Farm accidents in children: eleven years of experience

The aim of this study was to review accidental injuries to children on farms.

Between January 1988 and December 1999, childhood farm injuries referred to a trauma center were reviewed.

Forty-five children under 19 years of age were identified. Mean age was 7.3 years. Male to female ratio was 2:1. A total of 31 of 45 (69%) survived. A total of 14 of 45 (31%) died. The mechanism of injury was tractor in 15 (33%), animals in 13 (29%), other machinery in 9 (20%), falls in 4 (9%), burns in 2 (4%), equipment in 1 (2%), and mechanism not documented in 1 (2%). Twelve deaths involved tractors or machinery (86%), and 2 involved animals (14%). Thirty of forty-five (67%) accidents occurred between June and October. A total of 28 of 45 (62%) occurred between 1 PM and 6 PM. Nine fatalities (64%) were supervised. Predominant injuries were orthopedic in 25 of 45 (56%), neurologic in 19 of 45 (42%), and thoracoabdominal in 10 of 45 (22%). Eighteen (40%) underwent orthopedic surgery. Six patients (13%) had long-term disability. Seven survivors and 7 fatally injured patients (31%) had multiple injuries. Seven of 14 fatalities (50%) had solitary head injuries. The average transport time from scene to rural hospital was 1.5 hours, from rural hospital to trauma center, 2.3 hours. Twelve of fourteen fatalities (86%) were declared dead at the scene, and 2 died en route.

Efforts must be focused to prevent tractor and animal injuries.