1
|
Avila A, Lao OB, Neville HL, Yorkgitis BK, Chang HL, Thatch K, Plumley D, Larson SD, Fitzwater JW, Markley M, Pedroso F, Fischer A, Armstrong LB, Petroze RT, Snyder CW. Social determinants of health in pediatric trauma: Associations with injury mechanisms and outcomes in the context of the COVID-19 pandemic. Am J Surg 2024; 228:107-112. [PMID: 37661530 DOI: 10.1016/j.amjsurg.2023.08.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 07/17/2023] [Accepted: 08/19/2023] [Indexed: 09/05/2023]
Abstract
BACKGROUND Relationships between social determinants of health and pediatric trauma mechanisms and outcomes are unclear in context of COVID-19. METHODS Children <16 years old injured between 2016 and 2021 from ten pediatric trauma centers in Florida were included. Patients were stratified by high vs. low Social Vulnerability Index (SVI). Injury mechanisms studied were child abuse, ATV/golf carts, and firearms. Mechanism incidence trends and mortality were evaluated by interrupted time series and multivariable logistic regression. RESULTS Of 19,319 children, 68% and 32% had high and low SVI, respectively. Child abuse increased across SVI strata and did not change with COVID. ATV/golf cart injuries increased after COVID among children with low SVI. Firearm injuries increased after COVID among children with high SVI. Mortality was predicted by injury mechanism, but was not independently associated with SVI, race, or COVID. CONCLUSION Social vulnerability influences pediatric trauma mechanisms and COVID effects. Child abuse and firearm injuries should be targeted for prevention.
Collapse
Affiliation(s)
- Azalia Avila
- Joe DiMaggio Children's Hospital, Memorial Health, Hollywood, FL, 1005 Joe DiMaggio Dr, Hollywood, FL, 33021, USA.
| | - Oliver B Lao
- Joe DiMaggio Children's Hospital, Memorial Health, Hollywood, FL, 1005 Joe DiMaggio Dr, Hollywood, FL, 33021, USA.
| | - Holly L Neville
- Joe DiMaggio Children's Hospital, Memorial Health, Hollywood, FL, 1005 Joe DiMaggio Dr, Hollywood, FL, 33021, USA.
| | - Brian K Yorkgitis
- University of Florida, College of Medicine-Jacksonville, Department of Surgery, 655 8th St W, Jacksonville, FL, 32209, USA.
| | - Henry L Chang
- Tampa General Hospital - Children's Hospital, Tampa, FL, 1 Tampa General Cir, Tampa, FL, 33606, USA; Johns Hopkins All Children's Hospital, St Petersburg, FL, 501 6th Ave S, St. Petersburg, FL, 33701, USA.
| | - Keith Thatch
- Tampa General Hospital - Children's Hospital, Tampa, FL, 1 Tampa General Cir, Tampa, FL, 33606, USA; Johns Hopkins All Children's Hospital, St Petersburg, FL, 501 6th Ave S, St. Petersburg, FL, 33701, USA.
| | - Donald Plumley
- Arnold Palmer Hospital for Children, Orlando Health, Orlando, FL, 92 W Miller St, Orlando, FL, 32806, USA.
| | - Shawn D Larson
- University of Florida, College of Medicine-Jacksonville, Department of Surgery, 655 8th St W, Jacksonville, FL, 32209, USA.
| | - John W Fitzwater
- Baylor Scott & White McLane Children's Medical Center, Temple, TX, 1901 SW H K Dodgen Loop, Temple, TX, 76502, USA.
| | - Michele Markley
- Salah Foundation Children's Hospital, Broward Health, Ft. Lauderdale, Florida, 1600 S Andrews Ave, Fort Lauderdale, FL, 33316, USA.
| | - Felipe Pedroso
- Nicklaus Children's Hospital, Miami, FL, 3100 SW 62nd Ave, Miami, FL, 33155, USA.
| | - Anne Fischer
- Palm Beach Children's Hospital, West Palm Beach, FL, 901 45th St, West Palm Beach, FL, 33407, USA.
| | - Lindsey B Armstrong
- Johns Hopkins All Children's Hospital, St Petersburg, FL, 501 6th Ave S, St. Petersburg, FL, 33701, USA.
| | - Robin T Petroze
- University of Florida, College of Medicine-Jacksonville, Department of Surgery, 655 8th St W, Jacksonville, FL, 32209, USA.
| | - Christopher W Snyder
- Johns Hopkins All Children's Hospital, St Petersburg, FL, 501 6th Ave S, St. Petersburg, FL, 33701, USA.
| |
Collapse
|
2
|
Keenan HT, Wade SL, Miron D, Presson AP, Clark AE, Ewing-Cobbs L. Reducing Stress after Trauma (ReSeT): study protocol for a randomized, controlled trial of an online psychoeducational program and video therapy sessions for children hospitalized after trauma. Trials 2023; 24:766. [PMID: 38017574 PMCID: PMC10683223 DOI: 10.1186/s13063-023-07806-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 11/16/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND Post-traumatic stress symptoms develop in a quarter to half of injured children affecting their longer-term psychologic and physical health. Evidence-based care exists for post-traumatic stress; however, it is not readily available in some communities. We have developed an eHealth program consisting of online, interactive educational modules and telehealth therapist support based in trauma-focused cognitive behavioral therapy, the Reducing Stress after Trauma (ReSeT) program. We hypothesize that children with post-traumatic stress who participate in ReSeT will have fewer symptoms compared to the usual care control group. METHODS This is a randomized controlled trial to test the effectiveness of the ReSeT intervention in reducing symptoms of post-traumatic stress compared to a usual care control group. One hundred and six children ages 8-17 years, who were admitted to hospital following an injury, with post-traumatic stress symptoms at 4 weeks post-injury, will be recruited and randomized from the four participating trauma centers. The outcomes compared across groups will be post-traumatic stress symptoms at 10 weeks (primary outcome) controlling for baseline symptoms and at 6 months post-randomization (secondary outcome). DISCUSSION ReSeT is an evidence-based program designed to reduce post-traumatic stress symptoms among injured children using an eHealth platform. Currently, the American College of Surgeons standards suggest that trauma programs identify and treat patients at high risk for mental health needs in the trauma system. If effectiveness is demonstrated, ReSeT could help increase access to evidence-based care for children with post-traumatic stress within the trauma system. TRIAL REGISTRATION ClinicalTrials.gov NCT04838977. 8 April 2021.
Collapse
Affiliation(s)
- Heather T Keenan
- Department of Pediatrics, University of Utah School of Medicine, 295 Chipeta Way, Salt Lake City, UT, 84108, USA.
| | - Shari L Wade
- Cincinnati Children's Hospital Medical Center Division of Pediatric Rehabilitation, Department of Pediatrics, University of Cincinnati College of Medicine, 3333 Burnet Avenue, Cincinnati, OH, 45229-3039, USA
| | - Devi Miron
- Department of Psychiatry and Behavioral Sciences, Tulane University School of Medicine, 1430 Tulane Ave. #8055, New Orleans, LA, 70112, USA
| | - Angela P Presson
- Department of Internal Medicine, University of Utah School of Medicine, 30 N Mario Capecchi Dr. , Salt Lake City, UT, 84112, USA
| | - Amy E Clark
- Department of Pediatrics, University of Utah School of Medicine, 295 Chipeta Way, Salt Lake City, UT, 84108, USA
| | - Linda Ewing-Cobbs
- Children's Learning Institute, McGovern Medical School at UTHealth, 7000 Fannin, Suite 2401, Houston, TX, 77030, USA
| |
Collapse
|
3
|
Goodman LF, Birnbaum Flyer Z, Schomberg J, Maginas M, Wallace E, Vukcevich O, Awan S, Gibbs D, Nahmias J, Guner YS. Electric bicycles (e-bikes) are an increasingly common pediatric public health problem. Surg Open Sci 2023; 14:46-51. [PMID: 37519328 PMCID: PMC10372360 DOI: 10.1016/j.sopen.2023.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 05/11/2023] [Accepted: 06/16/2023] [Indexed: 08/01/2023] Open
Abstract
Purpose Electric bicycles (e-bikes) achieve higher speeds than pedal bicycles, but few studies have investigated the impact on injury rates specific to the pediatric population. Utilizing the National Electronic Injury Surveillance System (NEISS), we compared rates of pediatric injury for e-bikes, bicycles, and gas-engine bicycles (mopeds) from 2011 to 2020. Methods Descriptive and bivariate inferential analyses were performed upon NEISS estimates of e-bike, bicycle, and moped injuries in children aged 2-18 years. Analyses were stratified by patient age and helmet usage. The Mann-Kendall test of trends was used. Results We identified 3945 e-bike, 23,389 moped, and 2.05 million bicycle injuries. Over time, the incidence of injury increased for e-bikes (Kendall's τ=0.73, p = 0.004), decreased for pedal bicycles (Kendall's τ= - 0.91, p = 0.0003), and did not change for mopeds (Kendall's τ = 0.06, p = 0.85). Males accounted for 82.5 % of e-bike injuries. The age group most commonly affected by e-bike injury (44.3 %) was 10-13 years old. The proportion of injuries requiring hospitalization was significantly higher for e-bikes (11.5 %), compared to moped and bicycle (7.0 and 4.8 %, respectively, p < 0.0001). In cases where helmet use or absence was reported, 97.3 % of e-bike riders were without a helmet at the time of injury, compared to 82.1 % of pedal bicycle riders and 87.2 % of moped riders. Conclusions The rate of pediatric e-bike injuries increased over the study period. Compared to riders on pedal bicycles or mopeds, children on e-bikes had infrequent helmet use and increased rate of hospitalization. These findings suggest that attention to e-bike safety and increasing helmet usage are important to public health among the pediatric population. Level of evidence IV.
Collapse
Affiliation(s)
- Laura F. Goodman
- Department of Surgery, University of California Irvine, Irvine, CA, United States
- Division of Pediatric Surgery, Children's Hospital of Orange County, Orange, CA, United States
| | - Zoe Birnbaum Flyer
- Division of Pediatric Surgery, Children's Hospital of Orange County, Orange, CA, United States
| | - John Schomberg
- Department of Nursing, Children's Hospital of Orange County, Orange, CA, United States
- CHOC Research Institute, Children's Hospital of Orange County, Orange, CA, United States
| | - Mary Maginas
- Department of Nursing, Children's Hospital of Orange County, Orange, CA, United States
| | - Elizabeth Wallace
- CHOC Research Institute, Children's Hospital of Orange County, Orange, CA, United States
| | - Olivia Vukcevich
- School of Medicine, University of California Riverside, United States
| | - Saeed Awan
- Department of Surgery, University of California Irvine, Irvine, CA, United States
- Division of Pediatric Surgery, Children's Hospital of Orange County, Orange, CA, United States
| | - David Gibbs
- Department of Surgery, University of California Irvine, Irvine, CA, United States
- Division of Pediatric Surgery, Children's Hospital of Orange County, Orange, CA, United States
| | - Jeffry Nahmias
- Department of Surgery, University of California Irvine, Irvine, CA, United States
- Division of Trauma, Burns, Critical Care, & Acute Care Surgery, University of California Irvine, Orange, CA, United States
| | - Yigit S. Guner
- Department of Surgery, University of California Irvine, Irvine, CA, United States
- Division of Pediatric Surgery, Children's Hospital of Orange County, Orange, CA, United States
| |
Collapse
|
4
|
Cintean R, Eickhoff A, Zieger J, Gebhard F, Schütze K. Epidemiology, patterns, and mechanisms of pediatric trauma: a review of 12,508 patients. Eur J Trauma Emerg Surg 2023; 49:451-459. [PMID: 36001123 PMCID: PMC9925538 DOI: 10.1007/s00068-022-02088-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 08/09/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Pediatric traumas are common and remain a unique challenge for trauma surgeons. Demographic data provide a crucial source of information to better understand mechanisms and patterns of injury. The aim of this study was to provide this information to improve treatment strategies of potentially preventable morbidity and mortality in children. MATERIAL AND METHODS A retrospective review of every pediatric trauma treated in the emergency department (ED) between 2015 and 2019 was performed. Inclusion criteria were the age between 0 and 14 years and admission to the ED after trauma. Demographic data, time of presentation, mechanism of injury and pattern of injury, treatment, and outcome were analyzed. Different injury patterns were assessed in relation to age group, sex, mechanism of injury and treatment. RESULTS A total of 12,508 patients were included in this study. All patients were stratified into five age groups: babies under the age of 1 (8.8%), toddlers between 1 and 3 (16.8%), preschool children between 4 and 6 (19.3%), young school children between 7 and 10 (27.1%), and young adolescents between 11 and 14 (27.9%). The predominant sex in all age groups was male. 47.7% of patients were admitted between 4 and 10 pm; 14.8% of the patients arrived between 10 pm and 8 am. Peak months of admissions were May to July. Overall, 2703 fractures, 2924 lacerations and superficial tissue injury, 5151 bruises, 320 joint dislocations, 1284 distortions, 76 burns, and 50 other injuries were treated. Most common mechanisms for fractures were leisure activities, falls, and sports-related activities. Forearm fractures were the most common fractures (39.5%) followed by humerus fractures (14%) and fractures of the hand (12.5%). A total of 700 patients with fractures (25.9%) needed surgery. 8.8% of all patients were hospitalized for at least one day. 4 patients died in the hospital (0.03%). CONCLUSION Despite of higher risk, severe injuries in children are rare. Minor injuries and single fractures are common. Treatment should be managed in specialized centers to ensure an interdisciplinary care and fast recovery. Peak times in the late afternoon and evening and summer months should be taken into consideration of personnel planning.
Collapse
Affiliation(s)
- Raffael Cintean
- Department of Trauma-, Hand-, and Reconstructive Surgery, Ulm University, Albert-Einstein-Allee 23, 89081, Ulm, Germany.
| | - Alexander Eickhoff
- Department of Trauma-, Hand-, and Reconstructive Surgery, Ulm University, Albert-Einstein-Allee 23, 89081 Ulm, Germany
| | - Jasmin Zieger
- Department of Trauma-, Hand-, and Reconstructive Surgery, Ulm University, Albert-Einstein-Allee 23, 89081 Ulm, Germany
| | - Florian Gebhard
- Department of Trauma-, Hand-, and Reconstructive Surgery, Ulm University, Albert-Einstein-Allee 23, 89081 Ulm, Germany
| | - Konrad Schütze
- Department of Trauma-, Hand-, and Reconstructive Surgery, Ulm University, Albert-Einstein-Allee 23, 89081 Ulm, Germany
| |
Collapse
|
5
|
Pulliam K, Gardner D, Edmunds P, Moody S, Aldridge N, Lyons S, Jenkins T, Kotagal M, Brown RL, Falcone RA. Partnering with high-risk communities to successfully reduce pediatric injury over time. J Pediatr Surg 2022:S0022-3468(22)00777-1. [PMID: 36670000 DOI: 10.1016/j.jpedsurg.2022.12.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 12/01/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022]
Abstract
PURPOSE Injury is the leading cause of childhood morbidity and mortality. Injury prevention (IP) initiatives are often created in isolation from the communities most affected. We hypothesized that the use of a comprehensive approach to injury prevention through community partnerships will result in a measurable reduction in pediatric injuries. METHODS The IP program at our free-standing level 1 pediatric trauma center developed partnerships within eight targeted high-risk communities. IP coordinators and community partners implemented programs driven by community-specific injury data and community input. Programs focused on home, bike, playground, pedestrian, and child passenger safety. Program components included in-home education with free safety equipment and installation; free bike helmet fittings and distribution; community playground builds; and car seat classes with education, free car seat distribution and installation. Using trauma registry data, we compared injuries rates in targeted communities with non-intervention communities county-wide over an eight-year period. RESULTS Between 2012 and 2019, nearly 4000 families received home safety equipment and education through community partnerships. Approximately 2000 bike helmets, 900 car/booster seats, in addition to safety messages and education were provided across the intervention communities. Over this 8-year time period, the injury rates significantly decreased by 28.4%, across the eight targeted high-risk communities, compared to a 10.9% reduction in non-intervention communities across the county. CONCLUSIONS Effective injury prevention can be achieved through partnerships, working in solidarity with community members to address actual areas of concern to them. Sharing data, seeking ongoing community input, continuously reviewing learnings, and implementing identified changes are crucial to the success of such partnerships. LEVEL OF EVIDENCE Level III.
Collapse
Affiliation(s)
- Kasiemobi Pulliam
- Department of Surgery, University of Cincinnati College of Medicine, 3230 Eden Avenue, Cincinnati 45267, OH, USA.
| | - Dawne Gardner
- Division of Pediatric General and Thoracic Surgery, Cincinnati Children's Hospital Medical Center 3333 Burnet Avenue, Cincinnati 45229, OH, USA
| | - Patrick Edmunds
- Division of Pediatric General and Thoracic Surgery, Cincinnati Children's Hospital Medical Center 3333 Burnet Avenue, Cincinnati 45229, OH, USA
| | - Suzanne Moody
- Division of Pediatric General and Thoracic Surgery, Cincinnati Children's Hospital Medical Center 3333 Burnet Avenue, Cincinnati 45229, OH, USA
| | - Nichole Aldridge
- Division of Pediatric General and Thoracic Surgery, Cincinnati Children's Hospital Medical Center 3333 Burnet Avenue, Cincinnati 45229, OH, USA
| | - Stephanie Lyons
- Division of Pediatric General and Thoracic Surgery, Cincinnati Children's Hospital Medical Center 3333 Burnet Avenue, Cincinnati 45229, OH, USA
| | - Todd Jenkins
- Division of Pediatric General and Thoracic Surgery, Cincinnati Children's Hospital Medical Center 3333 Burnet Avenue, Cincinnati 45229, OH, USA
| | - Meera Kotagal
- Division of Pediatric General and Thoracic Surgery, Cincinnati Children's Hospital Medical Center 3333 Burnet Avenue, Cincinnati 45229, OH, USA
| | - Rebeccah L Brown
- Division of Pediatric General and Thoracic Surgery, Cincinnati Children's Hospital Medical Center 3333 Burnet Avenue, Cincinnati 45229, OH, USA
| | - Richard A Falcone
- Division of Pediatric General and Thoracic Surgery, Cincinnati Children's Hospital Medical Center 3333 Burnet Avenue, Cincinnati 45229, OH, USA
| |
Collapse
|
6
|
Ridings LE, Espeleta HC, Streck CJ, Davidson TM, Litvitskiy N, Bravoco O, Kassam-Adams N, Ruggiero KJ. Assessing service quality and access in trauma centers through behavioral health screening, education, and treatment after pediatric injury. J Pediatr Surg 2022; 57:632-636. [PMID: 35090719 PMCID: PMC9287491 DOI: 10.1016/j.jpedsurg.2022.01.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 01/07/2022] [Accepted: 01/12/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND Over 120,000 U.S. children are hospitalized annually for traumatic injury, with approximately 20% developing acute stress disorder (ASD), posttraumatic stress disorder (PTSD), or depression. The ACS COT recommends that trauma centers address emotional recovery after injury; however, few pediatric trauma centers (PTCs) assess behavioral health symptoms. This study describes results from a survey with PTC providers assessing the landscape of behavioral health screening, education, and treatment. METHODS Trauma program leaders from 83 US Level I and II trauma centers across 36 states completed a survey assessing center characteristics and decision-making, availability, and perceptions of behavioral health resources. RESULTS Nearly half (46%) of centers provide behavioral health screens for pediatric patients, and 18% screen family members, with screens mostly conducted by nurses or social workers for ASD or PTSD. Two-thirds provide child behavioral health education and 47% provide education to caregivers/family. Two-thirds provide treatment connections, typically via referrals or outpatient clinics. Behavioral health screening, education, and treatment connections were rated as very important (M > 8.5/10), with higher ratings for the importance of screening children versus caregivers. Child maltreatment (59%), observed patient distress (53%), child substance use (52%), injury mechanism (42%) and severity (42%) were prioritized in screening decision-making. CONCLUSION Service provision varies by method, resource, and provider, highlighting the lack of a roadmap for centers to provide behavioral health services. Adoption of universal education and screening procedures in PTCs is crucial to increase access to services for injured children and caregivers. PTCs are well-positioned to offer these services. LEVEL OF EVIDENCE Level II.
Collapse
Affiliation(s)
- Leigh E Ridings
- Medical University of South Carolina, College of Nursing, Charleston, SC, United States.
| | - Hannah C Espeleta
- Medical University of South Carolina, College of Nursing, Charleston, SC, United States
| | - Christian J Streck
- Medical University of South Carolina, College of Medicine, Department of Surgery, Charleston, SC, United States
| | - Tatiana M Davidson
- Medical University of South Carolina, College of Nursing, Charleston, SC, United States
| | - Nicole Litvitskiy
- Medical University of South Carolina, College of Nursing, Charleston, SC, United States
| | - Olivia Bravoco
- Medical University of South Carolina, College of Nursing, Charleston, SC, United States
| | - Nancy Kassam-Adams
- Children's Hospital of Philadelphia, Center for Injury Research and Prevention, Philadelphia, PA, United States; University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States
| | - Kenneth J Ruggiero
- Medical University of South Carolina, College of Nursing, Charleston, SC, United States
| |
Collapse
|
7
|
Sawe HR, Milusheva S, Croke K, Karpe S, Mfinanga JA. Pediatric trauma burden in Tanzania: analysis of prospective registry data from thirteen health facilities. Inj Epidemiol 2022; 9:3. [PMID: 35039088 PMCID: PMC8762441 DOI: 10.1186/s40621-022-00369-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 01/07/2022] [Indexed: 11/10/2022] Open
Abstract
Background Trauma is among the leading causes of morbidity and mortality among pediatric and adolescent populations worldwide, with over ninety percent of childhood injuries occurring in low-income and middle-income countries. Lack of region-specific data on pediatric injuries is among the major challenges limiting the ability of health systems to implement interventions to prevent injuries and improve outcomes. We aim to characterize the burden of pediatric health injuries, initial healthcare interventions and outcomes seen in thirteen diverse healthcare facilities in Tanzania. Methods This was a prospective cohort study of children aged up to 18 years presenting to emergency units (EUs) of thirteen multi-level health facilities in Tanzania from 1st October 2019 to 30th September 2020. We describe injury patterns, mechanisms and early interventions performed at the emergency units of these health facilities. Results Among 18,553 trauma patients seen in all thirteen-health facilities, 4368 (23.5%) were children, of whom 2894 (66.7%) were male. The overall median age was 8 years (Interquartile range 4–12 years). Fall 1592 (36.5%) and road traffic crash (RTC) 840 (19.2%) were the top mechanisms of injury. Most patients 3748 (85.8%) arrived at EU directly from the injury site, using motorized (two or three) wheeled vehicles 2401 (55%). At EU, 651 (14.9%) were triaged as an emergency category. Multiple superficial injuries (14.4%), fracture of forearm (11.7%) and open wounds (11.1%) were the top EU diagnoses, while 223 (5.2%) had intracranial injuries. Children aged 0–4 years had the highest proportion (16.3%) of burn injuries. Being referred and being triaged as an emergency category were associated with high likelihood of serious injuries with adjusted odds ratio (AOR) 4.18 (95%CI 3.07–5.68) and 2.11 (95%CI 1.75–2.56), respectively. 1095 (25.1%) of patients were admitted to inpatient care, 14 (0.3%) taken to operation theatre, and 25 (0.6%) died in the EU. Conclusions In these multilevel health facilities in Tanzania, pediatric injuries accounted for nearly one-quarter of all injuries. Over half of injuries occurred at home. Fall from height was the leading mechanism of injury, followed by RTC. Most patients sustained fractures of extremities. Future studies of pediatric injuries should focus on evaluating various preventive strategies that can be instituted at home to reduce the incidence and associated impact of such injuries. Supplementary Information The online version contains supplementary material available at 10.1186/s40621-022-00369-7.
Collapse
Affiliation(s)
- Hendry R Sawe
- Department of Emergency Medicine, Emergency Medicine Department, MUHAS, Muhimbili University of Health and Allied Sciences, P.O. Box 65001, Dar es Salaam, Tanzania. .,Department of Emergency Medicine, Muhimbili National Hospital, Dar es Salaam, Tanzania.
| | - Sveta Milusheva
- Development Impact Evaluation Group, World Bank, Washington, DC, USA
| | - Kevin Croke
- Development Impact Evaluation Group, World Bank, Washington, DC, USA.,Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | | | - Juma A Mfinanga
- Department of Emergency Medicine, Muhimbili National Hospital, Dar es Salaam, Tanzania
| |
Collapse
|
8
|
Abstract
The focus of this article centers on bicycle injury prevention and related infrastructure. The article discusses the current epidemiology of cycling injuries, and known prevention strategies, specifically individual recommended practices related to helmet use in both adult and pediatric populations. The article also discusses different ways in which the environment plays a role in protecting cyclists from injuries, and what environmental changes have been adopted to reduce the likelihood for cycling injuries.
Collapse
|
9
|
Molloy MJ, Shields W, Stevens MW, Gielen AC. Short-term outcomes in children following emergency department visits for minor injuries sustained at home. Inj Epidemiol 2021; 8:16. [PMID: 33896423 PMCID: PMC8071606 DOI: 10.1186/s40621-021-00307-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 02/16/2021] [Indexed: 05/31/2023] Open
Abstract
Background Minor injuries are very common in the pediatric population and often occur in the home environment. Despite its prevalence, little is known about outcomes in children following minor injury at home. Understanding the impact of these injuries on children and their families is important for treatment, prevention, and policy. The objectives of our study were (1) To describe the distribution of short-term outcomes following pediatric minor injuries sustained at home and (2) To explore the relationship of injury type and patient and household demographics with these outcomes. Methods Children (n = 102) aged 0–7 years with a minor injury sustained at home were recruited in an urban pediatric emergency department as part of the Child Housing Assessment for a Safer Environment (CHASE) observational study. Each patient had a home visit following the emergency department visit, where five parent-reported outcomes were assessed. Relationships were explored with logistic regression. Results The most common type of injury was soft tissue (57.8 %). 13.2 % of children experienced ≥ 7 days of pain, 21.6 % experienced ≥ 7 days of abnormal activity, 8.9 % missed ≥ 5 days of school, 17.8 % of families experienced ≥ 7 days of disruption, and 9.1 % of parents missed ≥ 5 days of work. Families reported a total of 120 missed school days and 120 missed work days. Children who sustained a burn had higher odds of experiencing pain (OR 6.97), abnormal activity (OR 8.01), and missing school (OR 8.71). The parents of children who sustained a burn had higher odds of missing work (OR 14.97). Conclusions Families of children suffering a minor injury at home reported prolonged pain and changes in activity as well as significant school and work loss. In this cohort, burns were more likely than other minor injuries to have these negative short-term outcomes reported and represent an important target for interventions. The impact of these injuries on missed school and disruption of parental work warrants further consideration.
Collapse
Affiliation(s)
- Matthew J Molloy
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, USA. .,Present affiliation: Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave, MLC 9016, OH, 45229, Cincinnati, USA.
| | - Wendy Shields
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins Center for Injury Research and Policy, Baltimore, USA
| | - Molly W Stevens
- Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, USA.,Department of Surgery, Division of Emergency Medicine, University of Vermont Larner College of Medicine, Burlington, USA
| | - Andrea C Gielen
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins Center for Injury Research and Policy, Baltimore, USA
| |
Collapse
|
10
|
Pulliam K, Kotagal M, Lin TK, Patel MN. Use of glue embolization in management of traumatic bile leak: A case report. Trauma Case Rep 2021; 33:100468. [PMID: 33855156 PMCID: PMC8024764 DOI: 10.1016/j.tcr.2021.100468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2021] [Indexed: 11/19/2022] Open
Abstract
Blunt abdominal trauma is a common cause of solid organ injury in children. Nonoperative management has been established as the standard of care for suspected liver and spleen injuries without peritonitis. Major ductal injury with resultant biloma is a rare complication of nonoperative management of blunt liver injury. Endoscopic retrograde cholangiopancreatography (ERCP) and/or percutaneous drain placement are considered to be safe adjuncts in the management of these bile leaks. However, in the rare cases of persistent bile leak, further nonoperative alternatives have not been reported. In this case report we present a novel multidisciplinary approach to managing persistent bile leaks in blunt liver injury.
Collapse
Affiliation(s)
- Kasiemobi Pulliam
- Department of Surgery, University of Cincinnati College of Medicine, 3230 Eden Avenue, Cincinnati, OH 45267, United States of America
| | - Meera Kotagal
- Division of Pediatric General and Thoracic Surgery, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, United States of America
- Department of Surgery, University of Cincinnati College of Medicine, 3230 Eden Avenue, Cincinnati, OH 45267, United States of America
- Corresponding author at: 3333 Burnet Avenue, MLC 2023, Cincinnati, OH 45229, United States of America.
| | - Tom K. Lin
- Division of Gastroenterology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, United States of America
- Department of Pediatrics, University of Cincinnati College of Medicine, 3230 Eden Avenue, Cincinnati, OH 45267, United States of America
| | - Manish N. Patel
- Division of Interventional Radiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, United States of America
- Department of Radiology, University of Cincinnati College of Medicine, 3230 Eden Avenue, Cincinnati, OH 45267, United States of America
| |
Collapse
|
11
|
Voelker J, Voelker C, Voelker J, Engert J, Schendzielorz P, Hagen R, Rak K. Button batteries and typical swallowed foreign bodies can be differentiated in high-resolution X-Rays. Int J Pediatr Otorhinolaryngol 2021; 142:110604. [PMID: 33421671 DOI: 10.1016/j.ijporl.2020.110604] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 12/28/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Button battery ingestions have emerged as an increasing medical issue in recent years, especially for children. The frequent use of these energy sources in small appliances and toys is responsible for their ubiquitous occurrence in households. In addition to other possible foreign bodies, button batteries are particularly dangerous as they can cause severe complications in the aerodigestive tract. OBJECTIVE The study aimed for a detailed analysis of specific radiographic identifiers of button batteries and similarly configured potential esophageal foreign bodies in high-resolution X-ray scans. METHODS A selection of potentially hazardous button batteries - in cases of ingestion (CR2032) or aspiration (LR44, LR1130) - was made. Other clinically relevant radio-opaque objects of similar size and shape have been selected accordingly. High-resolution X-ray scans (33.3 lp/mm) were made using an in vitro model in porcine esophageal preparations. A systematic, comparative analysis was carried out with the digital radiographic images. FINDINGS In the study described, the selected foreign bodies were scanned at distinct angles in high image quality. Using button batteries, radiographically details of their internal structures were shown that have not yet been described. The known markers, as well as new detailed characteristics, were found in the experimental setting. The differentiation from other typical esophageal foreign bodies was possible by analyzing four relevant identification features: the edge properties, internal structures, the size, and differences in 0°/90° scans. CONCLUSIONS The study results reveal that specific features of potential esophageal foreign bodies can be identified by improved radiographic resolution, contrast, and dynamics. Thus, the diagnostic reliability in distinguishing 'high-risk foreign bodies' from less dangerous ones could be increased. In the future, button batteries could be detected more reliably with intelligent digital image analysis and enhanced radiographic technology. This may further support clinical triage algorithms and help reduce medical complications in cases of foreign body ingestions.
Collapse
Affiliation(s)
- Johannes Voelker
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Josef-Schneider-Str. 11, Wuerzburg, D-97080, Germany.
| | - Christine Voelker
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Josef-Schneider-Str. 11, Wuerzburg, D-97080, Germany
| | - Joachim Voelker
- Department of Diagnostic and Interventional Radiology, St. Josef's Hospital Wiesbaden, Beethovenstr. 20, Wiesbaden, D-65189, Germany; Academic Teaching Hospital of Johannes Gutenberg University, Langenbeckstr. 1, D-55131, Mainz, Germany
| | - Jonas Engert
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Josef-Schneider-Str. 11, Wuerzburg, D-97080, Germany
| | - Phillipp Schendzielorz
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Josef-Schneider-Str. 11, Wuerzburg, D-97080, Germany
| | - Rudolf Hagen
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Josef-Schneider-Str. 11, Wuerzburg, D-97080, Germany
| | - Kristen Rak
- Department of Oto-Rhino-Laryngology, Plastic, Aesthetic and Reconstructive Head and Neck Surgery and the Comprehensive Hearing Center, University of Wuerzburg, Josef-Schneider-Str. 11, Wuerzburg, D-97080, Germany
| |
Collapse
|
12
|
Weaver NL, Buskirk TD, Jupka K, Williams J. Organizational factors related to the adoption of an injury prevention program by U.S. children's hospitals. Transl Behav Med 2019; 9:768-776. [PMID: 30053295 DOI: 10.1093/tbm/iby038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Revised: 12/21/2017] [Accepted: 03/13/2018] [Indexed: 11/12/2022] Open
Abstract
Most childhood injuries can be prevented with the correct use of safety devices and appropriate supervision. Children's hospitals are well positioned to promote these behaviors with evidence-based programming; however, barriers exist to adopting such programs. The purpose of this study was to describe organizational and administrative factors related to the adoption of an efficacious injury prevention (IP) program by children's hospitals in the USA. IP specialists at 232 U.S. children's hospitals were invited to complete a baseline survey, and then offered Safe N' Sound (SNS), an efficacious computer IP program targeting parents of young children. Following this promotion period, specialists were surveyed again to assess their level of SNS adoption. Organizational and administrative factors associated with SNS adoption were identified using conditional random forest models (n = 93). Random forests identified a set of six predictors with potential utility for classifying hospitals as having SNS adoption activity or not; the final pruned classification tree indicated that four of these were best able to differentiate hospitals with and without adoption activity-having a medical director, having other hospital units that provided IP programming, the number of requests the IP unit received within the past year, and the belief of administrative leaders in their responsibility to develop programming all influence decisions. Hospitals without a medical director were most likely to demonstrate adoption activity. Medical directors, or other organizational leaders, can facilitate the adoption process for evidence-based intervention, but may need to be engaged intentionally when disseminating new products, tools, or approaches.
Collapse
Affiliation(s)
- Nancy L Weaver
- Department of Behavioral Science and Health Education, College for Public Health and Social Justice, Saint Louis University, St. Louis, MO, USA
| | - Trent D Buskirk
- Department of Management Science and Information Systems, University of Massachusetts, Boston, MA, USA.,Center for Survey Research, University of Massachusetts, Boston, MA, USA
| | - Keri Jupka
- Parents as Teachers National Center, St. Louis, MO, USA
| | - Janice Williams
- Carolinas Center for Injury Prevention, Department of Emergency Medicine, Carolinas Medical Center, Charlotte NC, USA
| |
Collapse
|
13
|
Nwanna-Nzewunwa O, Ngamby MK, Cox J, Feldhaus I, Motwani G, Monono ME, Etoundi GA, Dicker RA, Hyder AA, Juillard C. Epidemiology and cost of pediatric injury in Yaoundé, Cameroon: a prospective study. Eur J Trauma Emerg Surg 2019; 46:1403-1412. [PMID: 30976820 DOI: 10.1007/s00068-019-01104-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 02/25/2019] [Indexed: 11/25/2022]
Abstract
PURPOSE Unintentional injury is the leading cause of death among children aged 10-19 years and over 95% of injury deaths occur in low- and middle-income countries (LMICs). As patterns of injury in the pediatric population may differ from those in adults, risks specific to children in LMICs need to be identified for effective injury prevention and treatment. This study explores patterns of pediatric injury epidemiology and cost in Yaoundé, Cameroon to inform injury prevention and resource allocation. METHODS Pediatric (age < 20 years) trauma patient data were collected at the emergency department (ED) of Central Hospital of Yaoundé (CHY) from April through October 2009. Univariate, bivariate, and multivariate analyses were used to explore injury patterns and relationships between variables. Regression analyses were conducted to identify predictors of receiving surgical care. RESULTS Children comprised 19% (544) of trauma cases. About 54% suffered road traffic injuries (RTIs), which mostly affected the limbs and pelvis (37.3%). Half the RTI victims were pedestrians. Transportation to CHY was primarily by taxi or bus (69.4%) and a preponderance (71.1%) of the severely and profoundly injured patients used this method of transport. Major or minor surgical intervention was necessary for 17.9% and 20.8% of patients, respectively. Patients with an estimated injury severity score ≥ 9 (33.2%) were more likely to need surgery (p < 0.01). The median ED cost of pediatric trauma care was USD12.71 [IQR 12.71, 23.30]. CONCLUSIONS Injury is an important child health problem that requires adequate attention and funding. Policies, surgical capacity building, and health systems strengthening efforts are necessary to address the high burden of pediatric injuries in Cameroon. Pediatric injury prevention efforts in Cameroon should target pedestrian RTIs, falls, and burns and consider school-based interventions.
Collapse
Affiliation(s)
- Obieze Nwanna-Nzewunwa
- Center for Global Surgical Studies, Department of Surgery, Zuckerberg San Francisco General Hospital and Trauma Center, University of California, San Francisco, San Francisco, USA
| | | | - Jacob Cox
- School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Isabelle Feldhaus
- Department of Global Health and Population, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Girish Motwani
- Center for Global Surgical Studies, Department of Surgery, Zuckerberg San Francisco General Hospital and Trauma Center, University of California, San Francisco, San Francisco, USA
| | - Martin Ekeke Monono
- World Health Organization (WHO) Regional Office, Brazzaville, Republic of the Congo
| | | | - Rochelle A Dicker
- Department of Surgery, University of California, Los Angeles, 10833 Le Conte Ave, 72-215 CHS, Los Angeles, CA, 90095, USA
| | - Adnan A Hyder
- International Injury Research Unit, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Catherine Juillard
- Department of Surgery, University of California, Los Angeles, 10833 Le Conte Ave, 72-215 CHS, Los Angeles, CA, 90095, USA.
| |
Collapse
|
14
|
Park MS, Kang SH, Cho YJ, Yang JS. Rapid Healing and Remodeling Process of Pediatric Seat-Belt Fracture without Surgical Treatment. Korean J Neurotrauma 2018; 14:169-172. [PMID: 30402440 PMCID: PMC6218343 DOI: 10.13004/kjnt.2018.14.2.169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 09/07/2018] [Accepted: 09/27/2018] [Indexed: 11/22/2022] Open
Abstract
Pediatric seat-belt fracture is a rare condition, and its management has not been well defined. The authors report a case of pediatric Chance fracture that was managed conservatively and that demonstrated rapid bone healing. A 7-year-old boy presented with back pain after a motor vehicle accident. Plain lumbar spine radiography, three-dimensional computed tomography (CT), and magnetic resonance imaging revealed a seat-belt fracture type C (classified by Rumball and Jarvis), and the patient's condition was managed conservatively. The patient started to ambulate with a brace 2 weeks after the injury. Spine CT performed 100 days after the injury revealed a remodeled fracture, and dynamic radiography did not show any evidence of instability or kyphotic deformity. We suggest that if there are no neurological deficits or severe deformities, then a pediatric seat-belt fracture should be managed conservatively, because the bone healing process is far more rapid in children than it is in adults and because of possible growth problems after surgery.
Collapse
Affiliation(s)
- Mu-Seung Park
- Department of Neurosurgery, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea
| | - Suk Hyung Kang
- Department of Neurosurgery, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea
| | - Yong Jun Cho
- Department of Neurosurgery, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea
| | - Jin Seo Yang
- Department of Neurosurgery, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, Korea
| |
Collapse
|
15
|
Marek AP, Nygaard RM, Cohen EM, Polites SF, Sirany AME, Wildenberg SE, Elsbernd TA, Murphy S, Dean Potter D, Zielinski MD, Richardson CJ. Rural versus urban pediatric non-accidental trauma: different patients, similar outcomes. BMC Res Notes 2018; 11:519. [PMID: 30055647 PMCID: PMC6064103 DOI: 10.1186/s13104-018-3639-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 07/24/2018] [Indexed: 11/11/2022] Open
Abstract
Objective Our aim was to compare urban and rural non-accidental trauma for trends and characterize where injury prevention efforts can be focused. Pediatric trauma patients (age 0–14 years) at two level I adult and pediatric trauma centers, one rural and one urban, were included and data from the trauma registries at each center was abstracted. Results Of 857 pediatric admissions, 10% of injuries were considered non-accidental. The mean age for all non-accidental trauma patients was significantly lower than the overall pediatric trauma population (2.6 vs. 7.7 years, P < 0.001). Significantly more fatalities occurred in the non-accidental trauma cohort (5.7% vs. 1% P = 0.007). In nearly half of all non-accidental trauma patients, the primary insurance was government programs (49%) and 46% were commercial insurance. The proportion of government insurance in non-accidental trauma was higher in both urban and rural cohorts. There were similar rates of urban and rural patients sustaining non-accidental trauma who were uninsured (6.5 vs. 5.3%). Patients that were younger, in a rural location, and receiving government insurance were at higher risk of non-accidental trauma on univariable analysis. However, only age remained an independent predictor on multivariable analysis.
Collapse
Affiliation(s)
- Ashley P Marek
- Department of Surgery, Hennepin County Medical Center, 701 Park Ave S, P5, Minneapolis, MN, 55415, USA
| | - Rachel M Nygaard
- Department of Surgery, Hennepin County Medical Center, 701 Park Ave S, P5, Minneapolis, MN, 55415, USA.
| | - Ellie M Cohen
- Department of Surgery, Hennepin County Medical Center, 701 Park Ave S, P5, Minneapolis, MN, 55415, USA
| | - Stephanie F Polites
- Department of Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Anne-Marie E Sirany
- Department of Surgery, Hennepin County Medical Center, 701 Park Ave S, P5, Minneapolis, MN, 55415, USA
| | - Sarah E Wildenberg
- Department of Surgery, Hennepin County Medical Center, 701 Park Ave S, P5, Minneapolis, MN, 55415, USA
| | - Terri A Elsbernd
- Department of Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Sherrie Murphy
- Department of Surgery, Hennepin County Medical Center, 701 Park Ave S, P5, Minneapolis, MN, 55415, USA
| | - D Dean Potter
- Department of Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Martin D Zielinski
- Department of Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Chad J Richardson
- Department of Surgery, Hennepin County Medical Center, 701 Park Ave S, P5, Minneapolis, MN, 55415, USA
| |
Collapse
|
16
|
Hogan CM, Weaver NL, Cioni C, Fry J, Hamilton A, Thompson S. Parental Perceptions, Risks, and Incidence of Pediatric Unintentional Injuries. J Emerg Nurs 2017; 44:267-273. [PMID: 28988836 DOI: 10.1016/j.jen.2017.07.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 07/24/2017] [Accepted: 07/25/2017] [Indexed: 10/18/2022]
Abstract
INTRODUCTION More than 9,000 children die annually from various causes of unintentional injury. Of all the pediatric unintentional injuries occurring in the United States, 8.7 million are treated in emergency departments, and 225,000 require hospitalization annually. Health education programs are available to address these injuries. The objective of this research was to examine the distribution of self-reported high priority injury risks in an urban Midwestern pediatric level 1 trauma center and investigate the relationship between parental perceptions and injury-prevention behaviors. Prevalence rates for 3 data sources are compared. METHODS Missouri Information for Community Assessment (MICA) was categorized to mirror variables corresponding with risks of injury presented in the Safe 'n' Sound (SNS) program. Level 1 trauma center data were examined to determine how the variables were distributed compared with MICA data and with the parent-reported levels. RESULTS A total of 429 SNS surveys were compared with ED data and MICA data. For SNS users, car crashes were identified as the highest risk, specifically due to the use of incorrect car seats. The injuries seen most often in the emergency department were falls, and falls were also the most prevalent injury captured by MICA. Controlling for demographics, parental perceptions predicted several risks for injury. DISCUSSION Because parental perceptions are significantly related to risks of injury, prevention programs aiming to decrease injuries could focus on the perceptions. Not only can perceptions be used to tailor health communication materials, these perceptions can be the targets of change. Further work might investigate the extent to which changes in perceptions result in increased adoption of safety practices.
Collapse
|
17
|
Koppolu R. Pediatric falls from windows: a health policy model for prevention. J Pediatr Health Care 2014; 28:182-5. [PMID: 24559806 DOI: 10.1016/j.pedhc.2013.12.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2013] [Revised: 12/05/2013] [Accepted: 12/05/2013] [Indexed: 10/25/2022]
|
18
|
Jatana KR, Litovitz T, Reilly JS, Koltai PJ, Rider G, Jacobs IN. Pediatric button battery injuries: 2013 task force update. Int J Pediatr Otorhinolaryngol 2013; 77:1392-9. [PMID: 23896385 DOI: 10.1016/j.ijporl.2013.06.006] [Citation(s) in RCA: 127] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Accepted: 06/03/2013] [Indexed: 01/10/2023]
Abstract
Over the last 10 years, there has been a dramatic rise in the incidence of severe injuries involving children who ingest button batteries. Injury can occur rapidly and children can be asymptomatic or demonstrate non-specific symptoms until catastrophic injuries develop over a period of hours or days. Smaller size ingested button batteries will often pass without clinical sequellae; however, batteries 20mm and larger can more easily lodge in the esophagus causing significant damage. In some cases, the battery can erode into the aorta resulting in massive hemorrhage and death. To mitigate against the continued rise in life-threatening injuries, a national Button Battery Task Force was assembled to pursue a multi-faceted approach to injury prevention. This task force includes representatives from medicine, public health, industry, poison control, and government. A recent expert panel discussion at the 2013 American Broncho-Esophagological Association (ABEA) Meeting provided an update on the activities of the task force and is highlighted in this paper.
Collapse
Affiliation(s)
- Kris R Jatana
- Department of Otolaryngology-Head and Neck Surgery, Nationwide Children's Hospital and Wexner Medical Center at Ohio State University, Columbus, OH 43205, United States.
| | | | | | | | | | | |
Collapse
|