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Injury Prevention: The Pediatrician’s Perspective

Injury Prevention: The Pediatrician’s Perspective. Kyran Quinlan, MD, MPH Associate Professor University of Chicago. What this talk is not. NEISS NEISS All Injury WISQARS CPSIA GIS Jarts. Leading causes of death--US, 2007. Age group (years).

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Injury Prevention: The Pediatrician’s Perspective

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  1. Injury Prevention: The Pediatrician’s Perspective Kyran Quinlan, MD, MPH Associate Professor University of Chicago

  2. What this talk is not NEISS NEISS All Injury WISQARS CPSIA GIS Jarts

  3. Leading causes of death--US, 2007 Age group (years)

  4. http://www.co.humboldt.ca.us/health/FIMR/intro.pdf

  5. Pediatric clinic 7-month-old brought by mom for burns suffered when infant rolled out of bed and wedged between bed and radiator this morning.

  6. Pediatric clinic 7-month-old with burns to head, face, arm, side Admitted to burn unit

  7. Ten Radiator Burn Cases 7 months to 5 years 3 were hospitalized All between September and April Cellulitis developed in 2 children One child was burned twice

  8. Ten Radiator Burn Cases 3 burned after being trapped between a bed and a radiator 3 reported to Department of Children and Family Services All reports determined to be “unfounded”

  9. Housing Authority Letter to bring issue to their attention Tone of cooperation rather than confrontation

  10. Inspection of 2 project buildings All 169 units inspected 36 (21%) had adequate radiator covers and pipe insulation Of the 104 units with children under 10 years, 15 (14%) had this protection.

  11. Housing Authority Response Replacement and repair of radiator covers and pipe insulation All 11 buildings with steam radiators

  12. Emergency Room 2-year-old female scalded. She spilled noodle soup on herself as she removed it from microwave oven.

  13. 2 year old female Scalded Face, Chest and Abdomen Opened microwave oven and removed Ramen Noodles

  14. 18-month-old

  15. Now anyone can make rice in 90 seconds

  16. Tap water vs. not Feldman and Katcher CPSC and standards of hot water heaters electric 125°F gas 120°F Tap water is cause of only 10-15% of child scalds

  17. Children admitted for non-tap water scalds Number Age (months) Lowell G, Quinlan KP, Gottlieb L, Pediatrics 2008

  18. Mechanisms of Child Scald Burn Pulled over a cup, bowl or cookware while climbing (39%) Hot substance spilled onto them by someone else (15%) Climbed to reach the hot substance (11%) Opened the microwave and removed the hot substance (9%) Lowell G, Quinlan KP, Gottlieb L, Pediatrics 2008

  19. Scalded after opening a microwave 9 children under 5 years 2 of them under 20 months After the bell rang Lowell G, Quinlan KP, Gottlieb L, Pediatrics 2008

  20. Results 40 subjects without developmental delay 15 to 59 months 22 male

  21. Able to open a “pull” door % Total Number8 10 10 8 4

  22. Able to open a “push” door % Total Number8 10 10 8 4

  23. Able to remove a cup % Total Number8 10 10 8 4

  24. Able to start microwave % Total Number8 10 10 8 4

  25. Prevention Current lockout function inadequate Redesign so young children can not open microwave

  26. Prevention We are your colleagues Treating injured children motivates MDs Primary prevention ultimate goal

  27. Heaven heaven is a place a place where nothing nothing ever happens

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