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Children's injuries in a Scottish district general hospital
Colin A Graham1, Andrew Macdonald, James Stevenson
1Crosshouse Hospital, Kilmarnock KA2 0BE, Scotland, UK. cagraham@cuhk.edu.hk
Insights
Paediatric injury is a common reason for emergency department (ED) visits. Increased use of safety devices like cycle helmets could significantly reduce childhood injuries and ED attendances.
Area of Science:
- Pediatrics
- Public Health
- Trauma Care
Background:
- Injuries frequently lead to emergency department (ED) visits for children.
- Limited data exists on the range of paediatric injuries presenting to district general hospitals (DGHs).
- This study aimed to comprehensively document injury presentations at a DGH ED.
Purpose of the Study:
- To characterize the spectrum of paediatric injuries presenting to a district general hospital emergency department.
- To assess the utilization of safety devices during childhood injury incidents.
- To identify patterns and potential preventative strategies for paediatric trauma.
Main Methods:
- A prospective questionnaire study was conducted on consecutive paediatric patients (<14 years) presenting to a DGH ED in Scotland.
- Data collected included injury circumstances, use of safety devices, and supervision levels.
- Hospital admission data and mortality information were obtained to provide a complete picture.
Main Results:
- 1,378 questionnaires were completed out of 10,697 eligible patients.
- Safety devices were underutilized; cycle helmets were used in 26% of cycling incidents and seat belts in 71% of car incidents.
- Unsupervised incidents were common, especially at school (73%), and cycling/pedestrian injuries peaked in summer and after school hours.
Conclusions:
- Trauma is a significant cause of paediatric emergency department attendance.
- Underutilization of preventative measures, such as cycle helmets, represents a missed opportunity for injury reduction.
- Enhanced use of safety devices, particularly cycle helmets for school-aged children, could substantially decrease injury incidence and ED visits.
Background:
Injury is a common cause of emergency department (ED) attendance but there are few data published on the spectrum of paediatric injury in a typical district general hospital (DGH). This study aimed to provide a complete picture of injury presentations to such a centre.
Methods:
Prospective questionnaire study of consecutive paediatric attendances at a DGH ED in Scotland (annual attendance 53,500 patients) due to injury or poisoning. Paediatric in this context was defined as less than 14 years on the day of presentation. Admission rates were identified from the hospital information system and information on deaths was sought from the local Procurator Fiscal (the Scottish equivalent of the Coroner).
Results:
One thousand three hundred and seventy-eight questionnaires were completed from a potential 10,697 eligible patients. Safety devices (helmets, belts, etc.) were in use in only 99 cases. Cycle helmets were used in 26% of cycle incidents and seat belts were used in 71% of car incidents. Cycling and pedestrian incidents were more common during the summer months and outside school hours. Adult supervision was present in 49% of incidents. Seventy-three percent of incidents at school were unsupervised. There were 5.6 admissions to hospital per day in the 0-13 years age group for all causes, with little seasonal variation in admission rates. There were three deaths during the year, two from SIDS and one due to choking, all in infants.
Conclusion:
Trauma is a common cause of ED attendance in children. Preventative measures are still underutilised and could make a significant impact on the incidence of children's injuries and possibly ED attendances. Cycle helmets could play a major role in injury prevention in school age children in this area.
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