Can we save more

children?

Matteo Bartolomei –nurse specialist in CC Area

- Can we reduce infant mortality?

- Is clinical practice the only answer?

- What can we do?

PATTERSON MIKI M, 1999. Prevention: The Only

Cure for Pediatric Trauma. Orthopaedic Nursing.

• Trauma is the leading cause of death in the United States

• Every two deaths is due to a pediatric trauma

• 60% of the survivors of severe trauma suffers permanent injuries

Prevention programmes in schools for children from 6 to 14

Reduction of mortality rates

TERI CRAWLEY-COHA, 2001. Childhood injury:

A status report. Journal of Pediatric Nursing.

• Drowning is the second leading cause of unintentional injury-related death in children under 14 years. Only four states in the U.S.A. have laws that require fences around residential pools

• 75% of injuries and deaths due to bicycle accidents could be prevented through the use of helmets

• In low-income families the children are four

times more likely to drown, twice as likely

to die in a car accident and 5 times more

likely to die in a fire.

MARY E. RIMSZA et al, 2002. Can Child Deaths Be

Prevented? The Arizona Child Fatality Review Program

Experience. Pediatrics.

Analysis of the possibility

of preventing pediatric

deaths (<18 years) in

Arizona from 1995 to 1999

(total 4806):

-road accidents, 90% were

avoidable (568 out of 634)

-drowning, 86% were

avoidable (161 to 187)

-murder 36% were

preventable (76 to 201)

Nagesh N. Borse et al, 2008. Childhood Injury Report: Patterns of

Unintentional Injuries among 0-19 Year Olds in the United States,

CDC - Centers for Disease Control and Prevention.

• More children die each

year for traumatic

events that added up for

all other diseases

• On average, 12,175

traumatic deaths occur

annually in the

population between 0

and 19

• males have double the

risk of fatal injuries than

females

Nagesh N. Borse et al, 2008. Childhood Injury Report: Patterns of

Unintentional Injuries among 0-19 Year Olds in the United States,

CDC - Centers for Disease Control and Prevention.

le cause di morte

differiscono per fascia di

età

la morte relativa a incidenti di

trasporto è la principale causa di

morte nei bambini (0-19 anni)

Causes of death

differ by age

group

Death occuring during

transport is the leading

cause of death in children

Nagesh N. Borse et al, 2008. Childhood Injury Report: Patterns of

Unintentional Injuries among 0-19 Year Olds in the United States,

CDC - Centers for Disease Control and Prevention.

• An estimated 9.2 million

children annually had an

initial emergency

department visit for an

unintentional injury.

• Injuries due to falls were

the leading cause of

nonfatal injury.

• Nonfatal injury

rates varied by

age group.

Dinesh Sethi et al, 2008. European report on child

injury prevention. WHO - WORLD HEALTH ORGANIZATION

• If all countries in Europe

had the same mortality

rate as countries with

lower rates, 3 young lives

out of 4 would be saved.

• Some countries have

made security a social

responsibility, they have

systematically created a

safe environment and

developed evidence-

based programmes

Dinesh Sethi et al, 2008. European report on child

injury prevention. WHO - WORLD HEALTH ORGANIZATION

• Children in low and middle income families are 60% more at risk of death in road accidents than those living in high income areas.

•Road traffic accidents are the leading cause of death in Europe approximately 16,400 children and adolescents die each year in road accidents

Dinesh Sethi et al, 2008. European report on child

injury prevention. WHO - WORLD HEALTH ORGANIZATION

• Children in low and middle income families are 60% more at risk of death in road accidents than those living in high income areas.

•Road traffic accidents are the leading cause of death in Europe approximately 16,400 children and adolescents die each year in road accidents

•safe roads planning

•speed control and alcohol test

•use of safety devices (seat belts,

helmets, safety seats for cars)

•bike paths and pedestrian areas

Dinesh Sethi et al, 2008. European report on child

injury prevention. WHO - WORLD HEALTH ORGANIZATION

• around 5000 children and

teenagers die from drowning

in Europe every year

• poorest population is 11

times more at risk of

drowning than the richer

• There is 20-fold differences

between countries with the

highest mortality rates and

those with lower rates

Dinesh Sethi et al, 2008. European report on child

injury prevention. WHO - WORLD HEALTH ORGANIZATION

• Children in low and middle income families are 60% more at risk of death in road accidents than those living in high income areas.

•Road traffic accidents are the leading cause of death in Europe approximately 16,400 children and adolescents die each year in road accidents

•safe roads planning

•speed control and alcohol test

•use of safety devices (seat belts,

helmets, safety seats for cars)

•bike paths and pedestrian areas

Dinesh Sethi et al, 2008. European report on child

injury prevention. WHO - WORLD HEALTH ORGANIZATION

• Around 3000 children and

teenagers die because of

poisoning in Europe every

year

• There is 30-fold differences

between countries with the

highest mortality rates and

those with lower rates

• If the rates of all countries

equalled those of the

countries with the lowest

rate, 9 out of 10 lives could

be saved

Dinesh Sethi et al, 2008. European report on child

injury prevention. WHO - WORLD HEALTH ORGANIZATION

• Around 3000 children and

teenagers die because of

poisoning in Europe every

year

• There is 30-fold differences

between countries with the

highest mortality rates and

those with lower rates

• If the rates of all countries

equalled those of the

countries with the lowest

rate, 9 out of 10 lives could

be saved

•packs of medicines and poisons away

from children

•safe closets

•reduction in the availability of toxic

substances

•packages of non-lethal quantities of

drugs

•cretion of poison control centers

•do not take drugs in front of children

Dinesh Sethi et al, 2008. European report on child

injury prevention. WHO - WORLD HEALTH ORGANIZATION

• Around 1700 children and

teenagers die from burn in

Europe every year

• There is 85-fold differences

between countries with the

highest mortality rates and

those with lower rates

• poorest population is 38 times

more at risk of drowning than

the richer

• burns are related to unsafe

environments and in general to

domestic products

Dinesh Sethi et al, 2008. European report on child

injury prevention. WHO - WORLD HEALTH ORGANIZATION

• Around 1700 children and

teenagers die from burn in

Europe every year

• There is 85-fold differences

between countries with the

highest mortality rates and

those with lower rates

• poorest population is 38 times

more at risk of drowning than

the richer

• burns are related to unsafe

environments and in general to

domestic products

•installation of fire alarms and carbon

monoxide detectors (periodicall tested)

•Adjustment of the temperature of hot

water

•standard for lighters

•teach children how to leave the house

in case of fire

•keep hot foods and liquids away from

the table and edges

Dinesh Sethi et al, 2008. European report on child

injury prevention. WHO - WORLD HEALTH ORGANIZATION

• around 1500 children and

teenagers die from falls in

Europe every year

• If Europe had rates of virtuous countries, 9 out of 10 deaths would be avoided

• There is 22-fold differences between

countries with the highest mortality rates

and those with lower rates

Dinesh Sethi et al, 2008. European report on child

injury prevention. WHO - WORLD HEALTH ORGANIZATION

• around 1500 children and

teenagers die from falls in

Europe every year

• If Europe had rates of virtuous countries, 9 out of 10 deaths would be avoided

• There is 22-fold differences between

countries with the highest mortality rates

and those with lower rates

•modify or replace unsafe products

•install security locks on the windows

•define standards for playgrounds

•do not leave a child unattended on a

changing table, bed, couch or other

furniture

•keep one hand on the baby while

changing diapers

•always fasten a child to a highchair,

swing, changing table or stroller

Dinesh Sethi et al, 2008. European report on child

injury prevention. WHO - WORLD HEALTH ORGANIZATION

DROWING

2° POISONING

2° BURS

3°AND IN ITALY?

Dinesh Sethi et al, 2008. European report on child

injury prevention. WHO - WORLD HEALTH ORGANIZATION

ROAD ACCIDENT

25°

AND IN ITALY?

FALLS

16°

Dinesh Sethi et al, 2008. European report on child

injury prevention. WHO - WORLD HEALTH ORGANIZATION

If Italy had the same

mortality rate of the

countries with the best

performance on road

accidents,one out of

two lives could be

saved!

Children's Health and the EnvironmentWHO Training Package for the Health Sector

World Health Organization

PREVENTION

Inform, educate, change habits

Collect and analyze accident

data

Build a safer environment

Risk factors evaluation

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WHERE ARE WE NOW

Prevention is not a main issue in the

politicians’ plans

Lack of data, prevention national

programmes and research

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Where are we

heading to...

Thanks!

Thanks for

collabotation:

•stefano musolesi

•cristian sabbioni

•ilaria sandretti

•alessandro monesi

•massimo izzi

•lamberto calanchi