Injury Prevention Flashcards
What is the evidence in support of bike helmet legislation?
- increases helmet use
- reduces risk of head injury
What % of injuries in biking are due to head injuries?
20-40% (and almost all deaths)
By how much to helmets reduce the risk of brain and facial injury when biking?
47-72%
What type of bike helmet legislation is most effective?
-all-ages legislation, then laws requiring all riders
What is required to ensure bike helmet legislation is effective?
-enforcement to sustain its effectiveness and education
What factors make a kid more likely to wear a helmet?
-if an adult is also wearing a helmet
What are some additional strategies besides bike helmet legislation that can decrease bike injuries?
- dedicated bike lanes and paths
- sales tax exemptions and tax rebates to make bike helmets less expensive
What is the purpose of a child death review system?
- 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
What is the leading cause of death in kids in Canada age 1-19 yrs?
unintentional injury
In what particular areas has a child death review system helped?
- SIDS
- unintentional injuries
- suicide in youth
- homicide
- child maltreatment
What are the benefits of a child death review system?
- 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
What are key components of a child death review system?
- broad representation (coroner, child protection, health care providers, etc)
- structured process
- linkable databases
- evaluation mechanism
- support from government
What are risk factors for injury?
- aboriginal
- rural setting (e.g. agricultural workers)
- male
- SES
What are the top 3 leading causes of injury-related deaths?
1) MVC
2) drowning
3) threats to breathing
(falls are the leading cause of hospitalization)
What are the principles of injury prevention?
1) education
2) enforcement/legislation
3) engineering (changes to products or environments to make them safer)
What are the CPS recommendations about children and ATVs?
-kids
If you are going to operate an ATV what precautions should be taken?
- 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
Does Canada have a unified approach to ATV safety and enforcement?
nope. no jurisdiction in Canada is in accordance with all the CPS recommendations
What is the minimum age recommendation by ATV industry for riding?
6 years
-they have youth models
Which areas of Canada require special attention and focus regarding ATV use and why?
-remote northern and aboriginal communities where ATVs provide one of the only means of transportation
Which age group is the least compliant with safety practices for ATVs?
16-17 years
What are risk factors for youth regarding injuries from ATVs?
- inexperience
- inadequate physical size and strength
- immature motor and cognitive development
- tending to engage in risk-taking behaviours
Which group of kids is at highest risk for playground injuries?
-kids 5-9 yrs, M>F, during the summer season
What is the most common mechanism and resulting injury from playgrounds?
- fractures (usually of upper limb) from falls
- head injuries are 15%
What is the most common cause of death related to playground injuries?
-deaths are rare but usually strangulation
What are some strategies to reduce playground injuries?
- 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
What are some strategies paediatricians can employ?
- anticipatory guidance
- advocate for playgrounds to meet the current Canadian Standards association standards
- talk to parents about active supervision and safety
What are negative outcomes of choking and suffocation?
- death
- anoxic brain injury
- esophageal perforation
What is the definition of choking?
Who is most at risk and what objects are the usual culprits?
- interruption of breathing by internal obstruction of airway
- kids
What is aspiration?
-object inhaled into the respiratory system
What is suffocation and what things are the usual culprits?
- airway obstruction by external objects that blocks nose and mouth
- soft toys, bedding
- plastic bags
What is strangulation and what things are the usual culprits?
- external constriction of the neck
- drawstrings on clothes, blinds, ropes, belts, leashes
What is entrapment?
mechanical interference with respiration, head and neck caught in a constricting position
(e.g. gap in playground, car window, etc)
What is traumatic/crush asphyxia?
-mechanical fixation of the chest (e.g. fallen furniture, burial in soil or grain)
What are some industry specific regulations to try and prevent choking and suffocation?
- 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
What are some recommendations related to preventing choking and suffocation?
- 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
What winter sports have the most associated injuries?
1) hockey
2) snowboarding
3) skiing
What types of injuries are more likely to be encountered by skiers vs snowboarders?
- 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
What are risk factors for injury with snowboarding and skiing?
- 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)
What are some prevention strategies to decrease ski and snowboarding accidents?
- 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
What should MDs provide as anticipatory guidance to families about skiing and snowboarding?
- 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
What should governments and ski slopes do to prevent injury?
- make helmets mandatory
- improve helmet access
- promote and ensure safe slope designs
Why are car seats and booster seats required?
- 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
What are the top 3 most common errors made related to transportation of kids in vehicles?
- 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
What are the stages of carseats and when can they move to the next stage?
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)
What are some specific car seat recommendations for premature or small infants?
- 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
What is a high-back belt-position car seat?
-provides head and neck support for cars without head restraints. Need to use with lap and shoulder seat belt
What is the infant/child/booster and child/booster car seats?
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
What is a low-back/backless belt/positioning booster?
- designed for cars with adjustable head restraint
- also need shoulder and lap belt
What is CPS’ position on booster seat legislation?
- 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
What is lap belt syndrome?
Pattern of injury to child’s internal organs and spine caused by an ill-fitting seat belt
Which seat in the car is the safest?
rear middle seat
When can a kid sit in the front?
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)
Can you put a rear facing car seat in front of an air bag?
never
What are the recommendations for proper car seat installation?
- 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
True or False. Forward facing seats require a tether strap.
True
How do you put a kid in a car seat?
- 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
What are CPS recommendations regarding use of snowmobiles?
- no kids 16 yrs
- kids
What group is the highest risk for injuries from snowmobiling?
- boys
- younger people are more likely to be victims
- head injuries are th e leading cause of injury and death
What are some risks of using a snowmobile?
- 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)
What is the second leading cause of death in kids 1- 4yrs of age?
drowning
Where do drownings of young kids tend to occur most?
- around the home
- infants mostly in bathtubs
- toddlers mostly in pools
At what age is the earliest a child can master basic aquatic locomotive skills?
When can they do front crawl?
4 years (regardless of when 'swimming lessons' start) -front crawl at 5.5 yrs
What is the evidence for swimming lessons in kids age 2-4 yrs?
- 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
What are some hazards of swimming lessons besides drowning?
- water intoxication with hyponatremia and seizures
- hypothermia
- infectious diseases (e.g. otitis externa)
What are the safety recommendations around residential pools?
- 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
