Head injuries in children and implications for their prevention*

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Between October 1986 and September 1987, 7, 967 children presented to the emergency department of the Princess Margaret Hospital for Children for the first time with injuries. Head injuries had been sustained by 3,187 (40%). The data was collected by use of a special form distributed by the nursing staff and completed by parents and medical staff. Information was obtained about the age and sex of the patients, the nature of the injury the site of occurrence, the activity at that time, and the context in which it took place. The use, or otherwise, of safety devices was also recorded. Injury severity was classified as follows: minor, treated in casualty department (80.7%); moderate, admitted to general ward (17.1%); severe, admitted to intensive care (2.2%). Examination of the data showed certain recurring problems, ie surfaces onto which children fell, bicycles, playgrounds, sporting injuries, vehicle accidents, inadequate supervision. Implications for prevention are (1) improved home design, particularly flooring and furniture; (2) better planning of home surroundings, play areas, and equipment; (3) determination of age at which children are capable of riding bicycles and coping with traffic; (4) extension and enforcement of restraint regulations to protect children in vehicles; (5) better supervision of children engaged in sports and recreational activities, and use of safety devices; (6) increased community awareness of the frequency of head injuries, and knowledge of how the numbers can be reduced and the severity diminished; and (7) improved knowledge of child growth and development, and better supervision by all care-givers.

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*

Presented at the 35th Annual Congress of the British Association of Paediatric Surgeons, Athens, September 21–23, 1988.

1

From the Department of Paediatric Surgery, Princess Margaret Hospital for Children, Perth, Western Australia; and the Child Accident Prevention Foundation of Australia (WA Division).

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