Unintentional Injury - Dr. Puchalski

THESE ARE PREVENTABLE INJURIES AND DEATHS

• Unintentional injury is the leading cause of death in children age 1-19 years.
• 5th leading cause of death in infants < 1 year.
• Motor vehicle accidents account for the greatest portion of these deaths.

Child Passenger Restraints!
If you remember nothing else, please remember basics of child passenger restraint so you can teach your patients

• Children < 13 yrs. should ride in the rear seat
• Infants should remain rear facing in the rear seat until they reach height or weight maximum for the seat (at least 2 yrs)
• Children should use a forward facing child safety seat with a harness until the reach the height or weight maximum for the seat (at least 4 yrs)
• Children should use a belt positioning booster seat with a lap-shoulder belt until the lap shoulder belt fits them correctly (usually  > 8 yrs and/or > 4’ 9’’)

Other Important Sources of Injury
Other common causes of death from unintentional injury- suffocation/SIDS, drowning, poisoning, fire/burns, falls

• SIDS risk factors- young maternal age, smoke exposure, poor prenatal care, drug/alcohol use, prone/side sleep position, bedsharing, soft bedding, overheating, preterm/low birth weight
  
• Sleep position is the strongest modifiable risk factor

• Bike helmets can decrease the rate of serious TBI by 69-88% in bicycle accidents.
• Bike helmet laws have made the largest impact in increasing helmet use in children.

• Falls are overall the most common cause of injury in children < 14 yrs.
• Deaths from falls are not common, more likely in falls from 3 stories or more, or when child’s head impacts a hard surface.

• ¼ of injury related deaths in adolescents 15-19 is related to a firearm.
• It is particularly important to address issues of fire arm safety with violently injured adolescents, families of children with mental health issues.

INJURY PREVENTION IN THE ED
Use your “teachable moment” to reinforce or teach families about injury prevention.
Consult social work.  Many issues require ongoing community services and support, and you can make sure your patients sent in the right direction.http://pedemmorsels.com/injury-prevention/

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