Avoidable Child injuries

Posted on 2013-07-14 22:00:34

Hardly a week goes by without a tragic story about a child who was injured; from children drowning in boreholes and household fires leaving children with severe burns, to road accidents involving school buses and domestic violence at the hands of their guardians. Even where these incidences are not fatal, their physical and psychological effects are lifelong. Injuries by definition refer to physical damage resulting from exposure to sudden and excessive energy that surpasses that which the body can handle, or damage due to the deprivation of a vital element such as oxygen. Child injuries may be intentional or unintentional and are a major cause of death and disability, more so in the developing countries. The rate of child injury in low income countries is 3.4 times than that in high income countries. The rate of death as a result from child injuries is also higher in the developing countries, accounting for up to 40% of childhood deaths. As expected, boys tend to get more frequent and more severe injuries than their female counterparts since they participate in more risky activities and tend to be more impulsive. Unintentional child injuries are leading causes of death and disability, and yet they can be prevented or minimized by exercising caution especially where there are known risks, and by implementing first aid measures to reduce the effects of these injuries when they do occur. We will discuss the top 5 unintentional child injuries. Road traffic accidents According to WHO (2009), half of the deaths due to road accidents in Kenya occur among children or young adults. Overall, more than 80% of road traffic accidents in Kenya are attributed to human error, be it due to alcohol intake, fatigue, sleep or use of distracting devices like mobile phones. The severity of injuries is compounded by other factors such as failure to use safety devices like seatbelts and children car seats. Now, most adults know this, but every weekend I notice parents or guardians driving with children unrestrained in the front seat, standing or even sitting with them in the driving seat. As much as the child may enjoy this experience (and I’m guessing the parent as well), the risks it poses are much higher than the momentary pleasure. The injuries an unrestrained child in the front seat would sustain during an accident are likely to be fatal, since they would involve the head and chest. Use of a seatbelt, can reduce the number of fatal and serious injuries by up to 60%. So the next time your child pleads with you to sit with you in the drivers’ seat, remember these statistics and protect your child, even if that makes you unpopular for a while. Infants and young children should use car seats, and older children should sit in the back seat, securely buckled. Falls Children fall as a normal part of growth; it is inevitable in learning how to walk and run, and is a component of play and sports. The severity of injury following a fall depends on the height from which the fall occurred, the landing surface and the landing position. Where falls are not fatal, they are a major cause of severe injuries in children, specifically head injuries and limb fractures with subsequent disability in extreme cases. Prevention of falls lies in recognizing where the risks are and taking measures to safeguard children accordingly. Guard rails for balconies, window guards for large windows and stair rails all help reduce chances of a fall from a height. Supervision of children especially during play is also crucial. Children are daring and are unlikely to see the risk of climbing anything and everything, from trees to buildings, to play ground structures. Having an adult monitoring play can reduce chances of a fall since risks can be identified and avoided. Poisoning Poisoning is injury that results from inhaling, ingesting, injecting or absorbing a substance that affects functioning of the body. There are many household products that can cause poisoning including washing and cleaning solutions, hair products, nail polish remover, insecticides and pesticides, paint, medications and so on. Once children start crawling and walking, they are likely to get into storage areas and ingest these poisons. This is most common in children from 6 months to 4 years. It is important for parents and guardians to be cognizant of these risks and take necessary action. Storage of potential poisons in a safe place out of reach of children is critical. Avoid using high surfaces in plain sight which may then encourage children to attempt climbing to reach them (increasing risk of falls). Most medications especially syrups tend to come with a child proof cup in case the child gets hold of the bottle. Tablets however may not be child proof and thus should be stored appropriately. Burns Burns injuries are those that are a result of the exposure of the different layers of the skin to hot liquids, solid or gases, open flames or even to some chemicals and electricity. As with other injuries, the rate of deaths due to burns is higher in low income countries, occurring 11 times more than in developed countries. There are some obvious environmental risks including the housing conditions, the use of kerosene stoves or open fires or cooking, candles, lack of exits, lack of fire extinguishers and so on. Burns can be prevented by raising or enclosing cooking areas, safe use of gas and kerosene stoves, separating living and cooking areas, safer housing design with adequate ventilation and exit in case of fire, access to extinguishers or water incase of a fire. Drowning Drowning refers to an event in which the child’s breathing is impaired as a result of immersion in a liquid. Drowning among infants is normally attributed to a lapse of supervision especially during bath times. In children between 1 year and 5 years, drowning is more common in swimming pools, while in older children this extends to include lakes, rivers, ponds or the ocean. In low income countries drowning also occurs in water tanks, canals, ditches and other water collection systems. Children under 5 years of age have highest drowning mortality rates worldwide. Prevention of drowning involves removing the hazard for example by draining unnecessary pools of water, limiting access to bathtubs or water tanks, creating barriers around water bodies, building safe bridges across rivers, and ensuring adequate supervision of children during recreational activities in water. It is important to promote children to learn how to swim but this must be done safely. But…. Even when all these prevention strategies are implemented, these unintentional injuries may still occur. It is therefore just as important to educate parents, guardians and other caregivers on the appropriate first aid measures to minimize the complications associated with these injuries.