Cook Children’s Health Care System is seeing a steep increase in serious injuries associated with these vehicles, including skull fractures, facial fractures, finger amputations and severe extremity fractures.

According to Cook Children's trauma registry data, injuries surged during the first half of 2026 compared with all of 2025. E-bike-related trauma cases increased 500%, rising from eight to 48 cases, while e-scooter injuries climbed 97%, from 29 to 57 cases. Because the trauma registry captures only the most severe injuries, the total number of emergency department visits is even higher.

This surge also saw a widening age gap: while the age range for these injuries so far in 2026 spans 4 to 17 years, the prior year saw a narrower range of 10 to 16 years for e-bikes and 4 to 17 for e-scooter injuries.

During the first two weeks of summer break alone, Cook Children’s treated 25 patients for e-bike and e-scooter injuries and 16 children for other personal electric vehicles. Many of those patients required admission to the Pediatric Intensive Care Unit (PICU).

“With e-bikes, kids are often not wearing appropriate protective gear or helmets,” said Taylor Louden, M.D., medical director of emergency services at Cook Children’s Medical Center – Fort Worth. “Sadly, we have had children struck by cars while riding on the road because they do not understand basic traffic laws.”

The U.S. Consumer Product Safety Commission (CPSC) recommends that children younger than 12 should not operate any e-bike capable of traveling faster than 10 mph.

Dr. Louden emphasized the importance of proper helmets.

“Always wear a helmet when riding anything with wheels,” said Dr. Louden, “For these faster e-bikes, we recommend a BMX-style helmet with face protection.”

Under the Texas Transportation Code, an e-bike is a bicycle with fully operational pedals, a motor of less than 750 watts, and an assisted top speed of 28 mph or less. Texas classifies e-bikes into three categories. While there are no age restrictions for riding a Class 1 or Class 2 e-bike, riders must be at least 15 years old to operate a Class 3 e-bike.

Sharon Evans, trauma injury prevention manager for Cook Children's, said families should remember that e-bikes and e-scooters are vehicles, not toys.

Evans and Dr. Louden offer the following safety tips for families:

Summer Ride Safety for E-Bikes and E-Scooters

• Adult supervision: Children should not ride these vehicles without direct adult supervision. Children younger than 12 should not operate them.
• Always wear a helmet: Make sure your child wears a properly fitted helmet. Helmets are the most important piece of safety equipment, but not all helmets are designed for e-bikes and e-scooters. Check the safety standards below to ensure children are wearing the appropriate helmet for the vehicle’s speed.
  • CPSC: All bicycle helmets sold in the U.S. must meet this standard. These are best for traditional bicycles and low-speed scooters.
  • ASTM F1952: Provides more protection than a standard bicycle helmet and may be good choice for riders traveling at speeds below 20 mph.
  • NTA 8776: Designed specifically for e-bike and e-scooter riders. This is the preferred choice for riders travelling at speeds above 28 mph.
  • DOT FMVSS-218: Provides the highest level of protection on this list and is best suited for higher speeds above or riding near heavy traffic.
    
• Perform a safety check before every ride:
  • Check the tires. Ensure they are inflated to the recommended pressure listed on the sidewall.
  • Test brake levers. Squeeze the brake levers while rolling the vehicle forward and backward.
  • Inspect vehicle. Check for loose parts or anything that appears damaged or abnormal.
    
• Follow the rules of the road:
  • Always ride on the right, in the same direction as traffic. Use the bike lane when available.
  • Stop and look both ways before entering a street or crossing an intersection.
  • Stop at all intersections.
  • Obey all traffic lights and signs.
  • Stay aware of your surroundings. Do not talk on the phone, text, or wear earbuds while riding.
    
• Night rides: Wear bright, reflective clothing and ensure the e-bike or e-scooter is equipped with light and reflectors.

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Sharon Evans, trauma injury prevention manager for Cook Children's Health Care System, explains that, while these may seem like gifts without much concern, it is important to understand they are vehicles. She offers families tips on how to help their children safely enjoy e-bikes and e-scooters. 

“Always wear a helmet,” emphasizes Evans.

• Always wear a helmet: Make sure you have the right helmet. For e-bikes/e-scooters that go up to 20 mph, a bike helmet is sufficient, but parents may want to invest in a stronger helmet to better protect their children.
• Perform a safety check before each ride:
  • Check the tires. Ensure they are inflated to the recommended pressure on the sidewall.
  • Check brake levers. Squeeze them while rolling the bike forward and backward to ensure the brakes engage and stop the e-bike/e-scooter.
  • Inspect your e-bike/e-scooter for loose nuts or anything that looks abnormal.
• Follow the rules of the road:
  • Always ride on the right, in the same direction as traffic. Use the bike lane if available.
  • top and look both ways before entering a street or crossing an intersection.
  • Stop at all intersections.
  • Obey all traffic lights and traffic signs.
  • Be aware of your surroundings. Do not talk on the phone or text. Do not wear earbuds; you cannot hear what is happening around you.
• Night rides: Make sure you wear bright, reflective clothing. Ensure your e-bike/e-scooter has a light and reflectors.

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Dr. Guirola is one of the select group of Cook Children’s doctors who have undergone and completed rigorous training to earn ImPACT credentials. Used by the world’s leading sports authorities, ImPACT is the most widely recognized science-based concussion and evaluation program available today. Cook Children’s has 26 credentialed doctors in nine locations to evaluate a child’s progress on returning to the playing field.

“There’s no evidence that helmets alter concussion risk for young football players,” said Ricardo Guirola, M.D., M.Ed., who specializes in sports medicine. “Helmets do play a protective role in decreasing the risk of fractures, intracranial injuries and oral injuries.”

The recalled helmets were manufactured by Xenith and the U.S. Consumer Product Safety Commission reports that the shells of the helmets can crack, posing a risk of head injuries. Xenith has released a statement saying they have corrected the issue on all helmets manufactured since March 2016. The serial number is printed on a white sticker inside the top of the helmet. For a list of the serial numbers included, visit www.xenith.com/recall.

Along with helmets, Dr. Guirola says young athletes shouldn’t depend on helmet attachments with claims of protecting from head injuries such as bumpers, pads and sensors.

“At this time, there have been no well-controlled studies show that helmets or third-party attachments prevent or reduce the severity of concussions,” Dr. Guirola said.

Awareness regarding the potential negative effects of concussions has increased dramatically in recent years, said Carla Hearl Morton, Ph.D., a pediatric neuropsychologist and also a member of the ImPACT program.

“As we learn more about concussions, guidelines for how best to treat athletes continue to evolve,” Morton said. “Most athletic trainers and coaches have completed several hours of education regarding how to manage a concussion immediately after it occurs. Regardless of any recommendations they may provide, it is a good idea to notify your child’s primary care physician so that his or her doctor can document the concussion in your child’s medical record, provide guidance in the acute phase of recovery, and better coordinate care if symptoms persist.”

To learn more about Cook Children’s ImPACT program, click here.

About the source

Ricardo Guirola, M.D., specializes in Rheumatology and Sports Medicine. Dr. Guirola takes care of athletes and being part of their active and directed therapy. As part of his education, Dr. Guirola obtained a Master's of Education. He uses those skills to teach families, students, residents, nurses and other physicians. Outside of his medical practice, Dr. Guirola spends times with family, runs and plays soccer and tennis.