Childhood injury: Significance and prevention strategies

doi:10.1016/S0882-5963(96)80095-9

Journal of Pediatric Nursing

Volume 11, Issue 4, August 1996, Pages 225-232

https://doi.org/10.1016/S0882-5963(96)80095-9 Get rights and content

Unintentional preventable injury is the number one killer of our children. Each year more children die of injuries than of all childhood diseases combined. It is important for nurses to understand the epidemiology and significance of childhood injury. This article discusses developmental and environmental factors that influence the child's probability of sustaining an unintentional injury and offers suggestions for client, family, and community injury prevention efforts for nurses.

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Cited by (31)

The characteristics of children referred to a child protection team in Japan and factors associated with decision-making: A retrospective study using a medical database
2022, Child Abuse and Neglect
Citation Excerpt :
The high proportion of young children referred is consistent with findings from previous studies (Benbenishty et al., 2014; Louwers et al., 2011). The youngest children are most at risk of both injury and maltreatment (Crawley, 1996; U.S. Department of Health, & Human Services, Administration for Children and Families, Administration on Children, Youth and Families, Children's Bureau, 2022; Schnitzer, 2006). In our study, medical personnel from emergency-care-related departments often reported these cases to the CPT, presumably recognizing that the youngest children are most at risk for injury and maltreatment.
Despite the potential efficacy of hospital-based multidisciplinary child protection team (CPTs), research analyzing Japanese CPT databases is scarce.
We aimed to describe the characteristics of children and families reported to a CPT in Japan and investigate factors associated with the substantiation of maltreatment.
This retrospective, cross-sectional study took place in a national children's hospital in Japan and included 350 children who were reported to CPTs between April 2014 and March 2018.
Univariable and multivariable logistic regression analyses were conducted using the CPT database and medical records.
Among 350 cases, 33.4 % were substantiated. Children of <6 years of age comprised 73.4 % of the cases. The majority (67.7 %) received an injury-related diagnosis and physical maltreatment was suspected in 68.3 % of cases. In the univariable analysis, older age, a primary diagnosis other than injury, reporting department, psychological maltreatment, witnessing intimate partner violence, maltreatment by relatives other than biological father or mother, developmental disability, emotional/behavioral difficulty or psychological disorder, maternal/paternal psychological difficulty, and maternal history of maltreatment were significantly associated with substantiation. When adjusted for demographic, child and familial factors, a diagnosis other than injury (AOR 2.02, 95 % CI = 1. 11–3.65) and parental psychological difficulties (AOR 2.49, 95 % CI = 1.37–4.55) were independently associated with substantiation.
Most cases reported to our CPT were young children with an injury-related diagnosis. Substantiation was associated with a diagnosis other than injury and parental psychological difficulties. Further prospective and comprehensive studies are needed to establish universal guidelines for databases of hospital-based CPTs.
Patterns of unintentional fatal drowning among children in North Tunisia: A 10-year study
2022, Revue d'Epidemiologie et de Sante Publique
Citation Excerpt :
A study by the Global Burden of Disease in 2017 stated that an average of 295,210 people died from drowning per year [2]. While the rate was higher in 1998, when nearly half a million deaths were due to drowning, the current numbers are still alarming [3]. Results from different studies around the world have shown that drowning is one of the leading causes of death among children [4,5].
This study aims to better understand patterns of unintentional fatal drowning among children in North Tunisia.
A cross-sectional retrospective study including all unintentional fatal drowning among children was conducted in the Legal and Forensic Medicine department in the Charles Nicolle Hospital, Tunis, between January 2010 and December 2019. Socio-demographic variables, as well as death circumstances, were documented for each victim and analyzed.
A total of 200 casualties were included in this study. The highest rate of deaths was observed in the summer (N=44). Most of the victims were males and 55.5% were aged between 13 and 18 years. The drowning occurred in a canal or the sea in 33.5 % and 29.5 % of the cases respectively. The distribution of drowning sites varied significantly by season and place of living: drowning in the sea was more likely to occur in the summer and in urban areas (p < 0.05). In the first years of life, drowning occurred mostly in buckets and wells (N=9 and N=10, respectively) while between 7 and 18 years, it was more frequent in a canal or the sea. Swimming was the leading activity before death in 50% of the cases.
Unintentional fatal drowning among children remains an underestimated major health problem in Tunisia especially in the population aged from 7 to 18 years. Effective prevention measures should be implemented nationwide, especially around seas and canals.
Cette étude vise à mieux comprendre la tendance des noyades accidentelles et mortelles chez les enfants dans la région du nord de la Tunisie.
Il s'agit d'une étude transversale rétrospective incluant toutes les noyades accidentelles et mortelles chez les enfants autopsiés dans le service de médecine légale de l'hôpital Charles Nicolle de Tunis, entre janvier 2010 et décembre 2019. Les variables socio-démographiques, ainsi que les circonstances du décès, ont été analysées pour chaque victime.
Un total de 200 victimes a été inclus dans cette étude. Le taux de décès le plus élevé était observé pendant l'été (N=44). Les victimes étaient majoritairement de sexe masculin et 55,5 % avaient un âge compris entre 13 et 18 ans. La noyade s'est produite dans un canal ou en mer dans 33,5 % et 29,5 % des cas respectivement. Le lieu de la noyade variait selon la saison et le lieu d'habitation : la noyade en mer était plus susceptible de se produire en été et dans les zones urbaines (p < 0,05). Au cours des premières années de vie, les noyades avaient lieu surtout dans des seaux et des puits (N=9 et N=10, respectivement), tandis qu'entre 7 et 18 ans elles survenaient surtout dans un canal ou en mer. Dans 50 % des cas, les victimes étaient en train de nager au moment de leur décès.
Les noyades accidentelles et mortelles chez les enfants restent un problème de santé publique sous-estimé en Tunisie, surtout dans la population âgée entre 7 et 18 ans. Des mesures de prévention efficaces devraient être mises en œuvre à l'échelle nationale, notamment autour des canaux et de l'eau de mer.
The medico-legal evaluation of injuries from falls in pediatric age groups
2015, Journal of Forensic and Legal Medicine
Citation Excerpt :
Lallier et al. found that head injuries were the most common type of injury, occurring in 39% of cases within the pediatric population.8 Review of the literature has shown that our study has similar results with different populations.11–15 In the current study, which consists of the pediatric age group, the most common type of injuries were head injuries, observed in 52.3% of all injuries, followed by soft tissue, musculoskeletal (extremity injury), multiple (head, thorax, abdominal and extremity), and thoracoabdominal injuries.
Blunt trauma from accidental falls or intentional jumping from great heights occurs frequently in forensic medicine. The goal of this study was to investigate injuries due to falls in children under 19 years of age.
Injuries from falls are the leading cause of visits to emergency departments and to deaths due to injuries. Various methods are used in the classification of falls. In this study, we have classified falls as “high-level” (≥5 m), “low-level” (<5 m) and “ground-level”.
We have retrospectively evaluated 814 boys (61.18%) and 512 girls (38.62%), making up a total of 1326 children (under 19 years old) with the mean age of 7.85 ± 3.46, that were admitted to State Hospital between January 2009 and December 2013 due to falls from heights and falls on ground-level. Falls were low-level in 738 cases, high-level in 176 cases, and ground-level in 412 cases. Cases were categorized by gender, age, age group, fall height, Glasgow Coma Scale (GCS), injured body part(s), mortality rate, and distribution according to months.
In conclusion, falls merit attention because of their high risk of mortality and morbidity, as well as their burden on medical budgets. If the medico-legal aspects of falls were evaluated with regard to preventive event or death, the importance of the topic could be better understood.
An ecological stance on risk and safe behaviors in children: The role of affordances and emergent behaviors
2015, New Ideas in Psychology
Citation Excerpt :
For instance, children aged 0–4 year shows the highest rate of drowning, whilst traffic injuries are the leading cause of death among 15–19-year-olds (Peden et al., 2008). Boys tend to have more severe and more frequent injuries than girls (Crawley, 1996; Moorin & Hendrie, 2008; Peden et al., 2008). Characteristics related to a child's temperament, such as the activity profile, impulsivity and distractibility, have also been related to accidental injuries (e.g., Manheimer & Mellinger, 1967; Pless, Taylor, & Arsenault, 1995).
Unintentional injuries are a major cause of disability and death among children. Initial strategies to address child safety issues have primarily either focused on the environment, trying to identify “risk environments”, or on the individual, trying to identify “at risk children”. More recently, the interaction between child and environment is starting to be addressed in order to enhance the understanding of childhood injuries. The present review suggests a framing of these studies in ecological theory, which implies that children with certain characteristics perceive certain affordances in the environment. In this context, risk may be considered a relational concept. The literature on risk prevention is reviewed and the role of caregivers in managing affordances is emphasized.
Contributing factors to preschool unintentional injury
2005, Journal of Pediatric Nursing
Injury is the leading cause of death and disability for preschoolers in the United States. Young children suffer disproportionate morbidity and mortality when injured. Pediatric nurses modify injury risk through injury prevention strategies and child and family education. Effective injury prevention programs cannot be designed, implemented, or evaluated without a fundamental understanding of the factors that contribute to the phenomenon of preschool unintentional injury. This article includes a discussion of the factors that contribute to preschool unintentional injury occurrence and is based on a combination of epidemiology theory and the health belief model. Evidence-based suggestions for modification of nursing practice are provided.
Influence of fall height and impact surface on biomechanics of feet-first free falls in children
2004, Injury
Objective: The objectives of our study were to assess biomechanics associated with feet-first free falls in 3-year-old children and to investigate the influence of impact surface type and fall height on key biomechanical measures associated with injury risk. Methods: Repeatable feet-first free fall experiments were conducted in a laboratory mock-up environment using an instrumented Hybrid II 3-year-old test dummy. Impact surface type and fall height were varied to examine their influence on biomechanical measures. Results: Feet-first falls from short distances (27 in.) (0.69 m) were found to have a low risk of contact-type head injury, regardless of impact surface type. When comparing different types of impact surfaces in a 27 in. (0.69 m) fall, head acceleration associated with falls onto playground foam was significantly less than that associated with falls onto wood, linoleum or padded carpet. For falls onto playground foam, femoral compressive loads and bending moments were found to significantly increase as fall height increased. Conclusions: Impact surface type and fall height were found to influence biomechanics associated with injury risk in feet-first free falls as assessed through experimental mock-ups using an instrumented child test dummy. Feet-first falls from short distances (27 in.) (0.69 m) were associated with a low risk of contact-type head injury as assessed using HIC, irrespective of impact surface type.

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Childhood injury: Significance and prevention strategies

Child motor vehicle injury

American Journal of Diseases of Children

On-lap travel: Still a problem in motor vehicles

Pediatrics

The injury fact book

Minor head injury in children: Out of sight but not out of mind

Journal of Clinical Child Psychology

Pediatric firearm injuries: Time to target a growing population

Pediatric Annals

Childhood burn injury

Chicago Medicine

(Iowa SPRAINS Data. Total farm-related injuries and fatalities in Iowa in 1992 & 1993)

Farm Safety Just 4 Kids

Accidental toddler drowning in 5-gallon buckets

Journal of the American Medical Association

Advance report of final mortality statistics, 1992

The causes, cost, and prevention of childhood burn injuries

American Journal of Diseases of Children

Disability from bicycle-related injuries in children

The Journal of Trauma

Data from the National Vital Statistics System. Office of Analysis and Epidemiology

U.S. Department of Transportation