Injury Prevention for Children How PT can help!. Topics to cover Playground Safety Bike Safety Water...
-
Upload
grant-washington -
Category
Documents
-
view
214 -
download
1
Transcript of Injury Prevention for Children How PT can help!. Topics to cover Playground Safety Bike Safety Water...
Injury Prevention for Injury Prevention for ChildrenChildren
Injury Prevention for Injury Prevention for ChildrenChildren
How PT can help!How PT can help!
Playground Safety• 200,000 ER admissions each year
secondary to playground injuries• most associated with falling from
equipment
Trampolines• Only children older than 6 years old should use
– Increase injury rate in younger children – 48% of injuries occurred in children under 9 years old
– Overall more girls than boys– Most injuries occur on trampoline– Most frequent injuries were fractures: arm/leg
most common– Second most frequent – sprains, strains and
dislocations– Most admissions to hospital occur in the 5 to 9
age range
Common Injuries (Canadian Hospital Injury Report)
• Breakdown event and factors contributing to the injury* What happened Frequency Percent ofInjuries – Attempted a maneuver, trick or flip: 27.3 – More than one person on trampoline at a time
bumped into, hit or fell on top of another personjumping, playing on trampolinepushed or fell off trampoline : 21.7%
Prevention of injuries• Adult supervision required• Bare feet – better traction less
slipping• One child at a time (how realistic?)• Net should have 250 pound limit
Trampolines• Springs covered
with padding• Anchor trampoline
into ground• No flips• AAP: trampolines
are not toys – should only be used as training devices
What about mini-tramps? (Pediatrics, July 2005)
• 32% of mini-tramp injuries occur to children under 6 years old
• Most frequent injury – head laceration• More females injured• Most injuries are on trampoline not
falling off• Just has hazardous as full size
AS PTs• Educate parents on trampoline
safety– One child at a time on trampoline– Enclosures– No Flips or rough housing– Bare feet– Mini tramps need supervision as well
Making Playgrounds Safe
• Playgrounds should fit the child: Children under 5 years old should use equipment only designed for pre schoolers
• Surfaces: sand, pea gravel, wood chips, synthetic– Should be at least 12 inches deep– Extend surface at least 6 feet in all directions
from equipment
Safe• Play structures more than 30 inches high
should be placed 9 feet apart• Swings should not have metal or hard wood
seats – swings should be at least 8 inches apart• Clearance between bottom of swing and
ground – 8 inches• Look for dangerous hardware: hooks, bolts• Make sure any spaces (i.e. ladder rungs) are
less than 3.5 inches and more than 9 inches apart to avoid head entrapment– One publication recommended kids wear bike
helmets on playground equipment to avoid heads getting trapped
Safe• Drawstrings: can potentially
strangle a child if they get caught – best to either remove from clothing or sew a seam in the middle of clothing so one side can not get pulled to far out
Pressure treated wood• Many treated wood contains arsenic
– Children should not eat food while playing on equipment built with pressured treated wood
– Wash hands with soap and water after play
– Arsenic can also “leak” into the ground
Sun exposure while on playgrounds
• 80% of skin damage from sun occurs before age 18
• Wear sunscreen, hats, sunglasses
Infants
• Babies under age 6 months need to be kept out of direct sunlight and wear lightweight clothing that covers their body– Wide brim hats– Baby-sized sunglasses– Stay out of sun between
10 AM and 4 PM
As PTs• Provide literature about playground
safety in lobby• Provide community playground
checks• Discourage trampoline usage unless
proper supervision present and used a training tool for sporting events
Bike Safety• 85 million bike riders in US
– 70% of kids ages 5 to 14 years ride bikes• More than 900 bike riders die each year: 50% are
under 15 years old• 85% killed were not wearing a helmet• Where helmets are required – only 52% of
kids wear• 50% wearing helmets were not fitted properly
• 580,000 visit ER yearly: 67000 have head injuries• 1/8 cyclists with reported injury has a head injury –
45 to 88% of head injuries can be prevented by helmet use
• Indirect cost due to not using helmet – 2.3 billion per year
Perspective• Injuries per 1000 participants
– Basketball: 21.2– Football: 20.7– Bicycling: 11.5
• However, more bike riders treated in ER than other sports
• Among boomers, biking is the deadliest sport – boomers die from head injuries twice as often as children – however between ages of 5 and 15 injury rate is the highest
• Less than 50% of boomers wear helmets
– Snowboarding: 11.2– Skateboarding: 8.9– Inline skates: 3.9
Amusing Stats• Bike riding is less dangerous than
skydiving, motorcycling, living, swimming and water skiing
• But more dangerous than airline flying, hunting, cosmic radiation from transcontinental flights, home living
Bike • Death rate highest between 10PM - 1 AM – 8
times higher than during midmorning/early afternoon
• 32% of tested bicyclists who were killed had been drinking– One drink increases probability of serious bike
accident by a factor of 6• Among children – most bike fatalities occur within
1 mile of home• Among children 14 years and younger – accidents
secondary to bicyclist’s behavior – i.e. running stop sign, riding against flow of traffic, etc
Helmet usage• Between ages 4 to 15 could prevent
– Between 135-155 deaths– Between 39000 and 45000 head injuries– Between 18000 and 55000 scalp and face
injuries
– Every dollar spent on bike helmets, saves society $30 in direct medical and other costs to society
Helmet usage• If 85% of child bike riders wore
helmets – lifetime medical cost savings would be between $109 million and $142 million
• Treatment for non-fatal bike injuries in children under 14 years cost an average of $218000 per injured child
PT • State associations should push for legislation requiring
helmet use• Sponsor bike derbies – training in proper riding, correct
fit of bike and helmet, helmet use, bike inspections, etc• Encourage parents to buy helmets for their children –
especially in rural areas (one study found almost 0% of kids wear helmets in rural areas)
• Helmet use increases with helmet campaign intensity• Recommend children ride on sidewalks until they are
10 years old• Avoid riding at night
Water safety• Drowning is the
second leading cause of unintentional death among children ages 14 and under
• Children ages 1-4 years are at the highest risk for drowning
• Young children can drown in as little as 1 inch of water
Drownings• Occur quickly and silently with children• 2 minutes after submersion, LOC occurs• Irreversible brain damage occurs after
4 to 6 minutes• Most drownings occur when children
are left unattended by pool or tub or bucket of water (5 gallon)
Prevent drownings• Stay with young children when they are in the
bathtub – even if they are with an older sibling• Empty buckets as soon as done with chores –
if on break – place bucket where child can not reach
• Closely monitor children when swimming – always swim with a buddy
• Provide swimming lessons for all your children• Learn CPR• No children under 14 years old should use
personal watercraft
PTs• Provide literature in lobby about
water safety• Take some time discussing safety
issues with parents during treatment times
• Model good water safety if have therapy pool program
Backpacks• Wear backpack over both not one shoulder• Be sure backpack right size for child• Use alternatives – packs with wheels –
avoid athletic bags • Encourage school to allow more frequent
locker breaks through out the day so kids do not have to carry so many books