overview of childhood injury
TRANSCRIPT
7/28/2019 overview of Childhood Injury
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CHILDHOOD INJ URIES
Dr hanan abbasAssistant professor of family medicine
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Injuries are responsible for 10% of all deaths worldwide.
• Someone dies from an injury every five seconds.
• More than 15,000 people die as a result of injuries every day .
• About 5.8 million people die from injuries every year .
Injuries kill 32% more people around the world than malaria,tuberculosis, and HIV/AIDS combined.
Scope of the Problem
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5-24 years of age: 2001
Rank 5-9 10-14 15-19 20-24
1
1,283 1,553 6,646 7,765
2
1,899 3,398
3272 1,611 2,360
4137
5189
Unintentional Injury
Congenital
AnomaliesSuicide
Homicide Congenital
Anomalies Malignant Neoplasms
Malignant Neoplasms Homicide
Source: CDC, NCHS Vital Statistics System-Mortality.
Heart
Disease
HomicideHeart Disease
Age group
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Highlights•157,078 deaths due to injuries-all ages
(13,806 of these were 5-19 years of age)
•Unintentional injuries were the leading cause of death for childrenand adolescents 5-19 years of age
The five leading mechanisms of injury deaths for those 5-19:
Motor vehicle traffic (48%)Firearm (21%)Suffocation (7%)Drowning (5%)Poisoning (5%)
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ury ea ra es accor ng o n en among
rsons
-19 years of age: 1990 and 2001
1990 2001 1990 2001
All injury 12.7 8.5 71.5 50.9
Unintentional 10.3 6.9 42.5 32.8
Suicide 0.8 0.7 11.1 7.9
Homicide 1.5 0.8 17.0 9.4
Undetermined 0.2 0.1 0.7 0.7
*Rate per 100,000 populationSources: CDC, NCHS Vital Statistics System-Mortality, U.S. Bureau of the Census- decennial census population counts for 1990, 2001population estimates based on the 2000 census.
Ages 5-14 Ages 15-19
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5-19 years of age, 1998-2001
1
10
100
1,000
10,000
100,000
5 6 7 8 9 10 11 12 13 14 15 16 17 18 19
Note: Data are plotted on the log scale, data for 1998-2000 are an average.Sources: CDC, NCHS-National Hospital Ambulatory Care Survey, National Hospital Discharge Survey, National Vital Statistics System-
Mortality.
Rate per 100,000 population
Injury-related hospitalizations-(1998-2001)
Injury-related emergency department visits-(1998-2001)
Injury Deaths-(2001)
Age
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among persons under 18 years of age: 1999-2000
0
20
40
60
80
100
120
140
160
Male
Female
Emergency dept. visits per 1,000 population
Unintentional
injuriesFalls Cut/pierceStruck
object/personIntentional
injuries
Motor vehicletraffic
Note: Data are a two-year average for 1999-2000.Source: CDC, NCHS-National Hospital Ambulatory Care Survey.
Cause (unintentional injuries)
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Selected
characteristic
Home
inside
Home
outside
School/child care
center/
preschool
Street/
highway/
parking lot
Sport facility/recreation
area/
lake/river/pool
Male:Under 12 years 37.3 18.3 9.9 *4.0 10.1
12-17 years *10.0 19.1 38.3 19.7 44.6
Female:Under 12 years 30.0 12.4 8.4 *4.3 6.5
12-17 years 12.3 13.6 24.8 *13.3 18.5
Episodes per 1,000 population
Place of occurence
Annual rate of medically attended injury and poisoning episodes byplace of occurrence and by selected characteristics: 2001
Note: *Data do not meet standard of reliability and precision.
Source: CDC, NCHS-National Health Interview Survey.
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CHILDHOOD
INJURIESThe Road
Environment
Pedestrian
Cyclist
Car occupants
The HomeEnvironment
Falls
Burns and scalds
House FiresPoisoning
Lacerations
Suffocation
Drowning
The Leisure
Environment
Drowning
Playground Injuries
Sports Injuries
The School/
Work
Environment
Falls
Burns
Scalds
Lacerations
Poisoning
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Risk Groups
Some groups are more vulnerable to injuries than others. The scope of theproblem varies considerably by:
Age: Injuries are one of the top three causes of death amongpeople between the ages of 5 and 44 years.
Sex: Nearly twice as many men as women die from injuries eachyear.
Income group: Within countries, poorer people have higher ratesof injury-related deaths than wealthier people.
Region: More than 90% of all injury-related deaths occur in low-and middle-income countries.
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Nonfatal Consequences
Tens of millions of people who suffer nonfatal injuries requirehospitalization, emergency department or general practitioner care,or treatment outside the health system.
In addition to direct physical harm, those affected by injuries andviolence may also experience a range of other mental and physical
health consequences, including:
• Anxiety and depression
• Risky behaviors (e.g. alcohol, tobacco, and other drug use;unsafe sexual practices)
• HIV, STDs, and unwanted pregnancies
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Economic Costs
Along with the significant – and often devastating – physical, mental, andemotional consequences of injuries, those affected also experienceconsiderable economic losses resulting from:
• Cost of treatment
• Reduced or lost productivity (e.g. in wages)
Road traffic crashes cost most countries between 1% – 2% of their grossnational product. The economic costs of road traffic crashes worldwide
has been estimated at US$ 518 billion.
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Guidelines for conducting community
surveys on injuries and violence.
WHO; 2004
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VERBAL AUTOPSY
A two step procedure
Data collection : interview of bereaved relatives tocollect information on symptoms experienced by
deceased before death, using some form of surveyinstrument
COD assignment : methods include
physician review of VA data ICD certification, coding, and tabulation
computerised algorithms for population fractions
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Creating Safe Environments
A caregiver should
Know applicable safety practices for child care
Screen environment for hazards and remove
Use safety devices, where applicable
Monitor for environmental hazards
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Know developmental levels of children
Promote safety through action, word, and deed
Role model safety practices to children and parents
Be aware of conditions that contribute to injury
Closely observe children, especially during at-risk
conditions
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Type of Environment
Child Care Centers
Child care centers governed by licensingChild care centers that are multi-use facilities
Child care centers that are not subject to rules andregulations
Family Child Care Homes In-Home Child Care
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By Child
Developmental level
Emotions Stress
Imitation
Behavior
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By Adult
Inattention
Lack of knowledge
Lack of communication
Lack of safety precautions
Emotions
Stress
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Where
Place
Indoors/OutdoorsWhen
Time of day
Tired, hungry, in a hurry
Conditions
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Modifications
Removal of hazards and use of safety devices
Modify behavior using feedback, positivereinforcement, diversion, role playing throughpractice drills
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Monitoring Ongoing process
Formalized
Use checklists
Study injury reports
Observation is foremost activity inmonitoring
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Implications for Caregivers
Role Modeling Safe practices
Education Caregivers
Children
Parents
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Safe staff to child ratio Child care training
Pay attention
Avoid conflict
Reality Check:
Child Care Safety Checklistfor Parents
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Understand and avoid risks to health, safety, andnutrition
Use developmental appropriate practice
Facility licensed or registered, if required
Open door policy for parents