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Supervision of young children with fall injuries
Yessenia Castro1, Elizabeth C Powell, Karen M Sheehan
1Children's Memorial Hospital, Department of Pediatrics, Northwestern University's Feinberg School of Medicine, Chicago, Illinois, USA.
Insights
Supervision strategies, even with visual contact or physical proximity, were insufficient to prevent fall injuries in young children presenting to the emergency department. Many falls occurred despite caretakers being attentive or within reach.
Area of Science:
- Pediatrics
- Injury Prevention
- Child Safety
Background:
- Limited data exists on supervision practices for young children experiencing fall-related injuries.
- This study examines supervision and environmental factors in falls requiring emergency department care.
Purpose of the Study:
- To describe supervision and physical environment details for young children with fall injuries.
- To identify factors contributing to falls despite caretaker presence.
Main Methods:
- A convenience sample of 108 children under 7 years old with fall injuries was enrolled.
- Data collected included child demographics, fall circumstances, and supervision levels.
Main Results:
- The average age was 3 years, with 70% of falls from a height (e.g., stairs).
- Supervision varied, with 45% observing, 19% listening, and 9% reporting no supervision.
- Falls from height were more associated with listening or no supervision compared to observation or active engagement.
Conclusions:
- Many falls occurred while children were supervised, with most caretakers having visual contact or being within reach.
- Current supervision strategies appear insufficient to prevent falls in many situations.
- Further research is needed to develop effective fall prevention strategies for young children.
Background:
Specific information about the supervision of young children with injuries related to falls is limited. In this study, we describe the supervision and physical environment of falls resulting in medical care in the emergency department.
Methods:
We enrolled a convenience sample of 108 children younger than 7 years with fall injuries.
Results:
The average age was 3 years, and 56% were male. Seventy-six (70%) were a fall from a height including 16 that involved stairs. Among caretakers in a nongroup setting (n = 95), most (61%) were supervising more than one child. The attention to the child was holding or playing with the child (13%), observing (45%), usually constantly, or listening for the child (19%); 9% reported no supervision at the time of the fall. Thirty-two percent stated they were touching or within reach of the child. Of falls indoors (n = 56), the supervisor was in the same room as the child for more than half of cases. There was no association between the number of children supervised and fall type (height vs. same level). When compared with those with same level falls, children with falls from a height were more often supervised with listening or no supervision (vs. observation, holding, or playing with the child) χ², p = 0.004.
Conclusions:
Many children were supervised at the time of their fall. Most caretakers had visual contact, and up to a third were touching or within reach of the child. The strategies used in these apparently low-risk situations were insufficient to prevent the falls we report.
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