The objective of this study was to describe a population of children admitted to a tertiary care pediatric hospital with severe trauma to identify key areas for injury prevention research, and programming.
Retrospective chart review conducted on all children 0-17 years admitted to the Children's Hospital of Eastern Ontario (CHEO) between April 1, 1996, and March 31, 2000, following acute trauma. Each record was reviewed and assigned an ISS using the AIS 1990 revision. All cases with an ISS > 11 were included in the study.
There were 2610 trauma cases admitted to CHEO over the study period. Of these, 237 (9.1%) had severe trauma (ISS > 11). Sixty-two percent were male. Twenty-nine percent were between the ages of 10 and 14 years, 27% between 5 and 9 years, 16% between 15 and 17 years, 15% between 1 and 4 years, and 13% less than 1 year old. The most common mechanisms of injury were due to motor vehicle traffic (39%), falls (24%), child abuse (8%), and sports (5%). Of those resulting from motor vehicle traffic, 53 (57%) were occupants, 22 (24%) were pedestrians, and 18 (19%) were cyclists. When combining traffic and nontraffic mechanisms, 26 (11% of all severe trauma cases) occurred as a result of cycling incidents. The most severe injury in 65% of patients was to the head and neck body region.
Research efforts and activities to prevent severe pediatric trauma in our region should focus on road safety, protection from head injuries, avoidance of falls, and prevention of child abuse.
Information concerning 520 bicycle accidents and their victims was obtained from medical records and the victims' replies to questionnaires. The analyzed aspects included risk of injury, completeness of accident registrations by police and in hospitals, types of injuries and influence of the cyclists' age and sex, alcohol, fatigue, hunger, haste, physical disability, purpose of cycling, wearing of protective helmet and other clothing, type and quality of road surface, site of accident (road junctions, separate cycle paths, etc.) and turning manoeuvres.
Cross-country skiing is a reasonably low risk sport that can be enjoyed by athletes of all ages. It is an excellent cardiovascular fitness sport that at the same time offers rewarding scenery and solitude. The risk of injury can be decreased by taking lessons, taking care on downhill sections, using equipment that does not have too much heel fixation, wearing proper clothing, and being in condition prior to the start of the season.
(1) To describe the characteristics of sledding injuries presenting to a pediatric emergency department and (2) To describe the sledding environment that leads to childhood sledding injuries.
A pediatric hospital emergency department in Ottawa, Canada and identified sledding sites in the region.
All patients less than 18 years with sled related injuries were included. Questionnaires were completed gathering information on the sled operator, the sled, the sledding site, and the injury. Site visits were made to designated and non-designated sledding hills in the Ottawa region to record data regarding sled operators, sleds, and the sledding environment.
Ninety-five patients were identified with sledding injuries and 81 (85%) completed the questionnaire. The mean age was 9.9 years (range 8 months to 17 years). The majority were male (63%). Most injuries occurred on non-designated sledding hills in the community (70%). Mild to moderate injuries were most common, however nine patients (11%) were admitted to hospital. Fifty-one per cent had adult supervision at the time of injury compared with 86% observed at the site visits. Common mechanisms of injuries were collisions with objects (33%), falls in icy conditions (28%), and going off jumps (16%). Most serious injuries occurred with contact with motor vehicles. There was no relationship between the type of sled used and the likelihood of injury.
Sledding hills which have obstacles, icy conditions, jumps, or proximity to roads may result in more childhood injuries. Children with no adult supervision are likely at higher risk of injury.
Cites: Ann Emerg Med. 1980 Mar;9(3):131-37362102
Cites: Br Med J (Clin Res Ed). 1985 Mar 16;290(6471):8213919808
Two studies, one retrospective (1972 to 1973) and one prospective (1974 to 1975), CONcerning eye injuries incurred by hockey players were conducted by the Canadian Ophthalmological Society with questionnaires to its members. Responses to the questionnaires were analyzed by age, type of injury, cause (i.e., hockey stick, puck, or other means), and results to visual acuity. The results were also designated by organized or unorganized participation. Almost 300 eye injuries were reported in each study. In the first study, 13.7% of the injured players became legally blind as a result of the injury; in the second study, 16% became legally blind. Organized hockey produced more injuries than unorganized hockey. The majority of the injuries were caused by the hockey stick. The injuries were both intraocular and extraocular. The group of 11- to 15-year olds received the highest number of injuries, and the older age group had the higher incidence of blindness. Studies have led to setting more rigid standards, altering rules of the game, and selecting face protectors for hockey players. Older players who care for their equipment prefer the plastic shield face protectors, and the younger players (who complain of fogging and scratching of the plastic) prefer mesh protectors through which neither the stick nor the puck can penetrate. New high sticking (above the shoulder level) rules were included in the 1976 official rule book for Canadian amateur hockey.
Assess the context and characteristics of hockey injuries, and evaluate the probable effects of regulations concerning mandatory use of head and neck protective equipment.
Descriptive study of 247 patients suffering from hockey injuries. Cases were recorded at the emergency room of the Hôpital de l'Enfant-Jésus, in Quebec City, from October 1 1991 to April 30 1992. Injury characteristics are presented by categories, and "Organized hockey on skates" (HPO) is the only category where protective equipment is mandatory.
Nearly 42% of consultations were related to non-HPO. In the HPO injuries 15.4% were head injuries whereas in other categories, head injuries represented 31.4%, 33.3% and 44.0% of total injuries.
Data suggest that regulation imposing mandatory head and neck protection should be maintained in the HPO category because of its apparent preventive effect. Accordingly, implementation could also be considered in other categories.