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Short vertical falls in infants
C A Tarantino1, M D Dowd, T C Murdock
1Department of Pediatrics, The Children's Mercy Hospital, Kansas City, Missouri 64108, USA.
Insights
Short vertical falls (SVF) in infants rarely cause severe injuries, with most resulting in minor harm. Being dropped by a caregiver poses a higher risk of significant injury compared to falls from furniture.
Area of Science:
- Pediatric Emergency Medicine
- Injury Prevention
- Child Safety
Background:
- Short vertical falls (SVF) are common in infants.
- Understanding injury patterns is crucial for appropriate medical evaluation.
Purpose of the Study:
- To define injuries resulting from short vertical falls in infants.
- To compare injury severity based on fall mechanisms.
Main Methods:
- Retrospective chart review of infants under 10 months.
- Analysis of injuries from falls up to 4 feet.
- Comparison of outcomes for different fall types.
Main Results:
- 167 infants were analyzed; 85% had minor or no injuries.
- Significant injuries (15%) included head injuries, skull fractures, and long bone fractures.
- Being dropped by a caregiver was independently associated with significant injury (OR: 6.4).
Conclusions:
- Most infant short vertical falls result in minor injuries.
- Falls from a caretaker's arms carry a higher risk of significant injury than falls from furniture.
- Intracranial hemorrhage was not observed in non-abuse related SVF cases.
Objective:
To define injuries from short vertical falls (SVF) in infants, and to compare those with minor or no injuries to those with significant injury.
Design:
Descriptive, retrospective chart review.
Setting:
Pediatric emergency department (PED) of an urban teaching hospital.
Subjects:
Infants < or = 10 months treated between January 1990 and December 1992 presenting with a SVF (< or = 4 feet).
Results:
167 patients met the definition. The mean age was 5.2 months; 56% were male. The mechanisms of injury included rolling off a bed (55%), being dropped from a caretaker's arms (20%), rolling off a couch (16%), and falling from other objects (10%). The majority of patients (85 %) had minor or no injury. Significant injuries were sustained by 15% (n = 25), including 16 with a closed head injury (12 with skull fractures), two with intracranial bleed, and seven with a long bone fracture. Subsequently, the two patients with intracranial hemorrhages were confirmed as being from child abuse. After excluding cases of suspected abuse, the only characteristic found to be independently associated with significant injury was being dropped by the caretaker (odds ratio: 6.4 vs rolling or falling from furniture, 95% CI: 2.0, 21.5).
Conclusion:
The most common mechanism of a SVF was rolling off a bed. Most patients sustained minor or no injury. No child sustained an intracranial hemorrhage from a SVF. The child with intracranial injury and/or multiple injuries warrants an investigation. Being dropped appears to be a greater risk for significant injury than rolling off or falling from furniture.