overview of childhood injury

7/28/2019 overview of Childhood Injury

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CHILDHOOD INJ URIES

Dr hanan abbasAssistant professor of family medicine



Injuries are responsible for 10% of all deaths worldwide.

• Someone dies from an injury every five seconds.

• More than 15,000 people die as a result of injuries every day .

• About 5.8 million people die from injuries every year .

Injuries kill 32% more people around the world than malaria,tuberculosis, and HIV/AIDS combined.

Scope of the Problem



5-24 years of age: 2001

Rank 5-9 10-14 15-19 20-24

1

1,283 1,553 6,646 7,765

2

1,899 3,398

3272 1,611 2,360

4137

5189

Unintentional Injury

Congenital

AnomaliesSuicide

Homicide Congenital

Anomalies Malignant Neoplasms

Malignant Neoplasms Homicide

Source: CDC, NCHS Vital Statistics System-Mortality.

Heart

Disease

HomicideHeart Disease

Age group



Highlights•157,078 deaths due to injuries-all ages

(13,806 of these were 5-19 years of age)

•Unintentional injuries were the leading cause of death for childrenand adolescents 5-19 years of age

The five leading mechanisms of injury deaths for those 5-19:

Motor vehicle traffic (48%)Firearm (21%)Suffocation (7%)Drowning (5%)Poisoning (5%)



ury ea ra es accor ng o n en among

rsons

-19 years of age: 1990 and 2001

1990 2001 1990 2001

All injury 12.7 8.5 71.5 50.9

Unintentional 10.3 6.9 42.5 32.8

Suicide 0.8 0.7 11.1 7.9

Homicide 1.5 0.8 17.0 9.4

Undetermined 0.2 0.1 0.7 0.7

*Rate per 100,000 populationSources: CDC, NCHS Vital Statistics System-Mortality, U.S. Bureau of the Census- decennial census population counts for 1990, 2001population estimates based on the 2000 census.

Ages 5-14 Ages 15-19



5-19 years of age, 1998-2001

1

10

100

1,000

10,000

100,000

5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

Note: Data are plotted on the log scale, data for 1998-2000 are an average.Sources: CDC, NCHS-National Hospital Ambulatory Care Survey, National Hospital Discharge Survey, National Vital Statistics System-

Mortality.

Rate per 100,000 population

Injury-related hospitalizations-(1998-2001)

Injury-related emergency department visits-(1998-2001)

Injury Deaths-(2001)

Age



among persons under 18 years of age: 1999-2000

0

20

40

60

80

100

120

140

160

Male

Female

Emergency dept. visits per 1,000 population

Unintentional

injuriesFalls Cut/pierceStruck

object/personIntentional

injuries

Motor vehicletraffic

Note: Data are a two-year average for 1999-2000.Source: CDC, NCHS-National Hospital Ambulatory Care Survey.

Cause (unintentional injuries)



Selected

characteristic

Home

inside

Home

outside

School/child care

center/

preschool

Street/

highway/

parking lot

Sport facility/recreation

area/

lake/river/pool

Male:Under 12 years 37.3 18.3 9.9 *4.0 10.1

12-17 years *10.0 19.1 38.3 19.7 44.6

Female:Under 12 years 30.0 12.4 8.4 *4.3 6.5

12-17 years 12.3 13.6 24.8 *13.3 18.5

Episodes per 1,000 population

Place of occurence

Annual rate of medically attended injury and poisoning episodes byplace of occurrence and by selected characteristics: 2001

Note: *Data do not meet standard of reliability and precision.

Source: CDC, NCHS-National Health Interview Survey.



CHILDHOOD

INJURIESThe Road

Environment

Pedestrian

Cyclist

Car occupants

The HomeEnvironment

Falls

Burns and scalds

House FiresPoisoning

Lacerations

Suffocation

Drowning

The Leisure

Environment

Drowning

Playground Injuries

Sports Injuries

The School/

Work

Environment

Falls

Burns

Scalds

Lacerations

Poisoning



Risk Groups

Some groups are more vulnerable to injuries than others. The scope of theproblem varies considerably by:

Age: Injuries are one of the top three causes of death amongpeople between the ages of 5 and 44 years.

Sex: Nearly twice as many men as women die from injuries eachyear.

Income group: Within countries, poorer people have higher ratesof injury-related deaths than wealthier people.

Region: More than 90% of all injury-related deaths occur in low-and middle-income countries.



Nonfatal Consequences

Tens of millions of people who suffer nonfatal injuries requirehospitalization, emergency department or general practitioner care,or treatment outside the health system.

In addition to direct physical harm, those affected by injuries andviolence may also experience a range of other mental and physical

health consequences, including:

• Anxiety and depression

• Risky behaviors (e.g. alcohol, tobacco, and other drug use;unsafe sexual practices)

• HIV, STDs, and unwanted pregnancies



Economic Costs

Along with the significant – and often devastating – physical, mental, andemotional consequences of injuries, those affected also experienceconsiderable economic losses resulting from:

• Cost of treatment

• Reduced or lost productivity (e.g. in wages)

Road traffic crashes cost most countries between 1% – 2% of their grossnational product. The economic costs of road traffic crashes worldwide

has been estimated at US$ 518 billion.



Guidelines for conducting community

surveys on injuries and violence.

WHO; 2004



VERBAL AUTOPSY

A two step procedure

Data collection : interview of bereaved relatives tocollect information on symptoms experienced by

deceased before death, using some form of surveyinstrument

COD assignment : methods include

physician review of VA data ICD certification, coding, and tabulation

computerised algorithms for population fractions



Creating Safe Environments

A caregiver should

Know applicable safety practices for child care

Screen environment for hazards and remove

Use safety devices, where applicable

Monitor for environmental hazards



Know developmental levels of children

Promote safety through action, word, and deed

Role model safety practices to children and parents

Be aware of conditions that contribute to injury

Closely observe children, especially during at-risk

conditions



Type of Environment

Child Care Centers

Child care centers governed by licensingChild care centers that are multi-use facilities

Child care centers that are not subject to rules andregulations

Family Child Care Homes In-Home Child Care



By Child

Developmental level

Emotions Stress

Imitation

Behavior



By Adult

Inattention

Lack of knowledge

Lack of communication

Lack of safety precautions

Emotions

Stress



Where

Place

Indoors/OutdoorsWhen

Time of day

Tired, hungry, in a hurry

Conditions



Modifications

Removal of hazards and use of safety devices

Modify behavior using feedback, positivereinforcement, diversion, role playing throughpractice drills



Monitoring Ongoing process

Formalized

Use checklists

Study injury reports

Observation is foremost activity inmonitoring



Implications for Caregivers

Role Modeling Safe practices

Education Caregivers

Children

Parents



Safe staff to child ratio Child care training

Pay attention

Avoid conflict

Reality Check:

Child Care Safety Checklistfor Parents



Understand and avoid risks to health, safety, andnutrition

Use developmental appropriate practice

Facility licensed or registered, if required

Open door policy for parents

overview of childhood injury

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