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How to Prevent the Most Common Children’s Injuries

 

Annie Soriano
Annie Soriano | photo by LifeBridge Health

 

As the omicron variant surges, hospitals in Maryland and across the country are filling up with patients. Dr. Annie Soriano, who directs pediatric emergency services at the ER-7 of Baltimore’s Sinai Hospital, says that protocols are in place to separate kids with COVID-19 from those without—but it’s becoming more difficult.

“Overcrowding is a challenge, and we’re working on keeping everybody safe,” she says.

Dr. Leticia Manning Ryan, director of pediatric emergency medicine at Johns Hopkins Medicine, says her department is taking several steps to avoid infectious exposure.

“I certainly would not hesitate to seek care in the event that your child has become injured and needs medical evaluation,” says Ryan, who is also an associate professor of pediatrics. “Unintentional injuries are the leading cause of death by far for children across all age groups.”

Dr. Leticia Manning Ryan | Photo by Johns Hopkins Medicine

According to the Centers for Disease Control and Prevention, more than 7,000 children and teens died from unintentional injuries in 2019—about 20 per day.

From 2018 to 2019, death rates were highest among boys and American Indian, Alaska Native and Black children.

But the “majority of all injuries that we see are preventable,” Ryan says. In her family, she has a “no helmet, no bike” rule.

“We involved the kids in picking out their helmets to give them some decision-making input,” she says.

What other steps can you take to protect your children and avoid a visit to the emergency department?

 

Injuires from falls

 

“Proper adult supervision can reduce risk for falls and burns,” says Dr. Forrest T. Closson, an emergency medicine pediatrician at the University of Maryland Children’s Hospital. “Other measures include proper use of child safety measures (helmets, car seats and seat belts), getting swim lessons, safe driving measures, lowering water heater temperatures and (installing) gates on stairs.”

Falls are the most common cause of injury for kids of all ages, with the CDC estimating that 8,000 children in the United States are treated for fall-related injuries every day.

“Falls at home commonly happen from beds or falling down stairs,” says Closson, also an assistant professor at the University of Maryland School of Medicine. “Falls outside the house often happen when walking or running—for example, twisting an ankle on a curb or through activities such as sports or skating.”

Dr. Forrest T. Closson | photo courtesy of Stephanie Janard

Babies and toddlers are especially susceptible to falls. The American Academy of Pediatrics strongly advises parents to avoid baby walkers, which can not only delay when a child starts to walk but also cause children to roll down the stairs and reach high objects such as medications or pot handles on the stove.

Additionally, when it’s time to switch from a crib to a bed, a safety rail can prevent children from rolling over the edge during the middle of the night.

Experts also recommend locking and blocking gates, doors and areas leading to porches, decks and balconies; installing window guards or child safety locks; and anchoring climbable and reachable furniture.

After falls, being struck by or against an object is the second-leading cause of pediatric emergency department visits, especially for kids who play sports.

 

Injuries from motor vehicle accidents

 

“Motor vehicle crashes are another common source of injuries, including bruises, neck injuries and head trauma,” Closson says. “Motor vehicle crash injuries commonly occur in young children improperly restrained in car seats and in often unrestrained adolescents and young drivers.”

Motor vehicle accidents are the leading cause of death among children and adolescents. Suicide is the second-leading cause of death among individuals in this age group.

 

Drowning deaths

 

For children ages 1 to 4, drowning is the leading cause of injury death. According to the CDC, drowning death rates, compared to white children, were 2.6 times higher among Black children ages 5 to 9 and 3.6 times higher among those ages 10 to 14.

 

A final word on childhood injuries …

 

While child unintentional injury death rates overall decreased 11% from 2010 to 2019 overall, certain groups are at increased risk. For example, motor vehicle death rates decreased 24% among white children but increased 9% among Black children. Poisoning death rates also decreased 24% for white children but increased 37% for Black children—and 50% for Hispanic children.

Additionally, according to a 2021 study of more than 13 million pediatric emergency department visits, Black and Hispanic patients were less likely to undergo diagnostic imaging compared to their white counterparts.

“Knowledge of potential bias, combined with keeping health care disparities at the forefront of our thoughts, makes each clinician better served to provide unbiased, evidence-based, high-quality care for our patients, of whom many can be considered groups at risk for health care biases,” Closson says.

Overall, according to America’s Health Rankings, mortality rates per 100,000 children are lower in Maryland compared to the rest of the country—2.8% lower for children ages 5 to 14, 0.5% lower for those 1 to 4 and 0.1% lower for those 15 to 19.

“Injuries are bound to happen to children. Given their age and developmental levels, kids are naturally curious and adventurous, and they may engage in risk-taking behaviors,” Closson says. “While we want kids to be active for all the health and social benefits, there are simple and easy measures to reduce the risk of injury.”

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