There are several definitions of the word “kickback,” and most of them have negative connotations. The Merriam-Webster online dictionary defines kickback as (1) a sharp violent reaction, and (2) a return of a part of a sum received often because of confidential agreement or coercion.1 Kickback, in fact, has several meanings—the Urban Dictionary, an online resource for pop culture terms and phrases, defines the term as “a get-together consisting of close friends, [involving] partying and drinking.”2 There is also a legal definition for kickback—specifically, the federal law that prohibits health care providers and suppliers from giving or receiving “remuneration” for the referral of patients or services covered by most government-run health programs, such as Medicare and Medicaid.

In addition to these more figurative meanings, kickback can refer to the physical reaction that results from a sudden, powerful force, such as the recoil from using a firearm or from starting an unsteadied power tool. One such popular tool is the chain saw, with which the term kickback describes the unexpected upward motion of the guide bar.

History of the chain saw

The first use of a chain handsaw was recorded in 1785 in John Aitken’s Principles of Midwifery or Puerperal Medicine, in which a fine serrated chain was described as having been used to remove diseased bone.3 In 1926, Andreas Stihl patented a 116-pound electric chain saw that required two people to operate. Near the end of World War II, chain saws were still heavy and required two people to operate. In 1949, McCulloch Motors Corp. debuted the world’s lightest chain saw at only 25 pounds. In 1973, the Husqvarna company created the automatic chain break, a safety device consisting of a lever that stops the chain after kickback, preventing injury to the operator.3

Chain saw injuries

According to the Centers for Disease Control and Prevention, approximately 36,000 people are treated annually in hospital emergency departments for injuries resulting from use of a chain saw.4

To examine the occurrence of chain saw-related injuries in the National Trauma Data Bank® (NTDB®) research dataset for 2013, admissions medical records were searched using the International Classification of Diseases, Ninth Revision, Clinical Modification diagnoses codes. Specifically searched were records that contained the following external cause of injury code (E-code): E920.1 (injuries from chain saw). A total of 5,570 records were found, of which 4,701 contained a discharge status, including 4,612 patients discharged to home, 58 to acute care/rehab, and 21 sent to skilled nursing facilities; 10 died. Of these patients, 97 percent were male, on average 45.5 years of age, had an average hospital length of stay of 2.5 days, an intensive care unit length of stay of 2.7 days, an average injury severity score of 4.5, and were on the ventilator for an average of 2.6 days. Injury location was available for 4,635, and most occurrences took place at home (65 percent), followed by industry (28 percent) (see Figure 1).

Figure 1. Location of injury

Location of InjuryWear the right gear

The chain saw is one of the most versatile power tools one can own; however, it cuts both flesh and wood with equal ease. Several safety measures should be taken to avoid injury while operating a chain saw. First, operate, adjust, and maintain the chain saw according to the manufacturer’s direction. Properly sharpen and oil chain saw blades, and choose the proper size saw for the job. Wear the appropriate protective equipment when operating a chain saw, including helmets, face shields, safety glasses, hearing protection, cut-resistant gloves and chaps, along with boots above the ankle.

Observe the above safety recommendations so that when you are done, you can kick back with your friends and family and enjoy the work that you did.

Throughout the year, we will be highlighting NTDB data through brief monthly reports in the Bulletin. The NTDB Annual Report 2014 is available as a PDF file online. In addition, information is available on the website regarding how to obtain NTDB data for more detailed study. To submit your trauma center’s data, contact Melanie L. Neal, Manager, NTDB, at


Statistical support for this article has been provided by Chrystal Caden-Price, Data Analyst, NTDB.


  1. Kickback. 2015. Available at: Accessed June 29, 2015.
  2. Kickback. Available at: Accessed June 29, 2015.
  3. Green A. A brief history of the chain saw. October 12, 2012. Available at: Accessed June 30, 2015.
  4. Preventing chain saw injuries during tree removal after a disaster. Centers for Disease Control and Prevention. Available at: Accessed June 30, 2015.

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