Water park injuries

BACKGROUND

The purpose of this study was to identify water park injuries, particularly injuries related to waterslides.

METHODS

This prospective observational study was carried out between May 2005 and September 2006 in a university hospital emergency clinic, which has 50,000 annual visits. The study form, including patient demographics, types and mechanisms of injuries and the final diagnoses, was completed for all patients. A total of 73 patients were enrolled into the study. The mean age of the patients was 23.92+/-15.05 and 48 patients (65.8%) were male.

RESULTS

The mechanisms of injury were as follows: 23 patients (31.5%) were injured on waterslides, 16 (21.9%) were injured in pools and 34 (46.6%) were injured by slipping and falling on the wet surfaces. After the emergency department evaluations, 15 patients (20.5%) were diagnosed to have spinal trauma, 16 (21.9%) head trauma, 15 (20.5%) maxillofacial trauma, and 30 (41%) other injuries.

CONCLUSION

In water park injuries, while children have especially head and maxillofacial trauma, extremity and spinal injuries are more frequent in the adult group. Unless sufficient and required safety precautions are maintained during water park activities, fatal injuries may occur.

Pediatric injuries associated with the use of children's wagons in the United States, 2002 through 2007

OBJECTIVE

To examine injuries among children treated in an emergency department (ED) related to use of a children's wagon.

METHODS

Data were obtained from the 2002 through 2007 National Electronic Injury Surveillance System. National estimates of ED visits associated with the use of a children's wagon were analyzed among children aged birth through 6 years in the United States.

RESULTS

From 2002 through 2007, there were an estimated 24,339 visits for injuries related to the use of children's wagons among children aged birth through 6 years, with an average annual injury visit rate of 14.5 per 100,000. Among injured children, 12% had a fracture and 17% had a closed head injury; most of these injuries were treated and the child released. The most frequently cited body part injured was the head (40%); the arm/wrist/hand was the most common body site to receive a fracture injury (48%). Boys had a higher injury visit rate than girls, and most patients (97%) were treated and released from the ED.

CONCLUSIONS

The injury patterns noted in this study are similar to those found with other wheeled vehicles and toys. More detailed information on the circumstances surrounding wagon injuries and a better understanding of the patterns of play associated with wagons would be helpful in designing effective risk reduction strategies.

Parent/Caregiver supervision and child injury: a systematic review of critical dimensions for understanding this relationship

This study reviewed the relationship between recognized dimensions of supervision and children's injuries based on Saluja et al's (Injury Control and Safety Promotion. 2004;11:17-22) hierarchal model of supervision strategies. A systematic review of peer-review studies was done with the earliest records available to 2007. There were 112 potentially relevant articles identified; 31 studies met all inclusion criteria. Reported studies were categorized according to the dimensions of supervision they addressed. Studies were not evenly distributed across the dimensions. There was evidence from the study that directly linking dimensions of supervision to child injury risk and outcomes is scarce. Future studies should consider attention, proximity, and continuity of supervision to provide a holistic understanding of the relationship between supervision and injury.

Childhood trauma profile at a tertiary care hospital in India

Childhood injuries are the leading cause of morbidity and mortality worldwide. We evaluated the type of pediatric injuries encountered in the emergency room amongst 225 children (boys 151, girls 64; age range, 2 mo-12 yr). Data were collected using a structured injury proforma over a period of 12 months. Injuries occurred at home (n=137, 60.8%), street (n=38, 16.8%), and playground (n=37, 16.4%). Most frequent injuries were falls (n=144, 64%) and road traffic injuries (RTI) (n=37, 16.4%). Injuries mostly consisted of fractures (n=72, 32%), bruises (n=39, 17.3%), and lacerations (n=35, 15.5%). Child abuse was recognized in 7 (3.5%) children. There was an average delay of 2 hour 50 minutes to reach the medical facility.

Common things are common: a case series of oral foreign bodies in paediatric patients

Reports of foreign bodies in the oral cavity are few in number. Three cases of children of varying ages, presenting with oral foreign bodies, and their subsequent diagnosis and management, are described. The importance of considering foreign bodies, as part of a differential diagnosis in paediatric patients, where aetiology is uncertain and clinical appearance is unusual, is highlighted.

[Music through earphones: an underestimated risk]

BACKGROUND

The authors studied exposure to the noise generated by digital music listening devices (MP3) as used by young people.

OBJECTIVES

to study the level of sound emission of some of these devices at 100%, 75% and 50% volume.

METHODS

Using a mannequin, the LeqA, LmaxA, LeqC and the peak in C of nine of the most commonly used devices was measured at levels of sound emission of 100%, 75% and 50%.

RESULTS

It was found that all the devices exceeded 100 dBA of Leq at 100% of the listening volume. We therefore estimated the Lex8, as recommended in Italian Law 195/06, to which these young people are exposed using the devices for 15, 30, and 60 minutes/day.

CONCLUSIONS

Young people undergoing daily exposures for only 15 minutes at maximal listening volume exceed the limit value of daily occupational exposure for workers, which Law 195/06 fixes at 87 dBA.

Gender and injury in Finnish comprehensive schools

The aim of this study is to analyze the gender differences in injuries at Finnish comprehensive schools. Nine schools reported a total of 1135 injuries to the injury register over two school years. Boys (56%) were injured more often than girls, their injuries happened more often during breaks at school yard, whereas girls hurt themselves during sport lectures in the gymnastic halls. The proportion of boys' injuries also increased with age. More often, boys' injuries were caused by intentional actions by other pupils. Girls injured their lower extremities more often, whereas boys injured their faces and head. Boys also suffered concussion more often than girls, and were also referred for further care to health care centres or hospitals more often than girls. The higher injury frequency among boys at school corresponds to the higher injury rate of males in general, which is true for work, traffic, and leisure-time injuries. Increased adult supervisor control especially during breaks can prevent most of school injuries.

Burkholderia gladioli associated abscess in a type 1 diabetic patient

Burkholderia gladioli, a bacterial pathogen, causes a variety of infectious ailments in immunocompromised individuals. We present a case report of foreign body associated Burkholderia gladioli related abscess in an immunocompetent type 1 diabetic patient. Relevant medical literature is reviewed to understand this unusual mode of presentation of this bacterium in our patient.

Content analysis of 100 consecutive media reports of amusement ride accidents

Accident investigations influence public perceptions and safety management strategies by determining the amount and type of information learned about the accident. To examine the factors considered in investigations, this study used a content analysis of 100 consecutive media reports of amusement ride accidents from an online media archive. Fatalities were overrepresented in the media dataset compared with U.S. national estimates. For analysis of reports, a modified "Haddon matrix" was developed using human-factors categories. This approach was useful to show differences between the proportions and types of factors considered in the different accident stages and between employee and rider accidents. Employee injury accounts primarily referred to the employee's task and to the employee. Rider injury reports were primarily related to the ride device itself and rarely referred to the rider's "task", social influences, or the rider's own actions, and only some reference to their characteristics. Qualitatively, it was evident that more human factors analysis is required to augment scant pre-failure information about the task, social environment, and the person, to make that information available for prevention of amusement ride accidents. By design, this study reflected information reported by the media. Future work will use the same techniques with official reports.

Magnetic toy ingestion: surgical implications

Children often ingest foreign bodies wihtout major consequences. Most foreign bodies will pass through the gastrointestinal tract without any detrimental results although in the case of multiple magnet ingestion, perforation and pressure necrosis, among a host of other possible effects, can occur. We describe a case of multiple bowel perforations as a result of fistulization from magnetic attraction across portions of the intestinal wall that demonstrate the importance in acquiring surgical attention.

Falls from playground equipment: will the new Australian playground safety standard make a difference and how will we tell?

ISSUE ADDRESSED

This study describes the trend in incidence of hospitalised falls from playground equipment of children aged 14 years or less in New South Wales (NSW) and considers the potential effectiveness of playground safety standards in reducing the impact of playground-related injuries.

METHOD

Hospitalisations of children aged 14 years or less following a fall from playground equipment were identified from the NSW hospitalisation data for the financial years 1992/93 to 2003/04 and described.

RESULTS

During 1992/93 to 2003/04 there were 16,828 hospitalisations of children aged 0-14 years as a result of a fall from playground equipment, at a rate of 106.6 per 100,000 children. The incidence of hospitalisation increased from 83.3 to 130.3 per 100,000 children between 1992/93 to 2003/04. Males aged 5-9 years had the highest rate of hospitalisation at 198.4 per 100,000 children. Injury type varied by age group, but injuries to the elbow and forearm were common for all age groups. The rate of upper limb fractures that resulted in hospitalisation increased, while the rate of serious head injuries decreased.

CONCLUSIONS

While severe head injuries have declined between 1992/93 to 2003/04, the increasing trend of upper limb fractures is of concern. Many factors need to be taken into account to assess the effectiveness of playground safety standards. The collection of exposure data is also crucial to be able to calculate the true risk associated with childhood falls from playground equipment.

[Perforation of the intestine after ingestion of magnetic items]

The ingestion of magnetic items is a potentially dangerous condition which may result in local necrosis and perforation of the intestine due to incrustation of the bowel wall between two magnetic bodies. We report a case of a 12-year old girl who ingested several magnetic items, causing perforation of the small intestine. We recommend surgical removal if more than one magnetic foreign body is ingested. If imaging results indicate that only one magnet has been ingested, we recommend a control x-ray within a few hours to confirm a secure passage of the foreign body.

[Magnetic items cause perforation of the bowel]

Two cases of bowel perforation after ingestion of two or more magnetic foreign bodies by children are described. Both patients had only minor gastrointestinal symptoms when submitted to hospital. In both cases, acute exploratory laparatomy was performed and bowel perforation was found. The literature describes no consensus to surgical strategy in such cases. Based on the present cases, our recommendation is that an acute abdominal x-ray should be made, followed by either an acute endoscopy or acute laparatomy, even if the patient shows no signs of gastrointestinal symptoms.

[Multiple bowel perforations after swallowing magnetic toys]

Ingestion of small foreign bodies is common in children, and usually does not cause any harm to the gastrointestinal tract. But ingestion of multiple magnets can be hazardous because of the strong attraction of the magnets through the bowel wall, which may lead to bowel wall necrosis and perforation. We describe the case of a 6-year-old autistic boy who swallowed 4 magnets which led to bowel obstruction and 8 small perforations. It is important to be aware of this potential risk if children ingest small magnetic toys.