Patterns of injury in pediatric patients in one Florida community and implications for prevention programs

A Profile of Bicycle-Related Injuries in Tai Po

Background

Implementation of prevention programs for bicycle safety should be based on a good understanding of the profile of bicycle accidents. The objective of this study was to investigate the differences in the severity of bicycle-related injuries when comparing with various risk factors, and to utilize this information to formulate the intervention measures.

Methods

A retrospective review was conducted on all patients (n=116) who were treated for bicycle-related injuries within a period of 66 days at the emergency department of a district hospital in Tai Po, New Territories.

Results

School-aged children, especially boys, were more commonly injured. The head and lower extremities were the common sites of injuries. Female gender (χ2=4.39; P<0.05) and injuries involving head and upper extremities (χ2=12.61; P<0.05) were associated with higher chance of serious injury.

Conclusion

Tai Po district had a high incidence of bicycle accidents due to its geographical location. Population at a greater risk for bicycle injury was the male gender school-aged children and therefore prevention program should be targeted at them.

Emergency nurses' role in pediatric injury and prevention

Emergency nurses are actively involved in primary, secondary, and tertiary pediatric injury prevention activities. This article outlines the steps that emergency nurses can take to identify common pediatric injuries treated in the Emergency Departments and integrate existing and evolving injury prevention resources into their repertoire of nursing skills. Research and demonstration projects conducted by emergency physicians, nurses, and prehospital care providers are highlighted.

Assessment of hospital and police ascertainment of automobile versus childhood pedestrian and bicyclist collisions

Information about automobile versus pedestrian or bicyclist collisions differ according to the source of collision ascertainment. Hospital records and police reports focus on different characteristics of a collision, which reflects differences in case finding as well as information regarding risk factors. Pedestrians and bicyclists 0-14 years of age who were involved in a motor vehicle collision in the city of Long Beach, CA, between January 1, 1992 and June 30, 1995, were included in the study. Police reports and medical records were used to identify cases. Police reports were found for 1,015 cases, and medical records identified 474 cases; 379 cases were common to both sources. A capture-recapture model was used to evaluate the degree of overlap between the two sources and to derive "ascertainment corrected" injury rates. The injury rate from combined sources was 333.5/100,000 children per year, the pedestrian injury rate was 210.6/100,000 children per year and the bicyclist injury rate was 122.9/100,000 children per year. The "ascertainment corrected" injury rate overall was 381.3/100,000 children per year, 233.0/100,000 for pedestrians and 153.9/100,000 children per year for bicyclists. Eighty percent of hospital-reported cases were captured in the police database, whereas only 37% of police-reported cases were captured by the hospital database. We found that hospital sources identified younger children, fewer bicyclists, more Asian and Hispanic children, and fewer African-American children when compared to police sources. For more comprehensive surveillance resulting in more accurate incidence rates and more complete information, it is better to use multiple sources of data.

Dental trauma management awareness of Singapore pre-school teachers

The purpose of this study was to assess the awareness of pre-school teachers concerning the management of traumatized teeth. A questionnaire survey of teachers' backgrounds, attitudes/practices and knowledge was distributed to all teachers who attended a dental education program organized by the Singapore Dental Health Foundation. Of a total of 291 teachers surveyed, 29% had received tertiary education, while the rest (71%) had received secondary education. The mean teaching experience was 6.8 +/- 6.9 years. About a quarter had previous experience in handling dental trauma. Sixty-three percent admitted having no knowledge of dental trauma; 79% were unsatisfied with their level of knowledge in this area; 95% were keen to have further education in dental trauma; 65% thought dental trauma emergency should be dealt with as soon as possible. Concerning knowledge, during-office hour emergency services were more familiar (84%) than after-office hour emergency services (15%), as was the concept of management of avulsed teeth (71%) compared to that of fractured teeth (51%). Knowledge about optimal storage media for avulsed permanent teeth was especially poor--being as low as 15%. Using multiple logistic regression analysis, it was found that teaching experience significantly influenced the respondents' self-assessed knowledge and their level of satisfaction with their knowledge (P = 0.012). Teachers with more teaching experience had better knowledge about the replantation of permanent teeth (P = 0.003). It is recommended that public education targeted at teachers should be carried out to increase dental trauma management awareness.

Promoting helmet use among children

Despite the proven efficacy of bicycle helmets, helmet use among children remains low. Helmet use among children riding bicycles significantly reduces head injuries and death. A variety of promotional programs to increase helmet use in children have demonstrated limited success. This article reviews a variety of approaches to increase helmet use among children. The PRECEDE-PROCEED model is applied and recommendations for community health nurses to promote helmet use among children are provided.

Perceptions, safety behaviors, and learning needs of parents of children brought to an emergency department

INTRODUCTION

This study was conducted at a level II Pediatric Trauma Center to assess the perceptions, safety behaviors, and learning needs of parents who brought their children to the emergency department.

METHODS

Surveys were distributed in the emergency department, and 412 parents/caretakers responded. A descriptive design provided the framework for data analysis.

RESULTS

A profile of caretakers of children in three age groups (1 to 4, 5 to 12, and 13 to 15 years) emerged. Whereas most parents and older children knew how to call 911, only half of the parents knew child CPR. Parents tended to underestimate their children's risks for motor vehicle-related and immersion injuries and were more concerned about kidnapping and assault. Less than half of the parents believed that most injuries can be prevented. Learning needs were indicated by 34% of parents, and CPR was mentioned most frequently. Parents' desires for learning tended to focus on care after injuries happened.

DISCUSSION

Health professionals need to spend more time teaching parents about the link between child development and risks for injury, to emphasize prevention. Interventions based on study results include the hospital Safety Helmet Discharge Plan.

Strategies to implement helmet legislation for child bicyclists

Research in the area of injury prevention has shown that legislation combined with education is the most effective way to increase helmet use in child bicyclists. Legislative activities have been proven to reduce injuries. Nurses can join with other interested stakeholders to form community coalitions, to educate the public, and to influence public policy.