Prevention Book

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Unintentional Childhood Injuries

Aka: Unintentional Childhood Injuries, Unintentional Childhood Injury, Injury Prevention in Children, Accidental Trauma in Children
  1. See Also
    1. Child Safety Seat
    2. Crib Safety
    3. Gun Safety
    4. Pet Safety
    5. Infant Walker
    6. Watercraft Safety
  2. Epidemiology
    1. Incidence of Unintentional Childhood Injury in U.S.
      1. Estimated non-fatal injuries per year: >20 million
      2. Required medical attention (2009): 8 Million
      3. Hospitalizations (2009): 132,000
      4. Fatal unintentional injuries per year: >11,000
        1. Most common cause of childhood deaths in U.S. (40%)
  3. Causes: Serious unintentional injury
    1. Non-fatal injuries requiring hospitalization
      1. Falls (33% of injuries)
        1. Infant Walkers, stairs, out of windows
      2. Contact Injury (23% of injuries)
      3. Laceration or skin punctures (6% of injuries)
      4. Motor vehicle accidents (5% of injuries)
      5. Bites or stings (4% of injuries)
      6. Bicycle accidents (4% of injuries)
      7. Poisonings
      8. Scald burns
      9. Pedestrian accidents
    2. Fatal injuries overall
      1. Motor vehicle accidents (58% of deaths)
        1. Represents 33% of toddler deaths
        2. In 2008, of 4748 fatalaties in under age 21 years, 79% involved age 16-20 year olds
      2. Drowning (11% of deaths)
        1. Represents 25% of toddler deaths
      3. Poisoning (8% of deaths)
      4. Fire or Burn Injury (6% of deaths)
      5. Suffocation (4% of deaths)
        1. SIDS, sleep surface related in infants
    3. Fatal injuries in Infants
      1. Suffocation (75% of deaths)
      2. Motor vehicle accidents (10% of deaths)
      3. Drowning (4% of deaths)
      4. Fire or Burn Injury (3% of deaths)
      5. Falls (2% of deaths)
      6. Poisonings (2% of deaths)
  4. Prevention
    1. General
      1. Never leave children unattended in a vehicle
        1. See Enclosed Vehicle Excessive Heat
    2. Infants
      1. See SIDS for prevention
      2. See Crib Safety
      3. Use window gaurds
      4. Do not use Infant Walkers
      5. Remove cords and other strangulation hazards around the crib
    3. Toddlers
      1. See Child Safety Seat
      2. Prevent Drownings
        1. Fencing should completely surround all pools
        2. Consider all water bodies a risk
          1. Do not leave age under 3 years unattended
          2. Risks: Ponds, streams, buckets, kiddie pools
      3. Prevent Burn Injury
        1. Set all hot water heaters to maximum of 130 degrees
        2. Matches should be stored out of reach
        3. Talk about smoke alarm with child
        4. Confirm all smoke detectors are operational
        5. Practice fire escape plan
      4. Prevent Poisonings
        1. Lock poisons out of reach (child-proof home)
        2. Place poison control information by phone
          1. Phone: 800-222-1222
        3. Contact poison control immediately in case of Poisoning
        4. Ipecac is NOT recommended
      5. Prevent falls
        1. Avoid bunk beds until 6 years old or older
    4. School age children
      1. Prevent Drownings
        1. Teach children how to swim starting at age 4 years old or older
        2. Wear U.S. Coast Guard approved personal floatation devices during all boating activities
        3. Use fences that isolate swimming pool from other areas of yard
        4. Adults should be in the pool and within reach of their children
        5. Adults should learn CPR and start Resuscitation without delay in case of Drowning
      2. Prevent motor vehicle accident injuries
        1. See Child Safety Seat and Seat Belts
        2. Do not ride in cargo area of pickup truck
        3. No off-road vehicles or lawn mower use <16 years old
      3. Use protective gear for activities
        1. Bicycle helmets
        2. Protective gear in downhill skiing, snow boarding
        3. Protective gear in skateboarding and Inline Skating
    5. Adolescents
      1. Prevent motor vehicle accident injuries
        1. Wear Seat Belts always
        2. No instant messaging (texting) or other distracting activity while driving (parents should model this)
        3. Risks: Speeding, tailgating, instant messaging and nighttime driving
  5. References
    1. Cohen (1997) Pediatrics 99:704-10 [PubMed]
    2. Schnitzer (2006) Am Fam Physician 74:1864-70 [PubMed]
    3. Theurer (2013) Am Fam Physician 87(7): 502-9 [PubMed]

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