Childhood injuries and their prevention, May 20, 2006

Childhood injuries and their prevention

Dr Arbinder Singal, Pediatric Surgeon in Vashi, Navi Mumbai, throws light on common injuries among children that can be potentially dangerious

Injuries are the leading health problem among children and may lead to serious consequences. Inherent curiosity of the children and their failure to under-stand a potentially harmful situation makes them prone for all sorts of injuries. Injuries are not entirely random events as thought earlier; rather they occur in a predictable fashion deter-mined by identifiable risk factors. Understanding of these risk factors is the key to injury prevention strategy. Common modes of injury in children are falls from height, vehicle related injuries, burns, sports-related injuries, chemical injuries, drowning and child abuse.

 Falls from height are especially common and may result in serious head injury, fractures, chest or abdominal injuries. These are related to kite flying and construction of non-parapet roofs especially in villages and small towns. Such incidence has decreased in big cities as the flats don't have roofs to play and kite flying is not very common in this part of India.

Vehicle related trauma is a major cause of mortality in cities near highways especially in cities like Navi Mumbai which are planned along major highways. Most of these injuries involve multiple body parts and organ systems, hence are serious in nature. The importance of all traffic pre-cautions, seat-belts and car-seats for infants cannot be overstressed. In western countries, it is illegal to drive a car without a car-seat for the small kids.

 Children crossing roads without supervision are prone to vehicle related in-juries, as the children fail to understand the inherent danger in moving traffic. It is utmost important to supervise the children while crossing the roads. Another cause of concern is carrying of the child by the mother while she pillion rides a scooter or a twowheeler. The child is in a very unstable position is vulnerable to fall off at slightest imbalance. Ideally, the children should be made to sit astride the vehicle between the parents or a four-wheeler should be used whenever it is necessary to travel with an infant.

 Burn injuries become rampant in the festival season of Diwali. Most serious are the injuries to the eye, which may even result in blindness. Superficial burns on limbs secondary to firecrackers are very painful and take time to heal.

Sports related injuries range from minor cuts to serious fractures. Cricket ball injuries can be serious if they concern the head or eye. We have seen cases of skull fractures and recently a teenager was operated for rupture of eye ball at Aditya Jyot Eye Hospital. Often the kids take the pre-caution of wearing the hel-met lightly, it is in this situation that the role of the coach and teachers is very important in ensuring that proper rules precautions are met before the kids are allowed to play.

Childhood drowning has become a serious issue in western countries and it should be looked at concern in our country also. Child abuse injuries are ones inflicted by parents on the kids, these are the gift of modern stressful life style. They should be suspected in cases of marital discord, withdrawn children, patterned and frequent injuries and scalds in small babies. Another common injury is foreign body getting stuck in respiratory tube or food pipe. Common culprits that get stuck up in airway are groundnuts, cashew bits, almonds, peas, whistle valves, safety pins etc. They can lead to sudden choking and obstruction in breathing. They are especially common in age group of 1-4 years, and in this age group kids should not be given nuts and other things to eat. Coins are most frequent foreign bodies to get stuck up in food pipe and these again need to be re-moved surgically.


Injuries to kids

Follow all traffic regulations and use helmets while driving two wheelers

Use of proper protective gear while playing

Small kids should not be left unattended near roads, swimming pools

Avoid giving nuts or toys with small pieces to young kids

 All precautions and supervision when children are playing with crackers

Safekeeping of chemicals and medicines in overhead cabinets and use of childproof capped bottles.


Preventive measures

Three factors interact to produce an injury. These are the vulnerable host, agent causing injury and a suit-able environment for the injury to occur. Efforts should be made primarily to modify the environment in which injuries occur as changing the behaviour and curbing the natural curiosity of the child is neither practical nor desirable. Multi-pronged efforts are must to achieve this goal like educating the parents, legislation and enforcement. With the holiday season, these are vitally important.


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