29. Traumatic Injuries in the Pediatric Population

Abstract

In an attempt to describe, understand, and prevent injuries in children, an audit was performed on all traumatically injured children treated in our pediatric emergency department over an 18-month period. This audit was designed to identify how children were injured, what ages are most susceptible to injury, which injuries are most prevalent, and where these injuries occurred. A retrospective chart review of all patients seen in the pediatric emergency department was performed between July 1, 2002 and December 31, 2003 to identify pediatric patients with a traumatic injury. Over this 18-month period, 45,011 patients younger than 17 years were treated in the pediatric emergency department and 6031 were deemed to have sustained a traumatic injury. The number of injured patients seen, age, sex, date and time of injury, place of injury, type and mechanism of injury, and inpatient admission or discharge home were the variables of interest. The results indicate that 2- to 4-year-olds and 11- to 13-year-olds are at greatest risk for traumatic injuries, followed closely by adolescents 14 to 17 years old. Falls were the leading mechanism of injury in 37% of the sample, 6% of which were falls from beds. Sports-related mishaps accounted for 12% of the injuries. Lacerations were the most prevalent type of injury (25%), followed closely by fractures (23%). Most of these injuries (39%) occurred in or around the home, while only 14% occurred at school. Male patients (65%) accounted for the majority of the injuries treated in the pediatric emergency department sample. Given the prevalence (58%) of traumatic injuries in the 2- to 4-year-olds and 11- to 13-year-olds, it is imperative to disseminate information on injury prevention through clinics, schools, clubs, and other organizations working with children and adolescents. Educational programs (ie, Safety Day demonstrations) that focus injury prevention education toward high-risk age groups and the most common mechanisms and types of injuries also must be a goal. Coaches and athletic directors should be targeted for injury prevention education in an attempt to decrease the number of sports-related injuries that occur. Educating medical and nursing staff to improve documentation on the location and mechanism of injury, as well as encouraging use of protective gear and restraints such as seat belts, car seats, and bicycle helmets also may help in the overall injury prevention efforts to reduce traumatic injuries in the pediatric population.