By Andrew Kiragu, MD, FAAP, Medical Director, Pediatric Intensive Care Unit, Hennepin County Medical Center, and Assistant Professor of Pediatrics, University of Minnesota
Almost invariably, with warmer weather comes plenty of Emergency Department and physician office visits for management of childhood injuries.
Trauma is the leading preventable health problem for children. According to data from the Centers for Disease Control and Prevention (CDC), unintentional injuries are the leading cause of death in the United States among children and teens aged 1–19 years. In fact, injuries kill more children than all other diseases combined, accounting for 37 percent of all deaths in this age group in 2009.
The economic toll is great; injuries are the leading cause of health care spending for children age 5 to 14 years. Annual lifetime cost of all injuries were estimated at $406 billion in 2006. While these numbers are high, the personal cost to children and families from a debilitating injury or death is immeasurable. The high incidence and preventable nature of child and adolescent unintentional injuries highlight the need for public health action.
There is much that we, as pediatricians, can do to aid in this effort and this principally revolves around talking to our patients and their families about injury prevention.
Safety Equipment
Discussion about the need for proper safety equipment like bike helmets is key. It is important that parents also model proper use of these safety devices since children take their cues regarding personal safety from their parents and because these devices can be life saving.
Last summer we admitted a teenage boy who was struck while riding his bicycle across a busy street. He sustained a mild traumatic brain injury and a number of cuts and bruises. The entire incident was caught on camera by a neighbor’s CCTV cameras. A review of the footage revealed what a horrible crash it had been. What is most remarkable about this story is that our patient was able to go home the following day because he had been wearing a bicycle helmet, which bore the brunt of the impact. At the very least, it prevented a more severe brain injury and at most, it saved his life.
Children in motor vehicles should use age-appropriate safety restraints, including child car seats and booster seats.
Safety while playing organized sports is also important. The importance of proper equipment and training in order to minimize the risk of serious injury cannot be overstated. To prevent and better recognize sports-related brain injuries, the CDC’s Heads Up Campaign provides athletes, parents and coach’s information about the recognition of sports-related concussions and advice about what to do when a concussion has occurred. Indeed, efforts by professional sports organizations to protect their players and move away from the previous almost nonchalant approach to sports-related concussions have increased societal recognition of these injuries.
Water Safety
With summer approaching, water safety is also very important. Drowning is a leading cause of injury-related death in children. About 20 percent of those who die from drowning are children ages 14 and younger. For every child who dies from drowning, another five receive emergency department care for nonfatal submersion injuries.
As educators and advocates, pediatricians can play an important role in the prevention of drowning through direct counseling, educational material and other resources. Pediatricians should also emphasize the need for close, non-distracted adult supervision of young children near any body of water.
Adequate fencing for pools, drain covers and other pools construction techniques to prevent entanglement and swimming lessons are other ways that drownings can be prevented.
The AAP recommends swimming lessons for children 4 years or older and no longer issues an advisory against swimming lessons or other aquatic experiences for children of any specific age. As part of the counseling of parents and adolescents, information should be shared with them about the risks associated with drug and alcohol use during any activity, especially water-related activities.
There is a lot more that can be done to protect our children including increased efforts in education about safety while engaged in recreational activities, work to prevent traumatic brain injury (especially those related to organized sports), engineering to improve the vehicles we drive in, safety equipment we use, and so on. There are also enforcement and legislative aspects to injury prevention. Our nation’s laws have been instrumental in helping to protect the most vulnerable in our society and we, as pediatricians, should play an integral role in encouraging our legislators to formulate laws that protect children.
Have a wonderful and safe summer!
References:
Morbidity and Mortality Weekly Report; April 16, 2012 Centers for Disease Control and Prevention; Unintentional Drowning: Get the Facts
AAP Committee on Injury, Violence, and Poison Prevention. Prevention of Drowning; Pediatrics 2010 126: e253 -e262
