E-bike and E-scooter accidents: What emergency doctors want riders and parents to know
Electric bicycles and scooters, commonly known as e-bikes and e-scooters, have become a common sight in neighborhoods, parks and borough streets throughout communities across the Philadelphia region. They offer a fun, affordable way to get around, but they also come with risks that many riders don't fully understand. As emergency departments across the U.S. treat more people injured in e-bike and e-scooter crashes, health experts, including one of our own trauma physicians, are urging riders and parents to take safety seriously and respect them as powerful vehicles that require training, attention and safe riding habits.
Why more kids and adults are riding e-bikes and e-scooters
E-bikes and e-scooters are popular because they're convenient, easy to use and can help reduce traffic congestion. More commuters, teens, tourists and delivery workers are turning to electric-powered transportation. Part of the challenge is that many riders may view e-scooters as toys and e-bikes as upgraded bicycles. In reality, some models can reach speeds that are much faster than traditional bikes and require greater skill to operate safely.
But as their popularity grows, so does the number of injuries. The Consumer Product Safety Commission (CPSC) reported that between 2017 and 2024:
- E-bikes were associated with 155,200 emergency department (ED) visits and 310 deaths
- E-scooters were associated with 380,000 ED visits and 206 deaths
What emergency departments are seeing
"We're seeing more patients arrive in emergency departments after e-bike and e-scooter crashes than we did just a few years ago," says Deviney Rattigan, MD, trauma and acute care physician at Main Line Health who rides an e-bike to work.
Trauma and emergency providers are seeing more serious injuries from e-bike and e-scooter crashes than many people expect. According to Dr. Rattigan, "Many of those injuries involve fractures, concussions and significant road rash that require medical treatment."
Common injuries include:
- Concussions and traumatic brain injuries
- Broken wrists, arms and collarbones
- Facial injuries and dental trauma
- Cuts and road rash
- Chest and abdominal injuries
- Internal bleeding from high-speed crashes
Unlike a typical bicycle fall, riders can be thrown farther and hit the ground with greater force because of the speed and weight of these devices. Children and inexperienced riders may be especially vulnerable. Children younger than 15 years old accounted for 9% of e-bike-related and 17% of e-scooters-related ED visits and 2% of e-bike and 5% of e-scooter deaths between 2017 and 2024 as tracked in the CPSC report.
"Many riders view e-bikes and e-scooters as recreational devices, but from a trauma perspective, we often see injuries that look much more like motorcycle crashes than traditional bicycle falls," explains Dr. Rattigan.
"Head injuries remain one of our biggest concerns, particularly when riders aren't wearing helmets."
Head injuries are a big concern, yet are preventable
Head injuries are among the most serious consequences of e-bike and e-scooter crashes. A helmet can significantly reduce the risk of severe injury, yet many riders choose not to wear one, as shown in the CPSC report that 37% of e-scooter patients treated in EDs had not worn safety equipment, such as a helmet.
"The single most effective step e-bike and e-scooter riders can take to reduce the risk of severe injury is wearing a properly fitted helmet every time they ride, regardless of how short the trip may be," explains Dr. Rattigan.
Seek immediate medical attention if a rider develops:
- Loss of consciousness
- Vomiting
- Severe headache
- Confusion
- Difficulty walking
- Vision changes
- Excessive drowsiness
- Dizziness or vertigo especially with sitting up or standing and walking
How to ride an e-bike or e-scooter safely
Be a rider who is ready for the road
Riding an e-bike requires more than balance and coordination. Riders need to understand traffic laws, recognize hazards and know how to react in unexpected situations. This is especially the case for younger e-bike and e-scooter riders.
"Children and teenagers may have excellent balance, but they often don't have experience driving, so they may not recognize the hazards of the road. They are essentially driving a motorized vehicle without any formal driving instruction and therefore may not anticipate or react appropriately in an emergency," says Dr. Rattigan. "That's where we see many preventable injuries."
The American Academy of Pediatrics recommendation is that children younger than 16 should not ride e-bikes. Pennsylvania law also requires riders to be at least 16 years old to operate an e-bike.
Use the right safety gear
Always:
- Wear a properly fitted helmet
- Consider gloves, knee pads and elbow pads
- Dress in bright or reflective clothing
- Use front and rear lights to be more easily recognized by cars
- Consider installing rearview mirrors on your helmet or handlebars
- Stay hydrated and dress appropriately for the weather
Follow the rules of the road
- Obey traffic signs and signals
- Ride in the same direction as traffic
- Use bike lanes when available
- Watch for turning vehicles at intersections
- Leave plenty of space between yourself and others
- Make sure you're well versed in the local laws for street vs sidewalk riding
- Make sure you always use proper hand signals
Pennsylvania law treats e-bikes and e-scooters differently:
- E-bike laws: Riders do not need a license, registration or insurance to operate a qualifying e-bike, but e-bike riders must be at least 16 years old
- E-scooter laws: e-scooters cannot be legally operated on public roads because they do not meet registration and equipment requirements
Pennsylvania riders can learn more through the PennDOT's overview of current laws for e-bikes and e-scooters, which includes helmet, lane and speed requirements. The laws may differ in your specific county or town, so check the regulations where you live before riding an e-bike or e-scooter.
Maintain your equipment
Before each ride:
- Check tire pressure
- Test the brakes
- Confirm lights are working
- Inspect the battery for damage
- Make sure handlebars and seats are secure
- Get annual maintenance, especially if you haven't ridden for a while
Prevent distractions
Keep your attention on the road by avoiding:
- Texting
- Phone calls (if you must take a call, pull over to a safe area)
- Watching videos
- Wearing earbuds or headphones that block surrounding sounds
Questions parents should ask before buying
If your child is over 16, they are old enough to ride an e-bike according to Pennsylvania law. However, before purchasing an e-bike or e-scooter for your child, consider:
- Can your child safely ride a traditional bike or scooter?
- Is your child mature enough to follow traffic laws?
- Can your child judge vehicle speeds and distances?
- Does your school district offer a safe riding course?
- Does this device travel faster than your child can safely manage?
- Do we have a properly fitted helmet?
- Where will the battery be charged and stored?
- Does the battery carry a certification by UL Solutions, which indicates it has been independently tested for safety?
These questions can help families make safer decisions before a child ever takes their first electric ride.
Are e-bikes more dangerous than traditional bicycles?
Yes, due to their high speeds, e-bikes can be more dangerous than traditional pedal bikes. The same goes for e-scooters. In fact, the Consumer Product Safety Commission (CPSC) reported that between 2017 and 2024:
- E-bikes were associated with 155,200 emergency department (ED) visits and 310 deaths
- E-scooters were associated with 380,000 ED visits and 206 deaths
- 15% of ED injuries were people who were struck, but not riding, an e-bike
- 44% of accidents treated at an ED did not involve a car or a truck
- 52% of e-bike- and 39% of e-scooter-associated visits to EDs were on streets or highways
But if you take proper precautions, you can be as safe on an e-bike as a traditional bicycle.
Why can e-bikes and e-scooters be more dangerous than they look?
Several features make these devices harder to handle than many people realize:
- Faster acceleration than pedal bicycles
- Smaller wheels that are more affected by bumps and potholes
- Quiet motors that are easy for others, like car drivers, to miss
- Little to no formal training requirements
- A false sense of confidence due to their ease of use
These factors can turn a small mistake into a serious injury.
What are common causes of e-bike and e-scooter accidents?
Rider error
Many crashes happen because riders lose control. 11% of e-scooter injuries at EDs were due to rider distraction, such as from cell phone use or loud music, according to the CPSC report.
Common errors include:
- Riding too fast
- Inexperience with throttle or braking systems
- Distracted riding
- Riding under the influence of alcohol or drugs
- Carrying passengers on devices designed for one rider
Environmental hazards
Road conditions can quickly become dangerous for riders.
Watch for:
- Potholes
- Loose gravel
- Wet pavement
- Debris in bike lanes
- Poor visibility during rain or at night
Collisions with cars and pedestrians
Car and truck drivers may not expect a rider to be moving as fast as an e-bike or e-scooter can travel. Riders on e-bikes and e-scooters may also struggle to stop quickly in crowded areas, increasing the risk of collisions with pedestrians, cyclists and cars.
Battery fires: A risk many overlook
Injuries aren't limited to crashes. The lithium-ion batteries that power e-bikes and e-scooters can overheat, catch fire or explode if damaged, improperly charged or paired with incompatible chargers. Cheap aftermarket batteries can create additional safety concerns.
To reduce risk:
- Choose products with UL-certified batteries and chargers
- Follow the manufacturer's charging instructions
- Do not charge batteries that are damaged or swollen
- Avoid charging batteries in extreme heat or cold
- Store batteries in a cool, dry place
- Check the CPSC website for recalls
Who is at higher risk of e-bike or e-scooter injuries?
Anyone can be injured, but some groups face greater risk.
Children and teens
Younger e-bike and e-scooter riders typically haven't yet developed the required balance and coordination skills or ability to recognize hazards and react appropriately when traffic conditions change. As such, the American Academy of Pediatrics recommends that children younger than 16 not ride e-bikes, and Pennsylvania law echoes with the same age minimum.
First-time riders
Rental e-scooters and borrowed e-bikes can create problems when riders are unfamiliar with the equipment's acceleration, braking and handling. Also, rentals often have no licensing requirements before using.
Night riders and commuters
Limited visibility increases the chance of a crash with a vehicle or pedestrian.
Delivery workers
Pressure to meet deadlines may encourage riskier riding behaviors among people delivering items as part of the gig economy.
Do children need a helmet on an e-bike and e-scooter?
Yes, Pennsylvania law requires riders younger than 12 to wear a helmet while riding a bicycle as well as e-bikes and e-scooters. However, helmets are recommended for riders of all ages and all types of bikes and scooters. Specialized helmets for motocross may provide extra protection for the higher speed electric formats.
Can e-bike and e-scooter batteries catch fire?
Are e-scooters legal in Pennsylvania?
Not at the moment, but continue to check the PA Vehicle Code for any changes in the law.
What should I do after an e-bike or e-scooter accident?
Check your body for severe injuries. If you are losing consciousness or vision, vomiting, have a severe headache, are confused, can't walk or feel drowsy, seek immediate medical care.
Have fun while staying safe
Riding an e-bike or e-scooter can be a fun and efficient way to travel, but they deserve the same respect as any other vehicle. Understanding the risks, following traffic laws, wearing a helmet and maintaining your equipment can help prevent many serious injuries. Our resident e-bike rider lives out this advice in her own life:
"I am very passionate about e-bike use as an environmentalist, an athlete and a health care worker, and I often opt to ride mine to work rather than drive. But I am honor-bound as a trauma doctor to advocate strongly for prevention and risk reduction," explains Dr. Rattigan.
"To that end, I don't care how silly I look. I always wear light-colored, weather-appropriate clothing, a reflective vest, tapered pants and a well-fitting helmet. I always use my front and rear lights, and I have a rearview mirror. I stay hydrated, keep my speed under control, brake gradually and yield to cars and trucks even if I have the right of way. And if I look outside and it is dark, icy, rainy or even just if the ground is wet, I find another way to work."
Whether you're an adult rider or a parent considering a purchase for your child, a few simple e-bike or e-scooter safety steps today can help prevent and e-bike or e-scooter accident and trip to the emergency department tomorrow.
Next steps
If you've been injured in an e-bike or e-scooter accident or have concerns after a crash, seek medical attention right away.
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