Using Local Data to Drive Injury Prevention Strategies Disclosures Objectives

Transcription

1 Using Local Data to Drive Injury Prevention Strategies Lee Ann Wurster MS, RN, CPNP Trauma Coordinator Disclosures No financials interest or other relationships with commercial entities Objectives Analyze local data to guide injury prevention strategies Identify patient populations at risk Educate patients and families of the risk of injuries Describe prevention strategies to impact your area 1

2 Problem Injury = #1 killer > 9,000 children age 0-19 died in 2010 Millions more treated in ED Leading causes of injuries Significant public health problem Data drives prevention 2

3 Nationwide Children s Hospital Between , 4709 patients admitted with an injury 62 Deaths FALLS Non fatal Admissions Related to Falls N=1776 Occurrences <1 1 4 yr 5 9 yr yr > 14 yr Age 3

4 Deaths related to Falls 10 9 Occurences <1 1 4 yr 5 9 yr yr > 14 yr Year 3 Falls prevention If It s High Up, It s High Risk Falls Prevention Summer bike safety campaign My Helmet is My Friend program Play It safe on line game and kiosk SAFE 4

5 MVC Occurrences Non Fatal Admissions Related to MVC N=381 <1 1 4 yr 5 9 yr yr > 14 yr Age Deaths related to MVC Age Total MVC < yr yr yr > 14 yr

6 Passenger Safety Infants/Toddlers Rear facing until at least 2 Passenger Safety Toddlers/Preschoolers Forward-facing with 5-point harness Passenger Safety School-Aged Children Belt-positioning booster seat until 4ft 9in and 8-12 years of age 6

7 Passenger Safety Older Children Lap and shoulder seat belt Rear seat until at least 13 years Passenger Safety No texting while driving pledge (on line) SAFE Car seat chooser app (2012) Sports Related Injuries 7

8 Non Fatal Admissions Related to Sports Injuries N=320 Occurences <1 1 4 yr 5 9 yr yr > 14 yr Age Sports Related Injuries Of the 320 admitted sports related injuries, 23 had intraabdominal injuries Pancreas: 15 yr. olds 2 Football 1 Soccer Liver: yr. olds 1 Football 1 Baseball Kidney: yr. olds 1 Football 1 Baseball Spleen: 8-17 yr. olds 2 Soccer 1 Baseball 6 Football 4 Baseball 1 Other 8

9 Intra-abdominal Injuries Blunt trauma Low-frequency, high risk Most common in contact sports Kidney Spleen Liver Recognizing Abdominal Injuries Abdominal pain/ tenderness over the injured area Rigid abdomen Left arm and shoulder pain Right sided abdominal pain and right shoulder pain Blood in urine Cold, sweaty skin Bruising to abdomen Nausea and vomiting Tachycardia Hypotension LOC Injury Prevention for Sports Related Injuries NCH offers PAV classes for coaches. Injury prevention is a section of the course. Sports medicine does performance and prevention programs for athletes. 9

10 Non-accidental Trauma Occurrences Occurrences Deaths Non fatal Related Admissions to Non Accidental related to Trauma NAT Non fatal Admissions Related to Assault N=12 N=204 N= NAT <1 <1 1 4 yr yr 5 9 yr yr yr > > yr <1 1 4 yr 5 9 Age yr yr > 14 yr Age Child Abuse 2.9 million child abuse reports every year in the US 80% of the time the parent was the perpetrator Abused children are 25% more likely to experience teen pregnancy Children who experience child abuse and neglect are 59% more likely to be arrested as a juvenile and 30% more likely to commit a violent crime 10

11 Non-accidental Trauma Prevention Kids on the Block Puppetry in classrooms Kenpo classes It s Not Cool to be Cruel- anti bullying program Understanding and responding to Family violence program Child Abuse Screening Tool 11

12 25 Non Fatal Admissions related to Drowning N= Occurences <1 1 4 yr 5 9 yr yr > 14 yr Age Occurences Deaths Related to Drowning Age N=13 <1 1 4 yr 5 9 yr Drowning Injury Prevention Water safety brochure Water safety activity book Content covered in babysitting classes, infant care classes and active parenting classes On hold messages 12

13 Hanging 6 Non Fatal Admissions Related to Hanging 5 N=29 Occurences <1 1 4 yr 5 9 yr yr > 14 yr Age Deaths Related to Hanging Occurences <1 1 4 yr 5 9 yr yr > 14 yr Age 13

14 Suicide Prevention Youth suicide prevention project Behavioral health Crisis unit Burns Time for a burn injury to occur Time Temp Adult 30 seconds 130 degrees F Child 10 seconds 130 degrees F < 5 seconds 140 degrees F Infant 1 second 140 degrees F Home hot water heaters are often set to 140 degrees 14

15 Mechanism of Injury 60% 50% 40% 30% % 10% 0% Scald Fire Object Chemical Electrical Age Distribution 70% 60% 50% 40% 30% % 10% 0% Prevention Strategies Helping hands Kids on the block fire safety Re-entry programs On hold messages Community education 15

16 What Can You Do? Screen patients for suicidal ideation and refer appropriately Talk about teaching children to swim and proper supervision around pools Ask about helmet use and give positive feedback when appropriate Educate parents about injury risks Assess patients for unusual bruising patterns not appropriate for developmental age and REPORT! Summary We know that it is possible to create conditions where injury is less likely to happen if we work together 16