Injuries and poisoning Flashcards
Leading cause of death and disability among kids and young adults?
- trauma (age 1-44)
When do unintentional injury deaths peak?
- during toddler years (1-4)
- adolescence and young adulthood (15-24)
Leading cause of unintentional injury?
- falls
- MVA/traffic
- poisoning
How can we as providers prevent injuries in children?
- at every well-child visit counsel parents on age appropriate injury prevention
Leading cause of accidental death in kids?
- motor vehicle injuries
Peak incidence of motor vehicle injuries?
- 15-24: adolescent drivers more likely to be involved in fatal MVA than adults
- due to alcohol, excess speed and no seat belts
How can we prevent motor vehicle injuries?
- safe driving habits
- driver’s ed
- safer cars
- safer roads
- restraints: age approp, properly installed and used
Child safety restraint guidelines?
- infants less than 1 and weighing less than 35 lbs should be in infant only rear facing child safety seat in back seat
- 1-4 and weighing 20-40 lbs can be in forward facing only or convertible child safety seat, installed in back seat of vehicle
- ages 4-6 need booster seat installed in back seat (booster seat for kids under 6 or less than 60 lbs in MT)
Submersion injuries are common in what age groups?
prevention?
- # 1 cause of unintentional injury/death ages 1-4
- # 2 cause of unintentional injury/death ages 5-9
- M:F ratio - 5:1
- locations: pools, lakes, streams, oceans, bathtubs (age 1)
- prevention: supervision near water, 2 seconds left alone is too long
- fence unguarded pools with self closing gates, swimming lessons, and diving safety
Risks of burns?
- house fires
- scalding burns: hot water, keep pan handles out of reach, keep water heater set below 125 F
- electrical burns: cords/plugs
- contact burns: hot appliances, wood stoves
- never leave a clothes iron or curling iron unsupervised while it is on
Scalding burns - how quickly they can occur?
- hot water causes 3rd degree burns in: 1 sec at 156 2 sec at 149 5 sec at 140 15 sec at 133
Most common cause of non-fatal injury? Peak incidence?
prevention?
- falls
- peak incidence: toddler years
- more than 700,000 hospitalizations a year
- 3rd leading cause of death from injury (all persons)
- prevention: home safety:
barriers, pointed corners, sharp edges, closed doors, inaccessible windows, bars on apt windows - no infant walkers!!
Pedestrian injuries highest risk in what age group? Prevention?
- highest risk: 10-15 years old
prevention: - pedestrian education
- look both ways
- walk on side walks or against flow of traffic
- adequate lighting, bright reflective clothing
- guardian supervision (esp under 9)
- traffic management:
observe/enforce speed limits and traffoc signs/lights - school bus stops away from high traffic areas
When are bike injuries highest risk of death?
- boys age 5-14
- head trauma most serious injuries
- most deaths involve crash with motor vehicle
- prevention: bike helmets
- bike safety education
- bike paths versus shoulder of road
Greatest risk period for FB/choking?
Prevention?
- 1st yr of life
- prevention:
age approp toys, food prep, liquid meds under 3 yrs, small objects out of reach
Common toy related injuries?
- aspiration and ingestion dangers
- burns and electric shock
- lacerations
- projectile injuries
- skateboards, rollerblades, other high speed devices
Most common sports injuries?
- sprains, strains, and contusions
- re-injury is a major problem
Types of life-threatening sports injuiries?
- severe head/neck injury
- cardiac or respiratory arrest
- severe hemorrhage or shock
- heat stroke
Differences in musculokseletal system in ped pts?
- ped bone has higher water content and lower mineral content: so less brittle than adult bone, thick periosteum in kids, rich blood supply
- physis (growth plate): cartilagionous structure that is weaker than bone predisposed to injury
Most commonly fractured bone in kids?
- clavicle
- younger kids fracture upper extremities
- get older, more risk for lower extremity fractures
- closed reductions of fractures more common in kids
Why are kids at risk for head trauma?
- large heads
- thin skulls
- poor muscle control
- diffuse edema more common than intracranial hematomas
When should you consider the possibility of serious injury in a child?
- if injured child has altered mental status or appears to have inappropriate behavior
- sig mechanism regardless of whether there are obvious injuries
- injured child has evidence of poor systemic perfusion
Guidelines for neuroimaging in head trauma?
- imaging recommended if LOC greater than 1 min, evidence of skull fx, or focal neuro findings
- consider imaging or observation if brief LOC
There is an increased likelihood of intracranial injury if what sxs and signs are present?
- immediate seizures
- HA
- vomiting
- lethargy