Home Accidents among Children: A Retrospective Study at a Tertiary Care Center in Oman

Maternal Knowledge and Awareness of Preventive Measures for Domestic Accidents Among Children in Jeddah, Saudi Arabia

BACKGROUND

Unintentional injuries are the leading cause of childhood injuries and result in thousands of deaths annually. However, children are at higher risk due to their increased curiosity and the time they spend at home. This study aimed to assess maternal knowledge regarding preventive measures for household injuries, including their frequency and severity.

METHOD

Using an electronic, self-administered questionnaire, this cross-sectional study assessed the knowledge and awareness of 433 mothers of children aged 1 to 12 years in our population between March 22 and July 31, 2023. Participants' awareness levels were the main outcome.

RESULTS

Of the participants, 54% reported that their children had experienced domestic injuries. The most frequently reported injuries were falls, burns, and wounds caused by sharp objects. Moreover, more than 50% of the children needed to visit the emergency department, of whom 10% required hospitalization. Regarding the awareness level score, 55% of mothers had moderate knowledge of home-related injuries. Furthermore, attending first-aid courses and other health education programs predicted higher awareness scores among the mothers.

CONCLUSIONS

More than half of the children in our study population had injuries that had occurred recently or in previous years. There was a significant discrepancy between the mothers' reported knowledge and their safety practices.

Readiness of Omani Families to Prevent Accidental Injuries at Home in Children Younger than Six Years Old

Objectives

We sought to assess the attitude of Omani families toward accidental injuries among children (aged < 6 years) and evaluate the safety measures and available preventive measures to reduce child injuries at home.

Methods

We conducted a cross-sectional survey examining the self-reported attitudes of Omani parents about accidental injuries (poisoning, falls, burns, and drowning) at home among children younger than six and house safety measures. A total of 220 parents of children aged < 6 years, admitted to a tertiary healthcare teaching hospital, were invited to participate over a period of six months (May to November 2018). Analysis of 178 participant data was performed using SPSS, as 44 of the answered questionnaires had missing data, or were related to children over the age of six.

Results

Only 16.9% of the Omani families had a history of a child injury in the year before the study. Males were more injured (61.0%) and 66.0% were younger than three years at the time of injury. A door to control access to stairs was available for 53.8% of the families. In 42.5% and 16.0% of the houses, children could access electrical sockets and wires, respectively. Fire alarms and extinguishers were not available in 90.8% and 82.1% of houses, respectively. Those who did not store medications and chemicals in safe places out of reach of children accounted for 56.7% and 63.3% of families, respectively.

Conclusions

Many of the studied families are not providing an adequate safe environment for children in their houses. Therefore, actions should be taken to increase awareness about accidental injuries prevention within homes and to implement actions so that a safe home environment can be enjoyed by children.

Prevalence and Risk Factors of Home Accidents Among Children Under Five Years of Age in Al-Baha, Saudi Arabia

INTRODUCTION

Internationally, home accidents are the main cause of preventable debilities and death among children and young persons. Many times, children survive accidents with physical or mental damage that curtails their activities in the long term. The most commonly reported accidental injuries include head injuries, open wounds, and poisoning. This study aims to assess the prevalence and factors associated with home accidents among children under five years old in the Al-Baha region, Saudi Arabia.

METHODS

A descriptive cross-sectional study was conducted among the community population in the Al-Baha region, Saudi Arabia, targeting all accessible parents who have children under five years old. A convenience sampling technique was used for sample collection during the period of three months (May 2023 to July 2023), where all accessible parents who fulfilled the inclusion criteria and agreed to participate were invited to fill out the received online study questionnaire. Section 1 covered the participants' demographic data. The second section covered the children's data and the third section included questions about home accident types, frequency, severity, and causes.  Results: The findings showed that 205 (58.2%) study parents reported a history of home accidents among their children. As for accident data, about 122 (59.5%) of the injured children were males. The most reported home accidents among children were fall/impact with hard objects (58.2%), burn (30.7%), asphyxia (27.6%), and poisoning (24.4%). Families with more than seven members and those with four or more siblings significantly experienced higher home accidents than others (p<0.001).

CONCLUSION

In conclusion, the current study showed that home accidents among children under five years of age were mainly falls and burns; they were mainly found among male children and children in families with highly educated mothers and many kids. A majority of the reported cases of home accidents were less severe and the hospitalization rates with complications were very few.

Analysis of the Home Accidents and Their Risk Factors in Iran: A Systematic Review and Meta-Analysis

Background

Home accident is among the most common type of trauma, in the second place after traffic accident. We aimed to determine the prevalence and factors affecting the occurrence of home accidents in Iran.

Methods

PubMed, Scopus, Web of Science, and national Persian databases including SID, MagIran, and Medical Articles Bank were searched for articles published until September 12, 2021. The pooled prevalence and factors affecting the occurrence of home accidents were calculated.

Results

Twenty articles were included in the meta-analysis. The pooled prevalence of home accident was 44% (95%CI: 32% to 56%). The pooled prevalence of foreign object/fall, stab or cut, suffocation, burn, poisoning and were 15% (95%CI: 10% to 20%), 24% (95%CI: 10% to 38%), 1% (95%CI:0.7% to 1.3%), 31% (95%CI:19% to 42.2%), and 6.8% (95%CI:4.2% to 429.4%), respectively.

Conclusion

The prevalence of home accidents in Iran is moderate but higher than in other countries. The findings of this review highlight the need for more attention to home accident in children and elderly in the South and Southeast regions of Iran.

Epidemiology, patterns, and mechanisms of pediatric trauma: a review of 12,508 patients

BACKGROUND

Pediatric traumas are common and remain a unique challenge for trauma surgeons. Demographic data provide a crucial source of information to better understand mechanisms and patterns of injury. The aim of this study was to provide this information to improve treatment strategies of potentially preventable morbidity and mortality in children.

MATERIAL AND METHODS

A retrospective review of every pediatric trauma treated in the emergency department (ED) between 2015 and 2019 was performed. Inclusion criteria were the age between 0 and 14 years and admission to the ED after trauma. Demographic data, time of presentation, mechanism of injury and pattern of injury, treatment, and outcome were analyzed. Different injury patterns were assessed in relation to age group, sex, mechanism of injury and treatment.

RESULTS

A total of 12,508 patients were included in this study. All patients were stratified into five age groups: babies under the age of 1 (8.8%), toddlers between 1 and 3 (16.8%), preschool children between 4 and 6 (19.3%), young school children between 7 and 10 (27.1%), and young adolescents between 11 and 14 (27.9%). The predominant sex in all age groups was male. 47.7% of patients were admitted between 4 and 10 pm; 14.8% of the patients arrived between 10 pm and 8 am. Peak months of admissions were May to July. Overall, 2703 fractures, 2924 lacerations and superficial tissue injury, 5151 bruises, 320 joint dislocations, 1284 distortions, 76 burns, and 50 other injuries were treated. Most common mechanisms for fractures were leisure activities, falls, and sports-related activities. Forearm fractures were the most common fractures (39.5%) followed by humerus fractures (14%) and fractures of the hand (12.5%). A total of 700 patients with fractures (25.9%) needed surgery. 8.8% of all patients were hospitalized for at least one day. 4 patients died in the hospital (0.03%).

CONCLUSION

Despite of higher risk, severe injuries in children are rare. Minor injuries and single fractures are common. Treatment should be managed in specialized centers to ensure an interdisciplinary care and fast recovery. Peak times in the late afternoon and evening and summer months should be taken into consideration of personnel planning.

Child maltreatment and protection in the Arab Gulf Cooperation Council countries: A scoping review

BACKGROUND

Research on child maltreatment and protection in the Arab Gulf Cooperation Council countries-Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates (UAE)-is limited but growing, as is child protection as a sector.

OBJECTIVES

We aimed to identify themes and gaps in existing research on child maltreatment and protection, identify opportunities for building capacity in research and practice.

PARTICIPANTS AND SETTING

N/A.

METHODS

We conducted a scoping review of empirical studies published in peer-reviewed journals in English and Arabic and reported methods and findings according to the PRISMA-ScR reporting protocol. Articles were coded by country, topic of research, and type of abuse studied, if any.

RESULTS

Our database search returned 6109 articles and 160 articles were included in our review. Themes included (1) prevalence, incidence, and characteristics of maltreatment, (2) outcomes associated with maltreatment, (3) attitudes, awareness, and reporting, (4) accidental injury and death potentially associated with neglect, (5) policy and practice. Eighty-seven articles studied Saudi Arabia, while 28 studied the UAE, 21 Kuwait, 13 Qatar, 12 Oman, and 11 Bahrain. Physical abuse was studied in 77 articles, followed by sexual abuse in 54 articles and emotional abuse in 54.

CONCLUSION

Although the medical community produces an encouraging volume of child maltreatment research, gaps remain. Intervention research is lacking, and further inquiry into family dynamics, culture, and spirituality could inform the development of effective interventions. Cross-sectoral collaboration among education, social work, law enforcement, and healthcare is also needed to safeguard children's rights in the GCC.

The Effect of the Covid-19 pandemic on emergency service home service calls due to home accidents in children aged 0-6 in Sakarya, Türkiye?

Background and Aim

The contribution of global pandemics to the emergence of home accidents is unknown. The study aims to retrospectively examine the effect of the Covid-19 Pandemic on Emergency Service Home Service Calls Due to Home Accidents in Children aged 0-6.

Methods

Data are reported in two sections. The descriptive part is a retrospective analysis of patients admitted to Sakarya Training and Research Hospital Pediatric Emergency and Adult Emergency Unit between March 16, 2019 and January 31, 2020 (non-COVID-19era) and March 16, 2020 and January 31, 2021 (COVID-19era). The second part of the study, the comparative part, presents mean data for 2019-2020 (non-COVID-19era) and 2020-2021 (COVID-19era) from the same center and the same period. These data will then be compared.

Results

A total of 9,110 pediatric patients applied to our center during the study period, of which 7,905 patients were in the non-Covid- 19era period and 1,205 patients were in the Covid-19 era. While the rate of hospital admissions decreased by 85% in the Covid-19era compared to the non Covid-19era, when the periods are evaluated within themselves; the forensic report retention rate in the Covid- 19era increased by 180% and the rate of hospitalization increased by 75%, The rate of drug overdose increased by 280% and chemical substance use increased by 325% compared to the non-Covid-19era. However The Covid-19 era, the fall rate decreased by 31% and the burn rate decreased by 17% compared to the non-Covid-19 era.

Conclusions

During the national lockdown period, our pediatric emergency department experienced significantly reduced volumes of children. Despite the decrease in hospital admission rate during the COVID-19 pandemic, there was still a very high increase in poisoning from home accidents. This study can provide a basis for further research on alternative strategies to address the problem of home accidents during the COVID-19 pandemic.

Pattern and Outcome of Non-Incidental Injuries in Children: Reports from a Tertiary Hospital

Domestic accidents and the resulting injuries are major global health concerns, especially when children are affected. Household accidents result in morbidity and mortality in children but are often neglected compared to the attention given to other childhood illnesses. This is a case series of 6 children involved in domestic accidents due to the caregivers' negligence. The patients presented at the Accident and Emergency Department of the University of Port Harcourt Teaching Hospital, Nigeria. Domestic accidents can result from falls from height leading to traumatic brain injury, which can be mild, moderate or severe. All the falls in this case series were preventable. Therefore, it is recommended that safety measures should be instituted at home and wherever children are to prevent any accident which can lead to physical injury and indirectly impact the parents, guardians and family.

The Pattern of Unintentional Injuries and Poisoning Among Children Admitted to King Abdulaziz Medical City, Jeddah, From 2014 to 2018 in Saudi Arabia: A Cross-Sectional Study

Background Unintentional injuries and poisoning among children are prevalent and severe causes of hospitalization and impairment. The number of accidental injuries among children increases every year, leading to a huge burden on communities and health institutions. Methods This study is a retrospective analytical cross-sectional study. Charts from January 2014 to December 2018 were reviewed to estimate the epidemiological distribution and types of unintentional injuries among children aged 14 years or younger, including newborns, who were admitted to King Abdulaziz Medical City (KAMC), Jeddah, Saudi Arabia. Results In this study, 353 children were included. Patients were those admitted to King Abdulaziz Medical City (KAMC), Jeddah, due to unintentional injuries and whose age varies from birth to 14 years. Most of the injured children were males (60.1%), but interestingly more female patients suffered from fracture injuries than males. The most common injury was found to be falling (38.5%), followed by road traffic accidents (RTA) (26.1%). The frequency of different types of injuries varied among different age groups. Infants' injuries were mainly falling (50%), while RTA was the most common injury among adolescents (94.7%). Moreover, the head and neck area was the most affected site contributing 39.1% of all sites. Outcomes of the accidental injuries were assessed as full recovery, disability, or death. Conclusion This study showed the proportion of unintentional injuries among children from birth to 14 years old in KAMC, Jeddah, Saudi Arabia. Overall, the most prevalent type of injury found in our study was falling. Moreover, injuries were more common among male patients. We concluded that most injuries could be avoided if parents or children's guardians practiced protective strategies mainly by ensuring a safe and clear environment for the children.

Death of children by domestic accidents: unveiling the maternal experience

ABSTRACT Objectives: to unveil the meanings of mothers whose children died as a result of domestic accidents in childhood. Methods: a qualitative research, in the light of Heideggerian phenomenology, with ten mothers whose children died from domestic accidents. It was carried out in a municipality of the Northeast Region of Brazil through phenomenological interviews between May and June 2017. The existential analytic was constituted by the comprehensive moments of the Heideggerian method. Results: the meanings unveiled pointed out that, to understand the sudden death of her child, the mother oscillates between feeling guilty, pointing and denying guilt. She reports emptiness, permanent pain, non-acceptance of her child’s death, and the desire to keep him in her life. In this journey, the fear that brings limitations to her life and that of her other children is revealed. Final Considerations: it was revealed that the death of the child in infancy compromises the integrality of being a mother, indicating the need for systematic and continuous care for the adequate management of the emotional and social effects.

Epidemiology of Drowning Incidents among Children at Sultan Qaboos University Hospital Oman

Objectives

We sought to study the epidemiology of drowning among children reported at Sultan Qaboos University Hospital in Oman.

Methods

We conducted a retrospective study of the patients who presented to the emergency department with a history of drowning over 10 years from January 2008 to December 2017. Patients with children aged one to 18 years old were included in the study. The data including demographics, timing and location of drowning, season, adult supervision, swimming ability, medical risk factors, duration of submersion, on spot resuscitation, emergency medicine department assessment, and hospital management and outcome were collected from electronic hospital information system using a preformed proforma. The outcome was categorized into either full recovery, severe neurological injury, or brain death based on the pediatric cerebral performance category (PCPC). A good outcome represents a score of 1–3 points, and a PCPC of 4–6 points corresponds to a poor outcome. We calculated correlation for all variables with the outcome by using chi-square and Fisher’s exact tests. A p-value of < 0.050 is taken as significant value.

Results

A total of 74 patients were included in the study; 54 (73.0%) were male, and 47 (63.5%) were aged < 6 years old. More than half (59.4%) of drownings happened in swimming pool, 21 (28.4%) children were unsupervised during the incident, and 39 (52.7%) required cardiopulmonary resuscitation (CPR). Out of all studied subjects, three (4.1%) were brain dead, and two (2.7%) developed severe neurological injury. On univariate analysis, the following variables were statistically significant (p < 0.050), predicting the poor outcome like lack of adult supervision, duration of submersion >10 minutes, asystole, Glasgow Coma Scale < 8, temperature < 35 ^oC, pH < 7, anion gap > 20, blood glucose > 10 mmol/L, abnormal chest X-ray findings, rewarming, CPR, intubation, inotropic support, and pediatric intensive care unit admission.

Conclusions

Our study suggests that children, especially males under the age of six with no swimming ability, need strict supervision next to bodies of water. Furthermore, preventive measures might include raising community awareness about the risk factors of drowning, commencing public CPR lessons, and strict pool safety regulation by related authorities.

Evaluation of changes in pediatric emergency department utilization during COVID-19 pandemic: Changes during COVID-19 pandemic

Background

During the coronavirus disease 2019 (COVID-19) pandemic period, the use of emergency services with pediatric non-COVID patients has decreased considerably. We aimed to examine whether there was a change in the demographic data, triage profile, causes, management, and cost of pediatric emergency department (PED) visits of non-COVID patients during the pandemic period.

Methods

This study was a retrospective, single-center, observational comparative study that was conducted at the PED. Patient records were examined during “the pandemic spring” and the same period of the previous year. Patient demographics, waiting time, and outcome of the PED visit were analyzed in the entire population of children admitted to the PED during the study period, whereas more precise data such as the reason for PED use, duration of symptoms, urgency levels according to the Emergency Severity Index (ESI), final diagnosis, management, and cost of patient care were analyzed in a sample of admitted patients. We used the chi-square test, Fisher's exact test, and Mann–Whitney U test for statistical analyses.

Results

A total of 62,593 PED visits occurred. During the pandemic period, PED visits showed a decrease of 55.8% compared to the previous year. Patients included in the sampling study group were selected using a systematic random sampling method. The median waiting time during the pandemic period was significantly shorter than the previous year (median 14 min [IQR: 5–32] vs. median 5 min [IQR: 2–16]; p<0.001). The median duration of symptoms was 1 day (1–2) in both groups. Emergency Severity Index (ESI) levels I, II, and III showed a significant increase (27.7% vs. 37.3%) in triage scoring compared to levels IV and V (72.3% vs. 62.7%) during the pandemic period (p<0.001). The median cost per patient during the pandemic period was statistically higher compared to the previous year ($19.57 [19.57–40.50] vs. $25.34 [31.50–52.01]; p<0.001). Overall costs during the pandemic period had a 1.6-fold decline.

Conclusion

We highlighted the changes in an ordinary PED profile during an extraordinary period. A shift in ESI levels in a more emergent direction was observed. While the number of nonurgent patients, especially those with infections, decreased, the rates of surgical cases, acute neurological and heart diseases, home accidents, and poisoning increased relative to the pre-pandemic period.

Injury Characteristics and Predisposing Effects of Various Outdoor Traumatic Situations in Children and Adolescents

Backgroud

Many studies have reported injury characteristics of individual traumatic situations. However, a comparative analysis of specific risks is meaningful to better understand injury characteristics and help establish injury-prevention measures. This study was conducted to investigate and compare injury characteristics in children and adolescents by various outdoor traumatic situations.

Methods

Outdoor traumatic situations were determined and classified into physical activity-related injury (n = 3,983) and pedestrian (n = 784) and passenger (n = 1,757) injuries in traffic accidents. Home injury (n = 16,121) was used as the control group. Then, the characteristics of each outdoor trauma were compared with 1:1 matched indoor trauma (among home injuries); each outdoor traumatic situation's predisposing risk for the injured body part, injury type, and injury severity were analyzed; and changes by age of frequency ranking among physical activity-related injuries were investigated.

Results

Outdoor trauma showed higher risks for limb injuries (injured body part), fracture and muscle/tendon injuries (injury type), and severe injuries (severity) than indoor trauma. Various outdoor traumatic situations presented different predisposing effects on injury characteristics. Among physical activity-related injuries, bicycle injury was commonest across all ages, and playing activities were common causes for injury for individuals of age < 9 years, whereas sports activities overwhelmed the common causes thereafter.

Conclusions

The findings would help to better understand the specific injury risk of various outdoor traumatic situations and may potentially facilitate the establishment of more effective injury-prevention measures.