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Pediatric injuries presenting to an emergency department in a developing country
T D Kirsch1, R W Beaudreau, Y A Holder
1Johns Hopkins School of Medicine, Department of Emergency Medicine, USA.
Insights
Pediatric injuries are a major cause of morbidity in Trinidad and Tobago, with falls being the most common cause. Emergency department surveillance can help identify high-risk groups for injury prevention programs.
Area of Science:
- Public Health
- Pediatric Injury Surveillance
- Traumatology
Background:
- Pediatric injuries represent a significant public health concern globally.
- Emergency departments (EDs) serve as critical sites for injury surveillance.
- Understanding injury patterns is essential for developing effective prevention strategies.
Purpose of the Study:
- To characterize the causes and outcomes of pediatric injuries.
- To utilize emergency departments (EDs) as a surveillance system for pediatric injuries.
- To inform injury prevention efforts in Trinidad and Tobago.
Main Methods:
- Prospective 14-day survey of all injuries in two national trauma referral hospitals.
- Data collection included patient demographics, injury type, cause, and outcome.
- Chi-squared test used for statistical analysis of categorical variables.
Main Results:
- Pediatric patients (< 20 years) constituted 41.5% of injury visits.
- Falls (44.4%) were the leading cause of injury, followed by blunt objects (12.3%) and sharp objects (11.8%).
- Home (46.2%) and school (25.5%) environments were primary settings for injuries.
Conclusions:
- Pediatric injuries are a substantial cause of morbidity and mortality in the country.
- ED surveillance offers an effective method for identifying high-risk pediatric injury groups and activities.
- Findings can guide the development of injury prevention programs in developing nations.
Purpose:
To describe the causes and outcomes of pediatric injuries using the emergency departments (ED) as a surveillance site.
Method:
Prospective, 14-day surveys of all injuries were conducted in the EDs of the two national trauma referral hospitals of Trinidad and Tobago. Data on patient demographics, type, cause, and outcome of injuries were collected. The chi 2 test for significance was used for categorical variables.
Results:
Pediatric patients (< 20 years) accounted for 41.5% (714/1722) of injury visits. Of these, 62.6% were male and 17.4% were < four years old, 26.2% four to nine years, 31.1% 10 to 14 years, and 25.4% were 15 to 19 years old. Three patients (0.4%) died, 68.6% were discharged, and 31.0% admitted. Intentional injuries accounted for 13.9% of injuries. Of the intentional injuries, the assailant was significantly more likely to be known than not (P < 0.01). The most common causes of all injuries were: falls, 44.4%; blunt objects, 12.3%; sharp objects, 11.8%; motor vehicle (including pedestrians), 7.4%; poison, 3.6%; and burns, 1.7%. Injuries occurring in the home accounted for 46.2%; in school, 25.5%; sports/recreation, 11.1%; and at work, 4.5%. The most common injuries were: lacerations, 30.8%, contusions/abrasions, 26.7%, fractures, 18.8%; and sprains/dislocations, 9.4%.
Conclusion:
Pediatric injuries are a significant cause of morbidity and mortality in this country, accounting for almost one third of injured patients. Because of the low frequency of pediatric injury deaths, ED surveillance may be a more effective means of identifying high risk groups and activities for injuries. Data from EDs may be useful in other developing countries to develop injury prevention programs.