, had not worn any protective gear or restraints.

A study of 1,243 children admitted to KKH between January 2011 and June 2014 found that two in three young cyclists, pillion riders and passengers involved in accidents had no headgear, seatbelts or booster seats.

The authors of the study published in the Singapore Medical Journal said use of protective headgear and restraints was “worryingly low”, especially among children who were seriously injured.

They said unprotected children in vehicle accidents were 8.4 times more likely to suffer serious harm than those with protection.

Dr Chong Shu-Ling of KKH said a child of 10kg who was unbelted in a collision at 50kmh “meets a force approximately equivalent to being dropped from a 9.85m height or three storeys”.

Six in 10 of these child accident victims were passengers in cars, three in 10 were pedestrians and one in 10 was a cyclist.

Of the children who needed to be hospitalised, 32 were warded in intensive care, 26 in high dependency and 308 in a general ward.

The rest were discharged after treatment at the emergency department.

Dr Sashikumar Ganapathy, one of the authors of the study and a consultant at the children’s emergency department of KKH, said some children with seemingly minor injuries were also warded as their condition could have worsened.

He said: “Based on how the injury happened, we may be able to anticipate whether the child’s condition may potentially deteriorate and admit him or her for monitoring.

Not all traumatic injuries are clinically evident at the time of presentation.

Monitoring is therefore required to detect any deterioration.”

About 28 per cent of the injured children were pedestrians. But they accounted for more than half the children who were seriously injured, making them a “highly vulnerable group”.

The authors, quoting international studies, said that child pedestrians were uniquely vulnerable as they were prone to errors of judgment and might find it hard to control their impulses.

“Given their small physical size, drivers’ view of them is easily obstructed,” the authors said.

The children were mostly aged between six and 10, with more boys than girls among the victims.

The police said the number of children aged 12 and younger involved in road accidents went up from 188 in 2013 to 241 in 2015, before sliding to 227 last year.

The authors, all doctors, suggested starting road safety lessons from the age of five, while the children are in kindergarten.

Their parents and guardians also needed to remind them of the need for protection, given “the dismal rate of use of appropriate restraints/ protective headgear for children while on the road,” the authors said.

Singapore Road Safety Council chairman Bernard Tay agreed with the doctors.

“Young children must remember that the roads are dangerous,” he said, adding that road safety lessons should be part of the school curriculum.

Mr Tay said it is especially important for parents and guardians to be good road safety models and take full responsibility for their children’s safety on the roads.

Tips to keep children safe

Safety tips from doctors at KK Women’s and Children’s Hospital.

Traffic accidents

• Ensure protective helmet is properly fitted for activities like skateboarding, roller blading, skating or cycling.
• Teach the child road safety habits. Do not allow the child to play or go on the roads unsupervised.
• Ensure the child puts on age-appropriate seat belts or booster seat restraints while in a vehicle. Kids under 13 should not ride in front passenger seat.

Poisoning

• Ensure young children are supervised at all times.
• Keep all medicines away from kids under the age of 12.
• Double-check name and dose before giving medicine to kids.
• Do not give medication meant for adults to children without first consulting a doctor.
• Consult a doctor immediately if a child is suspected to have had overdose of medication or taken the wrong medication.
  Take along the medication that was ingested and its packaging if available. Similarly, if a child is suspected of ingesting a household product, even if he or she appears well.
• Do not attempt to induce vomiting after a child has ingested a potential toxin.
• Call 995 if the child has a seizure, loses consciousness, complains of breathlessness or severe abdominal pain after a possible overdose/ingestion.