‘Every day, I see injured children from road traffic accidents’: KKH emergency doctor

SINGAPORE – When a boy just hit by a bus arrived at the hospital in 2024 with head injuries, medical staff quickly reduced the pressure in his brain before operating on him.

The 12-year-old had been cycling and was not wearing a helmet. He suffered a skull fracture and a brain haemorrhage.

He arrived at KK Women’s and Children’s Hospital’s (KKH) emergency department, where staff stopped the bleeding.

Worryingly, a KKH emergency doctor who treated the boy says she sees injured children from road traffic accidents every day.

Traffic deaths hit a 10-year high in 2025, with 149 people killed, compared with 141 in 2016. There were 142 deaths in 2024. The number of people injured has also risen – from 9,342 in 2024 to 9,955 in 2025.

Given the dire situation on Singapore’s roads, The Straits Times has been running a series of stories calling on all road users to be more careful.

Data from the National Trauma Registry shows that only 9.9 per cent of child cyclists and 28.1 per cent of adult cyclists were wearing helmets when road traffic accidents occurred.

The mortality rate for cyclists with helmets is 1.9 per cent, compared with 5.3 per cent for those without helmets.

Brain haemorrhage

The boy had been cycling to his tuition centre in Tampines when he was knocked over by a bus in August 2024.

He was first taken to Changi General Hospital (CGH) before being transferred to KKH after doctors discovered the brain haemorrhage, which can increase the pressure in the skull and damage the brain.

This can affect a person’s breathing ability, heart rate and blood pressure, and even leave a person in a permanent vegetative state or cause brain death, said Dr Supranee Mathiprechakul, who was one of the emergency doctors who tended to the boy.

By the time the boy reached KKH, the haemorrhage had more than doubled in size from the initial scan at CGH.

“The head is like a fixed space. If there’s bleeding, this causes more pressure in the (skull), which can squeeze the brain through the base opening of the skull, where the brain connects to the spinal cord,” Dr Supranee said. “If important parts of the brain get squeezed, it can cause the patient to stop breathing, stop their heart from beating, or cause brain death.”

If the brain bleed worsens and puts pressure on the brain, patients might have to undergo a craniotomy, where surgeons cut open their skull to relieve the pressure.

Dr Supranee said younger patients tend to be more prone to head injuries as their heads are larger in proportion to their bodies.

If they are hit by a vehicle and get flung, they tend to fall head first, which leads to a higher chance of head injuries.

The boy’s mother, Madam Vivian Liau, 43, a civil servant, was at work when CGH called her.

Her son underwent a brain operation that lasted over three hours, and was hospitalised for nearly two weeks.

She said: “I was quite emotional when I saw him in the hospital. I’ve cycled with him on that route before, and reminded him to use the pedestrian crossing, but I didn’t think he would meet with an accident at that very spot.”

Madam Liau said that after surgery, her son had difficulty reading and balancing himself. He underwent speech therapy and physiotherapy to regain his balance.

Although brain injuries cannot be reversed, neuroplasticity, which is the brain’s ability to adapt to injury, can help patients regain normal functions, said Dr Supranee.

As he was unable to sit his PSLE, the boy was posted to a secondary school based on his academic results in Primary 5 and Primary 6. Madam Liau said he is coping well in school.

Daily cases

Asked about how often children are taken to KKH’s emergency department, Dr Supranee said: “Every day, I see injured children from road traffic accidents.

“The majority of them suffer minor injuries and can be discharged on the same day. A few of them have to be admitted. The smallest proportion of patients require significant intervention like surgery.”

Other than head injuries, children who are involved in road traffic accidents might sustain soft tissue injuries that can progress and deteriorate later.

Dr Supranee said this is because children’s bones are more pliable and less likely to break. However, the impact can cause soft tissue injuries that are not discovered until the child’s condition deteriorates.

She added that cyclists on footpaths and park connectors can also suffer serious injuries.

Dr Supranee said: “We are seeing more cases of teenagers who go road biking. Some go at 20kmh to 30kmh, so when they fall, they can get facial, spinal or abdominal injuries. When a bicycle handlebar hits the abdomen, it can cause lacerations in the liver and the spleen, which can lead to significant bleeding.”

She urged parents to get safety gear such as helmets and proper footwear for their children as these can reduce the severity of injuries.

If a child gets into an accident, parents should call for an ambulance and not move the child unnecessarily as this might worsen any possible injuries.

And parents and caregivers should always remain vigilant when crossing the road.

Dr Supranee said: “For younger children, it’s important to have enough adults around because it can be difficult for one adult to look out for three children (at once).”