Related Experiment Videos
Fatal childhood injury patterns in an urban setting
C L Weesner1, S W Hargarten, C Aprahamian
1Department of Emergency Medicine, College of Wisconsin, Milwaukee.
Insights
Fatal childhood injuries in Milwaukee County were primarily caused by house fires, firearms, and drowning, differing from national trends. Primary prevention is crucial as few survivors receive inpatient care.
Area of Science:
- Public Health
- Epidemiology
- Trauma Research
Background:
- Childhood injuries remain a significant public health concern.
- Understanding local injury patterns is vital for targeted prevention.
- Emergency medical services (EMS) play a critical role in pediatric trauma care.
Purpose of the Study:
- To characterize fatal childhood injury demographics in an urban county.
- To evaluate the effectiveness of the emergency medical services system in pediatric trauma cases.
- To compare local injury patterns with national data.
Main Methods:
- Retrospective review of medical examiner files, prehospital and hospital records, and police/fire reports.
- Analysis of data from Milwaukee County, Wisconsin, for children aged 15 and under who died from injuries in 1989-1990.
- Evaluation of EMS response times, interventions, and patient outcomes.
Main Results:
- House fires (34%), firearms (19%), and drowning (11%) were leading causes of fatal injury.
- Motor vehicle occupant deaths were less common (7%).
- Homicides accounted for one-third of deaths, with firearms and assault as primary mechanisms. A significant percentage of patients were pronounced dead at the scene or arrived at the ED with no resuscitative efforts. Few victims survived to inpatient care.
Conclusions:
- Fatal childhood injury patterns in this urban setting differ from national averages, with higher rates of fire, firearm, and homicide deaths.
- Prevention strategies must be tailored to specific community injury profiles.
- The low survival rate to inpatient care underscores the importance of primary injury prevention.
Study Objective:
To describe fatal childhood injury patterns in an urban county and evaluate the use of the emergency medical services system.
Design:
Retrospective chart review of medical examiner files, prehospital and hospital records, and police and fire personnel reports.
Setting:
Milwaukee County, Wisconsin, an urban county with a population of approximately 1 million.
Participants:
All children 15 years old or younger who sustained a fatal injury in 1989 or 1990 (70).
Results:
House fires were the leading cause of death by injury (34%), followed by firearms (19%), and drowning (11%). Motor vehicle occupant deaths occurred less frequently (7%). One-third of deaths were homicides (48% firearms and 30% assault). Twenty-four percent of deaths were pronounced at the scene, 12% were dead-on-arrival (no emergency department resuscitative efforts), and 37% were dead-on arrival ED resuscitations. Only 27% of victims survived to become inpatients (84% died within 72 hours). Mean scene time (16.1 +/- 7.9 minutes), transport time (9.5 +/- 5.1 minutes), and success rates for prehospital peripheral IV insertion (72%), endotracheal intubation (91%), and intraosseous line (86%) were not significantly different among those who were dead-on-arrival, dead-on-arrival failed resuscitations, or eventual inpatients.
Conclusion:
Fatal childhood injury patterns in this urban setting differed from reported national injury patterns. This study found a higher percentage of deaths from fire, gunshot wounds, and homicides but a lower percentage of motor vehicle-related deaths. Prevention strategies need to address the injury patterns of a particular community. Only a small percentage of victims survived to receive inpatient care following their injuries, suggesting that primary prevention of injury may be the most effective intervention.