Sofa and bed-related pediatric trauma injuries treated in United States emergency departments.

INTRODUCTION: Children under the age of 5 years suffer from the highest rates of fall-related injuries. Caretakers often leave young children on sofas and beds, however, falling and rolling off these fixtures can lead to serious injury. We investigated the epidemiologic characteristics and trends of bed and sofa-related injuries among children aged <5 years treated in US emergency departments (EDs). METHODS: We conducted a retrospective analysis of data from the National Electronic Injury Surveillance System from 2007 through 2021 using sample weights to estimate national numbers and rates of bed and sofa-related injuries. Descriptive statistics and regression analyses were employed. RESULTS: An estimated 3,414,007 children aged <5 years were treated for bed and sofa-related injuries in emergency departments (EDs) in the United States from 2007 through 2021, averaging 115.2 injuries per 10,000 persons annually. Closed head injuries (30%) and lacerations (24%) comprised the majority of injuries. The primary location of injury was the head (71%) and upper extremity (17%). Children <1 year of age accounted for most injuries, with a 67% increase in incidence within the age group between 2007 and 2021 (p < 0.001). Falling, jumping, and rolling off beds and sofas were the primary mechanisms of injury. The proportion of jumping injuries increased with age. Approximately 4% of all injuries required hospitalization. Children <1 year of age were 1.58 times more likely to be hospitalized after injury than all other age groups (p < 0.001). CONCLUSION: Beds and sofas can be associated with injury among young children, especially infants. The annual rate of bed and sofa-related injuries among infants <1 year old is increasing, which underscores the need for increased prevention efforts, including parental education and improved safety design, to decrease these injuries.

Use of topical local anaesthetics for paediatric facial lacerations.

BACKGROUND: Closure of facial lacerations in young children can be difficult under local anaesthetic in an emergency department setting. Sedation or general anaesthetic are often required to close lacerations safely and to a good surgical standard. Our hospital introduced the use of local anaesthetic gel (LAT) following an audit, to reduce the need for paediatric admissions. In light of the current COVID-19 pandemic, this can be a valuable tool to help avoid admissions. OBJECTIVES: To ascertain the usefulness of LAT gel in reducing paediatric admissions. METHODS: Data was collected prospectively of all children presenting to the paediatric emergency department for input by the oral and maxillofacial team after the introduction of LAT gel. Data collected included age, aetiology, length and position of laceration, associated injuries and management. Use of LAT gel and other anaesthetics was recorded. FINDINGS: Over a 12 month period, 536 children attended the paediatric ED. Paediatric lacerations accounted for 45% of the reasons for attendance. LAT gel was used in management of 33% of patients with facial lacerations. The use of the gel was successful in 76% of occasions. Ninety children (16.8% of all attendances) were admitted to hospital during this time, of which 49 were paediatric lacerations. CONCLUSION: LAT gel is an effective adjunct to management of laceration in the paediatric population.