The Florida Pediatric Society

Article Explores Injuries of Infants Treated in Emergency Departments

"An infant's risk of injury is influenced by social and physical environments and products, which change as the infant matures during the first year of life," state the authors of an article published in the May 2008 issue of Pediatrics. Unintentional injuries are a significant cause of death and morbidity in the first year of life. Previous work has not fully explored this period of rapid change in human development. The study described in this article presents a detailed examination of the estimates, causes, and outcomes of unintentional injuries among infants 12 months of age or younger treated in emergency department (EDs). Using data from 2001 to 2004, the study describes external causes of injuries, and products related to injuries according to month of age and demonstrates a shifting trajectory of risk during the first year of life.

The authors analyzed data from an ongoing, national, ED-based surveillance system, the National Electronic Injury Surveillance System -- All Injury Program (NEISS-AIP), a stratified probability sample of hospitals having more than six beds and providing 24-hour emergency services in the United States or its territories. Data elements included age (in months), body part injured, cause, diagnosis, case disposition, gender, a brief narrative, location of injury event, and product involvement.

The authors found:

During 2001-2004, an estimated 1,314,000 injured infants were seen in EDs for nonfatal unintentional injuries.
Falls were the leading cause of nonfatal unintentional injuries for infants treated in EDs annually, followed by "struck by or against" (e.g., household items being dropped on infants, fingers or toes being caught in doors or toys, infants being poked by an object such as a toy or a straw).
Although relatively few infants were treated for nonfatal drowning injuries, almost half of these were admitted to the hospital. Other causes with above-average hospitalization rates included inhalation or suffocation injuries, motor-vehicle-occupant injuries, foreign body injuries, fire and burn injuries, and other transport injuries.
Injured infants were more likely to be male (55.2%) than female (44.8%).
Contusions or abrasions were the leading diagnosis overall (27.6%).
Contusion or abrasion, laceration, hematoma, foreign-body, and puncture injuries occurred most frequently to the head or neck region. More than one-third of fractures (37.2%) were to the arm or hand.
Bed was the most frequently noted product involved in the injury event for every month of age except 2 months and 12 months. Narrative comments reported infants falling, rolling, or sliding off the bed.
Ranks of other products changed markedly as the month of age increased.

The authors conclude that "interventions must consider enhancing the knowledge of milestones (e.g., through physician anticipatory guidance regarding mobility changes), use of home safety devices (e.g., installation of stair gates), and behavior changes (e.g., promoting consistent stair gate use)."

Mack KA, Gilchrist J, Ballesteros MF. 2008. Injuries among infants treated in emergency departments in the United States, 2001-2004. Pediatrics 121(5):930-937. Abstract available here.

More information is available from the following MCH Library's resources: - Child Safety and Injury Prevention: Selected Resources here

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