Refocusing on Childhood Injury Prevention
By Patty Bobbitt RN, BSN, CCM
The first week of September marks Childhood Injury Prevention Week, which makes this month a great time to revisit and brush up on facts around childhood injuries and strategies for prevention.
Injuries and their associated statistics are categorized by intent—unintentional or intentional—and outcome, either fatal or nonfatal. According to a report from the Centers for Disease Control and Prevention (CDC), unintentional injuries are the leading cause of death among children under age 19 in the United States, averaging over 12,000 deaths annually. Equally as concerning are the 9.2 million children who are treated in emergency departments annually for unintentional, non-fatal injuries.
The impact of childhood injuries can be long-lasting. Non-fatal injuries related to lack of oxygen or head trauma can leave children with significant impairment or disability, whether mental, physical, and/or behavioral in nature. Beyond impacting the developing child, these injuries can also carry lifelong consequences for the family as caregivers and for societal support systems as well.
Before considering prevention, it is first critical to understand the most common sources of childhood injury. For injuries resulting in fatality, a report from the CDC explains that causes for injury death vary be age group:
Suffocation represents two-thirds of injury deaths in children under one year of age.
Drowning is the leading cause of injury death for children ages 1 to 4.
Motor Vehicle Traffic-Related injuries are the leading cause of injury death for all other age groups (5 to 9, 10 to 14, and 15 to 19).
Regarding unintentional injuries that did not result in fatality, the report includes falls as the leading cause for all age groups under age 15. Other major causes regardless of age include being struck by or against an object, animal bites or insect stings, overexertion, burns, poisoning, and motor vehicle occupant injuries.
Factors that can increase the likelihood of injuries
Researchers have also looked into factors that make children more susceptible to injuries. A child’s developmental stage plays a major role. Pulling up to walk and learning to become steady can lead to falls, which accounts for falls as the leading cause of nonfatal injury in all age groups under age 15. As children become mobile and begin to explore their world, they will grasp at objects and put things in their mouths, pointing to suffocation as the leading cause of injury death in children less than one year. This exploratory behavior and unsteady gait also aligns with drowning as the leading cause of injury death in children ages one to four.
Research also indicates that males have higher injury rates than females across both fatal and nonfatal injury categories. Further breakdown shows that injury deaths vary by race and also by location, with higher rates among American Indian and Alaska Natives while states in the Northeastern U.S. represent the lowest rates overall.
Socioeconomic factors also play a role, as poor children are disproportionately affected by unintentional injuries. This could be related to lack of affordable safety equipment (smoke detectors, bicycle helmets, etc.) as well as a lack of safe spaces or facilities for play. Proper supervision is also a factor because safe and affordable day care is often not available to lower income families, leading to some children being left at home alone or in the care of older, less attentive siblings.
How to Prevent Childhood Injury
The goal of childhood injury prevention focuses on three tasks:
Prevention of new injuries
Reducing severities of injuries
Decreasing the severity of disabilities after an injury
The Center for Disease Control (CDC) developed The National Action Plan for Child Injury Prevention, comprised of more than 60 partners focused on guiding actions to reduce the burden of childhood injuries in the U.S. It provides a national platform to organize and implement prevention activities. Overall, the goals of this program are to:
Raise awareness;
Highlight prevention solutions; and,
Mobilize action through a national, coordinated effort from all stakeholders to reduce injuries.
As stakeholders in this initiative, healthcare providers (doctors, nurses, and care managers) play a major role in injury prevention by providing education and resources to families. Educating families about the importance of encouraging physical, mental and emotional development of their children in safe environments while also providing information about resources (affordable day care, car seat programs, smoke detector giveaways, etc.) is paramount in injury prevention.
Other simple suggestions may include:
Encouraging the use of safety helmets when bicycling or skateboarding as well as the use of other sport appropriate safety gear.
Supervising children around water and enrolling them in swimming lessons. They can often be obtained at the local YMCA for a reduced fee.
Storing medication out of the reach of children and using child safety caps.
While riding in the car, making sure children are secured in the appropriate car or booster seat and that the seat is properly secured to prevent additional injuries during a crash. Many fires stations will check for proper installation. For older children and teenagers, making sure they wear a seat belt while in the car.
Assessing the home environment for the need for safety barriers (gates, outlet covers) and smoke detectors. Encouraging setting water heater temperature, no higher than 120 degrees. Temperatures over 125 can cause severe burns.
All guns in the home should be locked and unloaded with ammunition locked separately. Do not keep loaded, unlocked guns in vehicles.
Though the first week of September is dedicated to Childhood Injury Prevention, for parents, providers and the community, childhood injury prevention must occur every day. All interventions aimed at combatting this largely under-recognized public health crisis are valuable, as we work to improve the health and overall life expectancy of our nation’s children.