Fall-Down Injuries in children in Treated at the Emergency Department; Preventable Aspects

PURPOSE: This study was conducted in order to evaluate the epidemiological characteristics of children with fall-down injuries according to age groups and to analyze the major trauma groups that were treated at the emergency room (ER). METHODS: Among 1,222 children under age 6 who were treated at the ER from January 2008 to December 2009, a retrospective study was conducted through examination of medical records. The children were classified by age into 3 groups: infant, toddler, and pre-schooler. In each group, the differences between the causative factors that led to the fall-down injuries were analyzed. Also, ISS (Injury Severity Score) score above 4 was classified as major trauma, and an ISS score 0-1 was classified as a minor trauma. The relationship between major trauma and age group was also analyzed. RESULTS: Through an analysis of child fall-down injuries, men (56.6%), toddler (47.3%), head-related symptoms (72.9%), furniture-related traumas (80.2%), and falls from less than a 1-m height (69.9%) were found to be common factors. Furthermore, in radiological studies, fractures and brain hemorrhages accounted for 16.9% of major traumas, and simple skull fractures were the most common (21.4%). Distributed according to age group, the factors relevant to fall injuries were fall height and head-related symptoms for infants, accident site, fall height and head-related symptoms for toddlers, and accident site for pre-schoolers (p<0.05). Also, head-related symptoms and fall height were independent factors of major trauma in all age groups. However, major traumas (17.3%) were related to dumped trauma, fall height and accident site (p<0.05). CONCLUSION: This study was mainly about head-related injuries, and toddler were most common victims. The relevant factors for the major trauma were falling height for infants, accident site and falling height for toddlers, and accident site, falling height for pre-schoolers.

Clinical Analysis of Pediatric Falls

PURPOSE: Clinical studies of falls as a major mechanism of pediatric injury are scarce in Korea. This study was conducted to help collect basic data for establishing strategies for preventing pediatric falls and for initial management in cases of pediatric falls. METHODS: We reviewed the medical records of 59 pediatric patients admitted to the emergency department of Kyungpook National University Hospital with a history of falls from January 2000 to December 2001. Data collected included the patient's age, gender, site and height of fall, the surface fallen upon, body region of injuries, method and outcome of management, and Injury Severity Score (ISS). RESULTS: The incidence of falls in children 4 years of age or younger and between 5 and 9 years of age was similar. Of all falls, 54.3% occurred at sites such as the home or a building in which it was presumed to be possible for a caretaker to attend to the children. The body region injured most commonly was the pelvis/extremity. The ISS was significantly higher when the patient fell from height of 2 meters or more or when the body region injured most severely was the head/neck. CONCLUSION: Strategies to prevent pediatric falls, which focus on careful supervision of children, reinforcement of safeguards at playgrounds, development of educational programs, and social provision of a means of child care during a caretaker's absence, are necessary to decrease the incidence of pediatric falls. In addition, the potential for severe injury is greater when the patient falls from a height of 2 meters or more, or when the body region injured most 555 severely is the head/neck.