Injury Prevention Flashcards

1
Q

What is the evidence in support of bike helmet legislation?

A
  • increases helmet use

- reduces risk of head injury

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2
Q

What % of injuries in biking are due to head injuries?

A

20-40% (and almost all deaths)

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3
Q

By how much to helmets reduce the risk of brain and facial injury when biking?

A

47-72%

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4
Q

What type of bike helmet legislation is most effective?

A

-all-ages legislation, then laws requiring all riders

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5
Q

What is required to ensure bike helmet legislation is effective?

A

-enforcement to sustain its effectiveness and education

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6
Q

What factors make a kid more likely to wear a helmet?

A

-if an adult is also wearing a helmet

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7
Q

What are some additional strategies besides bike helmet legislation that can decrease bike injuries?

A
  • dedicated bike lanes and paths

- sales tax exemptions and tax rebates to make bike helmets less expensive

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8
Q

What is the purpose of a child death review system?

A
  • conduct a comprehensive review of child deaths to advance understanding of how and why children die, to improve child health and safety and to prevent deaths and injuries in the future
  • avoids fault finding with service or care providers
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9
Q

What is the leading cause of death in kids in Canada age 1-19 yrs?

A

unintentional injury

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10
Q

In what particular areas has a child death review system helped?

A
  • SIDS
  • unintentional injuries
  • suicide in youth
  • homicide
  • child maltreatment
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11
Q

What are the benefits of a child death review system?

A
  • identify trends and make recommendations to modify RF, address issues
  • can improve medical and mental health best practices, legislation, etc
  • barriers are lack of a national strategy
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12
Q

What are key components of a child death review system?

A
  • broad representation (coroner, child protection, health care providers, etc)
  • structured process
  • linkable databases
  • evaluation mechanism
  • support from government
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13
Q

What are risk factors for injury?

A
  • aboriginal
  • rural setting (e.g. agricultural workers)
  • male
  • SES
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14
Q

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

A

1) MVC
2) drowning
3) threats to breathing
(falls are the leading cause of hospitalization)

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15
Q

What are the principles of injury prevention?

A

1) education
2) enforcement/legislation
3) engineering (changes to products or environments to make them safer)

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16
Q

What are the CPS recommendations about children and ATVs?

A

-kids

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17
Q

If you are going to operate an ATV what precautions should be taken?

A
  • government certified helmet
  • eye protection
  • protective clothing and footwear
  • ATVs designed for single riders should never take on passengers
  • do not operate vehicle after drinking or taking substances
  • complete an approved training course with mandatory testing to pass
  • local education programs are essential
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18
Q

Does Canada have a unified approach to ATV safety and enforcement?

A

nope. no jurisdiction in Canada is in accordance with all the CPS recommendations

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19
Q

What is the minimum age recommendation by ATV industry for riding?

A

6 years

-they have youth models

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20
Q

Which areas of Canada require special attention and focus regarding ATV use and why?

A

-remote northern and aboriginal communities where ATVs provide one of the only means of transportation

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21
Q

Which age group is the least compliant with safety practices for ATVs?

A

16-17 years

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22
Q

What are risk factors for youth regarding injuries from ATVs?

A
  • inexperience
  • inadequate physical size and strength
  • immature motor and cognitive development
  • tending to engage in risk-taking behaviours
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23
Q

Which group of kids is at highest risk for playground injuries?

A

-kids 5-9 yrs, M>F, during the summer season

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24
Q

What is the most common mechanism and resulting injury from playgrounds?

A
  • fractures (usually of upper limb) from falls

- head injuries are 15%

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25
Q

What is the most common cause of death related to playground injuries?

A

-deaths are rare but usually strangulation

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26
Q

What are some strategies to reduce playground injuries?

A
  • change design so that fall height is not as high and the surface child falls on helps decrease the injuries
  • use protective guardrails and barriers
  • appropriate surfacing includes loose fill (sand, wood chips) and synthetic surfaces
  • active supervision is important
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27
Q

What are some strategies paediatricians can employ?

A
  • anticipatory guidance
  • advocate for playgrounds to meet the current Canadian Standards association standards
  • talk to parents about active supervision and safety
28
Q

What are negative outcomes of choking and suffocation?

A
  • death
  • anoxic brain injury
  • esophageal perforation
29
Q

What is the definition of choking?

Who is most at risk and what objects are the usual culprits?

A
  • interruption of breathing by internal obstruction of airway
  • kids
30
Q

What is aspiration?

A

-object inhaled into the respiratory system

31
Q

What is suffocation and what things are the usual culprits?

A
  • airway obstruction by external objects that blocks nose and mouth
  • soft toys, bedding
  • plastic bags
32
Q

What is strangulation and what things are the usual culprits?

A
  • external constriction of the neck

- drawstrings on clothes, blinds, ropes, belts, leashes

33
Q

What is entrapment?

A

mechanical interference with respiration, head and neck caught in a constricting position
(e.g. gap in playground, car window, etc)

34
Q

What is traumatic/crush asphyxia?

A

-mechanical fixation of the chest (e.g. fallen furniture, burial in soil or grain)

35
Q

What are some industry specific regulations to try and prevent choking and suffocation?

A
  • any toy likely to be used by a younger kid must pass a small parts test (fit through empty toilet paper roll)
  • eyes on dolls must withstand a pull of 9kg for 5 mins
  • labels warning about choking hazards
36
Q

What are some recommendations related to preventing choking and suffocation?

A
  • revise the hazardous products act to include known hazards (e.g. bunk beds, drawstrings, etc)
  • daycares should integrate safety guidelines
  • communities should follow the standards for safe play spaces
  • manufacturers should reduce the use of plastic packaging and identify specific risks
  • give anticipatory guidance around choking
  • encourage CPR courses
37
Q

What winter sports have the most associated injuries?

A

1) hockey
2) snowboarding
3) skiing

38
Q

What types of injuries are more likely to be encountered by skiers vs snowboarders?

A
  • skiers - more likely to be injured due to collisions, more likely to injury lower extremities
  • snowboarders - more likely to be injured by falling, more likely to have wrist injuries and head injuries
39
Q

What are risk factors for injury with snowboarding and skiing?

A
  • snowboarder>skier
  • male
  • lack of experience
  • younger age
  • poor equipment/poorly adjusted bindings
  • rented or borrowed equipment
  • poor facility design (location of trees, lifts, etc)
40
Q

What are some prevention strategies to decrease ski and snowboarding accidents?

A
  • helmets
  • wrist guards
  • taking lessons
  • ski area and safety programs
  • never go alone
  • exercise ans stretch before activity
  • stay on marked trails
  • wear appropriate gear
  • stop when too tired
41
Q

What should MDs provide as anticipatory guidance to families about skiing and snowboarding?

A
  • wear proper protective hear
  • get lessons
  • be familiar with and adhere to alpine responsibility code
  • ensure safe environment, adequate supervision, good equipment
  • ensure proper fit and adjustment of equipment
  • no alcohol or drugs when on the slopes
42
Q

What should governments and ski slopes do to prevent injury?

A
  • make helmets mandatory
  • improve helmet access
  • promote and ensure safe slope designs
43
Q

Why are car seats and booster seats required?

A
  • MVCs are leading cause of death in Canadian children
  • car seats reduce risk of fatal injury by 71% when used correctly and booster seats reduce risk of injury by 57% compared to seat belt alone
44
Q

What are the top 3 most common errors made related to transportation of kids in vehicles?

A
  • seat not tightly secured (moves >2.5cm/1 inch in any direction)
  • harness not snug (more than 1 finger width between harness strap and kid)
  • chest clip not at armpit level

OTHER COMMON ERROS

  • not anchoring the tether strap for forward facing car seats
  • placing rear-facing infant seat in front of air bag
  • wrong angle of infant seats (should be at 45 degrees)
  • routing the seatbelt through an incorrect slot
  • using recalled infant seats or ones that have been in a previous crash
  • failing to restrain a child
45
Q

What are the stages of carseats and when can they move to the next stage?

A

Stage 1
-rear-facing until kid at least 10 kg AND at least one year and be able to walk
(when weight or height for infant seat is exceeded switch to infant/child seat but still rear facing)
-needs to be secured with seat belt or universal anchorage system

Stage 2

  • forward facing car seats
  • until at least 18 kg before moving to next stage
  • can use for kids 10-22kg and up to 122 cm
  • need secure with tether strap AND vehicles seat belt or universal anchorage system

Stage 3

  • booster seat
  • need to be at least 18 kg
  • can use until kid is at least 36 kg

Stage 4

  • seat belts
  • for kids >36 kg AND who are at least 8 years old AND who properly fit into adult seat belts (usually height at least 145cm)
46
Q

What are some specific car seat recommendations for premature or small infants?

A
  • use restraints without shields, abdominal pads/arm rests that could cause injury
  • ensure that the seat allows for an infant weight 2.27kg or less
47
Q

What is a high-back belt-position car seat?

A

-provides head and neck support for cars without head restraints. Need to use with lap and shoulder seat belt

48
Q

What is the infant/child/booster and child/booster car seats?

A

3-in1 or 2-in-1 seats

  • rear and/or forward facing, 5 point harness system which can be removed to covert seat to booster seat
  • use beehive seat belt after converted to booster seat
  • some still recommend using tether strap with booster seat as added precaution
49
Q

What is a low-back/backless belt/positioning booster?

A
  • designed for cars with adjustable head restraint

- also need shoulder and lap belt

50
Q

What is CPS’ position on booster seat legislation?

A
  • supportive of it but not all provinces have legislation
  • CPS feels it is necessary to bridge the gap from kids too big for carseat but too small for seatbelt alone
  • higher risk of help belt syndrome and spine injuries with seat belt
51
Q

What is lap belt syndrome?

A

Pattern of injury to child’s internal organs and spine caused by an ill-fitting seat belt

52
Q

Which seat in the car is the safest?

A

rear middle seat

53
Q

When can a kid sit in the front?

A

When they are at least 13 years old b/c front air bags can cause serious harm
(which the exception of compact extended cab pick up truck; kids are safer in the from row)

54
Q

Can you put a rear facing car seat in front of an air bag?

A

never

55
Q

What are the recommendations for proper car seat installation?

A
  • install tightly with no more than 2.5 cm of movement in either direction when pulled on at anchor point
  • rear-facing restraint system should be positioned at 45 degree angle
56
Q

True or False. Forward facing seats require a tether strap.

A

True

57
Q

How do you put a kid in a car seat?

A
  • rear-facing: shoulder harness should be at or below the infant’s shoulders and snug (only one finger btwn the collar bone and harness)
  • chest clip should be at level of the infant’s armpit
  • booster seat: lap belts should be over hips/pelvis not abdomen; and shoulder part over the middle of the clavicle and chest (not touching the neck)
  • should be able to bend knees comfortably over the edge of the seat
58
Q

What are CPS recommendations regarding use of snowmobiles?

A
  • no kids 16 yrs

- kids

59
Q

What group is the highest risk for injuries from snowmobiling?

A
  • boys
  • younger people are more likely to be victims
  • head injuries are th e leading cause of injury and death
60
Q

What are some risks of using a snowmobile?

A
  • death
  • head injury
  • drawoning when break through ice
  • hearing loss from prolonged exposure to excess engine noise
  • white finger syndrome (cold weather and had-arm vibrations of the handlebar)
61
Q

What is the second leading cause of death in kids 1- 4yrs of age?

A

drowning

62
Q

Where do drownings of young kids tend to occur most?

A
  • around the home
  • infants mostly in bathtubs
  • toddlers mostly in pools
63
Q

At what age is the earliest a child can master basic aquatic locomotive skills?
When can they do front crawl?

A
4 years (regardless of when 'swimming lessons' start)
-front crawl at 5.5 yrs
64
Q

What is the evidence for swimming lessons in kids age 2-4 yrs?

A
  • can improve swimming ability and deck behaviour but no evidence that they prevent drowning or near drowning
  • should be promoted as working on confidence and educating parents about water safety
65
Q

What are some hazards of swimming lessons besides drowning?

A
  • water intoxication with hyponatremia and seizures
  • hypothermia
  • infectious diseases (e.g. otitis externa)
66
Q

What are the safety recommendations around residential pools?

A
  • fenced on all 4 sides with a self-closing, self-latching gate
  • constant arms-length supervision
  • infants must always be held by an adult
  • PFDs for all kids who can’t swim
  • encourage CPR training for families