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Royal College Peds 2021 > CPS Injury prevention > Flashcards

CPS Injury prevention Flashcards

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1
Q

What is the 2nd leading cause of unintentional injury death in Canadian children 1-4 yo?

A

Drowning

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2
Q

True or false: swimming lessons for children 2-4 yo prevents drowning or near drowning.

A

False!

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3
Q

What are the 3 best strategies to prevent drowning in young children?

A
  1. Active adult supervision: arms length at all times
  2. Four sided pool fencing with self-closing, self-latching gate
  3. Government approved personal flotation devices should be usd for all young children and for those who cannot swim
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4
Q

True or false: pool alarms are effective in decreasing drownings by young children.

A

False!

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5
Q

Which population has the highest rate of bicycle-related injuries involving motor vehicle collisions?

A

Adolescents (especially males)

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6
Q

What is the most severe injury that occurs among child and youth bicyclists?

A

Head injuries

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7
Q

Which of the following is false:

a. There is strong evidence that bicycle helmet legislation increases bicycle helmet use
b. There is strong evidence that bicycle helmet legislation causes reduced bicycling
c. There is strong evidence that legislation reduces risk of bicycle-related head injury
d. Wide legislation has positive effects on helmet use and is further improved by enforcement and education

A

B! Evidence is mixed on this

-direc cause and effect relationship has not been demonstrated

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8
Q

What are the benefits of helmet legislation? (2)

A
  1. Reduces risk for head injury for every age group

2. Children are far more likely to use helmets in the presence of adults wearing helmets

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9
Q

What are the CPS’ recommendations on bike helmets? (5)

A
  1. All provinces should legislate and enforce bicycle helmet use for all ages
  2. Legislation should be rolled out using social marketing and education to raise awareness of bike helmet efficacy, accessibility and importance
  3. Other strategies to prevent bicycling injuries such as separating riders from motor traffic with bike lanes, pathways for commuting and recreational cycling should be implemented
  4. Physicians should counsel families about the importance of wearing bicycle helmets
  5. Sales tax exemptions or rebates and federal tax credits should be given to people who purchase bike helmets
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10
Q

Out of all injuries caused by sports/recreational activities, what is the number one cause of injuries resulting in the greatest harm?

A

Trampoline injuries (occurs less frequently but when they do, they’re bad!)

  • especially from home trampolines
  • 10% of cases occur under adult supervision
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11
Q

What is the most common injury seen in trampoline injuries?

A

Fractures - upper limb most common (accounted for majority of hospital admissions)

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12
Q

Where do most trampoline injuries occur?

  • in what circumstance do most injuries on trampoline occur?
  • do most injuries occur on the mat or fall off of the mat?
A

71-99% occur at home or at a neighbor’s house

  • most injuries occur when there is more than one child on the trampoline at the same time (up to 83%)
  • most injuries (60%) occur from falling ON the trampoline mat, the rest are falls off the trampoline THUS this means that even having spotters around the outside of the trampoline doesn’t eliminate injuries!
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13
Q

What is the most concerning possible trampoline injury?

A

Cervical spine injury with resulting paralysis

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14
Q

What are Health Canada’s recommendations on the use of trampolines?

  • what about AAP?
  • what about CPS?
A

Health Canada: use with caution: need supervision, no children < 6 yo, shock absorbing pads, no somersaults, enclosure netting, trampoline at ground level

AAP: should ban all home trampoline use and never ever allow children to use trampolines ever unless there are safety pads, safety harnesses with competent spotters trained in trampoline safety at all times, at a gymnasium

CPS: trampolines should NOT be used at home
-health care professionals should warn parents of the dangers of trampolines and advise against purchase

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15
Q

In what age group does the majority of trampoline related injuries occur?

A

5-14 yo

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16
Q

What is the minimum age recommended by the CPS for people to start operating snowmobilers?
-what is the minimum age children must be to be transported safely as passengers?

A

16 years or older to operate, 6 years or older to ride safely

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17
Q

What winter sport is associated with the highest rate of serious injury?
-what were the leading cause of death in this group?

A

Snowmobiling

-leading cause of death: head injury

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18
Q

What licensing is recommended for people 16 years or older for operating a snow mobile?

A

Graduated licensing program! Ie. newly licensed operators should have restrictions such as only riding during daylight on groomed trails, zero tolerance for alcohol

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19
Q

What should snowmobilers wear while riding a snowmobile?

-what should operators carry?

A
  • HELMET obvi
  • goggles
  • waterproof snowmobile suits
  • gloves and rubber bottomed boots

Operators should carry:

  • first aid kit
  • emergency tool kit with spark plugs, drive and fan belts, extra key
  • survival kit with flares
  • cell phone
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20
Q

What are the 3 leading causes of injury-related deaths?

-what is the leading cause of injury-related hospitalization?

A
  1. MVCs
  2. Drownings
  3. Threats to breathing

Injury-related hospitalization: falls

21
Q

What are the leading causal factors for serious and fatal motor vehicle collisions? (3)

A
  1. Driving speed
  2. Impaired driving
  3. Lack of occupant restraint
22
Q

True or false: head injury rates among youth cyclists are 25% lower in jurisdictions with helmet legislation compared to those without.

A

True!

23
Q

Which age group of children have the highest risk of playground injury?

  • what is the most common type of playground injury?
  • what is the most common result of the playground injury?
  • what is the most common cause of playground death?
A

5-9 yo

  • most common playground injury: falls
  • other causes: impact with an obstacle, body being cut/pinched/crushed, entrapment
  • most common result: upper extremity fracture is most common form of injury (usually from fall from climbing structure)
  • head injuries (15% of playground injuries, usually from fall from a swing)
  • most common cause of playground death: strangulation (clothing drawstrings, scarf, skipping rope get caught on play equipment, usually at top of a slide, heads trapped between bars especially when wearing a helmet)
24
Q

What are strategies to reduce playground injuries?

A
  1. Reduce maximum fall height of equipment
  2. Reduce the risk of falling from equipment by using protective barriers and guardrails, using vertical rather than horizontal bars to discourage climbing, using peaked or curved surfaces for guardrails to discourage use as play surfaces
  3. Improving protective surfacing under and around play equipment: use impact absorbing surfaces like coarse sand/pea gravel/wood chips/synthetic surfaces (NOT grass) to depth of at least 15 cm for preschool equipment and 30 cm for full-sized equipment
  4. Active supervision!!!
  5. Dress children in a neck warmer instead of a scarf to reduce strangulation, avoid clothing with drawstrings or cords
  6. Remove a child’s helmet before permitting access to play equipment
  7. Build home playgrounds to meet CSA standards
25
Q

What are contributing causes to ATV crashes involving children? (4)

A
  1. Driving inexperience
  2. Inadequate physical size and strength
  3. Immature motor and cognitive development
  4. Enagement in risk taking behaviours

**most common in teenage males

26
Q

True or false: there is good evidence suggesting that youth-sized models of ATVs are safer than adult sized models for youth.

A

FALSE! ATV companies have tried to encourage this but the youth ATVs are still heavy and can travel at significant speeds and are prone to flips/rollobers

27
Q

According to CPS recommendations, how old should a child be before they operate an ATV?

A

16 yo; this applies to ALL ATV sizes, even the youth ones since there is no evidence that youth ATVs are any more safe for youth to operate

28
Q

What are the recommendations for youth operators of ATVs who are 16 yo and older?

A
  1. ALWAYS WEAR HELMET, eye protection, and protective clothing/footwear
  2. NEVER EVER EVER take on passengers on a single rider ATV
  3. Never ride impaired
  4. ATV drivers should complete an approved training course (needs both theoretical and practical components and mandatory testing to pass the course)
29
Q

What are 2 serious complications (besides death) that can occur from choking or suffocation?

A
  1. Anoxic brain injury

2. Esophageal perforation

30
Q

What is the difference between choking and suffocation?

A

Choking: interruption of respiration by an internal obstruction of the airway
-suffocation: obstruction of the airway by an external object that blocks the nose and both (ie. bedding/mattress/plastic bag)

31
Q

Fill in the blank: the majority of choking and suffocation deaths occur in the _____ year of life with the majority of hospitalizations occuring in the first _____ years of life.

A

Deaths occur most commonly in 1st year of life.

-hospitalization in 1st 3 years of life

32
Q

In what environment is choking most likely to occur?

A

Home environment! (95%)
-presence of older siblings in the home increases risk for choking since toys and other small objects are more likely to be present and caregiving activities like feeding can be undertaken by older siblings

33
Q

What two items are the most commonly aspirated?

A
  1. Food

2. Coins

34
Q

What are the most common nonfood item causing choking deaths in children?

A

Latex balloons

35
Q

Which foods should overall be avoided in children under 4 years old due to choking hazard?

A

Hard candies, cough drops, gum, chewable vitamins, peanuts, sunflower seeds, fish with bones, snacks on toothpicks or skewers

36
Q

In older children, what is the most common cause of fatal asphyxial injury?

A

Strangulation
-curtain cords, drawstrings on clothing getting caught on a slide or caught on the bus door, handrail, dragged or run over in consequence

37
Q

What age should a child be to be able to use the top bunk of a bunk bed and why?

A

At least 6 yrs old since they are at higher risk for entrapment between the mattress and the wall or in the railing

38
Q

When used correctly, car seats reduce the risk of fatal and serious injuries by what percentage?

A

70%!!!! Wow!!

39
Q

What is the most common error or misuse of infant/child car seats?

  • what are the next 3 most common errors?
  • other common errors?
A
  1. Not using the correct seat for the weight and/or height of the child, usually in the form of premature graduation
  2. Seat not tightly secured to the vehicle (moves more than 2.5 cm in any direction)
  3. Harness not snug (more than one finger width fits between the harness strap and the child)
  4. Chest clip not at armpit level

***Other common errors: not anchoring the tether strap for forward facing child seats, placing a rear-facing infant seat in front of an air bag, wrong angle of infant seats (should be at 45 degree angle for head and neck support), not using a locking clip on the vehicle seat belt when necessary, routing the seat belt through an incorrect path of the infant/child restraint, routing the harness straps through incorrect slots of the infant/child restraint, using recalled or orhterwise unsafe seats (10 years or beyond manufacturers expiry date or previously in a vehicle at the time of a crash), failing to restrain the child

40
Q

What are the 4 stages of child restraints (ie. car seats)?

-when can a child graduate from each stage?

A

Stage 1: rear-facing carseat
Stage 2: forward facing carseat
Stage 3: Booster seat
Stage 4: Seatbelt

  • **Graduate from Stage 1 when the child is AT least 1 yo AND 10 kg (22 lbs) AND able to walk
  • ***Graduate from Stage 2 when the child is at least 18 kg
  • **Graduate from Stage 3 when the child is at least 36 kg and 145 cm (4 feet 9 inches) and at least 8 years old (age is used as a guideline since physical measurements are much truer markers of appropriate seating)

***should continue to use a rear facing seat as long as the height and weight limitations allow

41
Q

What are the 3 types of booster seats available in Canada?

A
  1. High-back, belt-positioning booster: provides head and neck support for children seated in vehicles without head restraints and must be used with a lap and shoulder seat belt assembly
  2. Infant/child/booster and child/booster seats (combination car seats)
  3. Low-back/beltless belt-positioning booster: designed for vehicles with adjustable head restraint where child is seated
42
Q

Which seat in a vehicle is the safest place for any passenger?

  • what age should children be before they should sit in the front seat of a vehicle?
  • what is the ONLY exception to these rules?
A

Rear vehicle seat!

  • rear middle position seat is the most protecting for a single occupant, placing the passenger the furthest possible distance from side impacts and side air bags
  • children need to be 13 yo before moving to the front seat of the vehicle
  • only important exception: in compact extended cab pick up trucks, children seated in the front row are safer than those in the second row
43
Q

True or false: the universal anchorage system for attaching a car seat is equally safe as securing a car seat to the vehicle itself.

A

True!

-some cars are equipped for the UAS, some are not.

44
Q

How much movement should be allowed when pulling on the car seat in either direction after installation?
-what angle should a rear-facing carseat be placed in?

A

Less than 2.5 cm (1 inch) of movement in either direction
-should place rear-facing car seat at 45 degree angle to prevent ejection in a collision and to prevent head and neck positinoing that may cause airway obstruction

45
Q

Which rear end seat should car seats be placed in?

A

MIddle rear seat position, farthest away from side airbags!

46
Q

For rear-facing restraint systems, how do you know that a child is restrained correctly in it?

A
  1. The shoulder harness should be snug, not allowing more than one finger insertion between the collar bone and the harness
  2. The restraint system chest clips hould be at the level of the infant’s armpit
47
Q

What are some examples of child safety and injury prevention actions that have resulted from CDR (child and youth death review)?

A
  1. Safe sleep campaign to prevent SIDS2. Creation of Cribs for Kids programs to obtain cribs for families in need3. Tougher penalties for drunk drivers4. Support for smoke detector installation programs5. Prescription drug round-ups to facilitate safer disposal of medications6. Folic acid awareness program7. Water safety initiatives such as pool fencing, swimming lessons for children from low income families ( to prevent drowning)
48
Q

For Child Death Review, what 3 aspects should the mandate include?

A
  1. Broad representation: CDR team should include coroner, representatives from law enforcement, child protection services, pediatrician, teacher, etc.2. Structured processes: reporting protocol3. Linkable databases: for collection, consolidation and dissemination of data4. Evaluative mechanism: to determine effectiveness of CDR recommendations and follow up5. Designated financial support from all levels of government

Royal College Peds 2021 (55 decks)

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