Chris Rhea doesn't really remember the impact after he lost his grip on the golf cart during a sharp turn and fell off the back. But he has heard about the sound.
"They said it sounded like a shotgun went off when I hit my head," the 25-year-old said. "I don't really remember. I think I blacked out for maybe a second or two."
His case was one of 68 golf cart-related injuries between 2000 and 2009 that turned up in an analysis of records at Medical College of Georgia Hospital.
The study in Otolaryngology-Head and Neck Surgery found 69 percent of those were head injuries and more than 60 percent of the injuries were to children, with an average age of 9.2 years old.
That is nearly twice the rate of a national study in 2008 that found 31.2 percent of the injuries were to children, and that injuries from golf carts had increased 130 percent between 1990 and 2006.
The high rate in children was not a surprise but "very much worried me," said Dr. Brian J. McKinnon, an assistant professor of neurotology/otology at Georgia Health Sciences University and one of the study's authors.
"When you go around the local areas, we're seeing more and more golf carts around. And we're seeing more and more children in the golf carts," he said. And it is often the children, sometimes teenagers, driving.
"And of course invariably they have kid brother or sister hanging on, because it is fun," McKinnon said. "I'll be honest with you, driving a golf cart when I was a kid was fun. And it's innocent. If you think about it, what could possibly go wrong? So there's the other aspect of it: There is a false sense of security with the golf cart."
With the injured adults, there was also another factor that might have figured into the injury: Nearly 60 percent had been drinking alcohol, and a lot of it, with an average of more than double the legal limit to drive.
Riding in a golf cart often requires a certain amount of response in order to not be thrown out by a sudden shift.
"Children do not have the level of awareness. They're easily distracted and therefore they may not be prepared," McKinnon said. "The patient who is impaired does not have the judgment."
Golf carts often lack seat belts and could use a better braking system on all wheels or the front wheels, McKinnon said.
State laws about who can drive a golf cart vary, he said. Georgia and South Carolina require a licensed driver, but Georgia yields to stricter local ordinances, such as the ones in Richmond and Columbia counties.
Golf cart maker E-Z-Go distributes a safety brochure with every vehicle.
"We are very conscientious about telling people that you absolutely should not use a golf car or any light transportation vehicle under the influence of drugs or alcohol," said Brandon Haddock, the company's manager of marketing communications.
Children should be big enough to sit with their feet firmly on the floor of the vehicle, and it should never be overloaded, Haddock said.
"People shouldn't cram three, four, five people onto a golf car seat or onto the vehicle," he said.
McKinnon said it is a multifaceted problem and all aspects will need to be addressed to help reduce the injury rate.
"We can improve the safety of these; unfortunately we also need to improve the safety of the driver, too," he said. "Education would be a big aspect, as well as changing the design."
Rhea, who was 21 at the time of his wreck, said he is not concerned about riding in golf carts in his current job at Jones Creek Golf Club. But he is more cautious about other activities that might cause another head injury.
His fall fractured the temporal bone on the side of his head, severed his olfactory nerve and put him in the hospital for four days.
"I can't smell or taste anything," he said. "Other than that, I was lucky."