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Çocuk Acil Servise Düşmeye Bağlı Travma Nedeniyle Getirilen Olgular

Year 2021, Volume: 9 Issue: 1, 5 - 10, 30.04.2021
https://doi.org/10.21765/pprjournal.874688

Abstract

Amaç: Çocuk acil ünitemize düşme nedeniyle başvuran travma olgularının kaza mekanizmasını ve kaza ilişkili ortaya çıkan sakatlıklarını değerlendirmeyi amaçladık.
Materyal-Metod: Çalışma 01.06.2009 – 01.02.2010 tarihleri arasında Gazi Üniversitesi Tıp Fakültesi Çocuk Acil Servis’ in de prospektif olarak düşmeye bağlı travma nedeniyle başvuran hastaların tanı, tedavi ve takipleri değerlendirilerek yapılmıştır.
Bulgular: Çalışmaya, 126 (%60)’sı erkek 210 olgu dahil edildi. Yaş ortalaması 44,5±45,01 (minumum:1 ay; maksimum:17 yıl) aydı. Yüz elli yedi hasta (%75), beş yaşın altında idi. 149 (%73,4)’unun ev içinde düştüğü, ev içinde düşen olguların 91 (%44,2)’inin 90 cm altı; 16 (%7,6)’sının 90 cm üzeri yükseklikten düştüğü görüldü. En çok zedelenen vücut bölgesi değerlendirildiğinde, 142 (%72,4) olgunun baş-boyun bölgesinden yaralandığı görüldü. Bu olgularında 76 (%38,8)’sın da yumuşak doku travması, 36 (%18,4)’sında laserasyon-kesi mevcuttu. 141 (%67,1) olguya direkt grafi, 53 (%25.2) hastaya kraniyal bilgisayarlı tomografi (BT) çekildiği görüldü. Yetmiş beş hasta (%40.1) mevcut klinik durumu nedeniyle acil gözlem ünitesine izleme alınmıştı. Bu olguların 54 (%72)’ü kafa travması olan olgulardı. Olguların 30 (%16)’una baş ve yüz bölgesindeki kesi-laserayon nedeniyle sütür atılmıştı. Değerlendirilen tüm hastalar herhangi bir mortalite ve morbidite olmadan muayene, tedavi ve/veya gözlem ardından taburcu edildi.
Sonuç: Düşme ilişkili travmalar sıklıkla ev içinde meydana gelmektedir. Ve en sık baş boyun bölgesi yaralanmaları görülmektedir. Özellikle okul öncesi dönmede yaşam ve oyun alanları evler olan çocukların sağlıklı şartlarda büyüyebilmesi ve düşme ilişkili travmalar nedeniyle acil servis başvurularının önlenmesinde ailelere çok iş düşmektedir. Güvenli ev ortamının nasıl oluşturulacağı ve alınacak önlemler hekimler tarafından ailelere anlatılmalıdır.

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References

  • Zuckerbraun NS, Powell EC, Sheehan KM, et all. Community childhood injury surveillance: an emergency department-based model. Pediatr Emerg Care. 2004;20(6):361-6.
  • Scuffham P, Chaplin S, Legood R. Incidence and costs of unintentional falls in older people in the United Kingdom. J Epidemiol Community Health. 2003;57:740–4.
  • Zagory JA, McLaughlin C, Mallicote M, et all. Retrospective Cohort Comparison of Fall Height in Children in the Greater Los Angeles Area: Targeting Populations for Injury Prevention. J Community Health. 2018;43(5):986-92.
  • Laraque D, Barlow B, Durkin M. Prevention of youth injuries. J Natl Med Assoc. 1999 ;91(10):557-71.
  • Chaudhary S, Figueroa J, Shaikh S, et al. Pediatric falls ages 0-4: understanding demographics, mechanisms, and injury severities. Inj Epidemiol. 2018:10;5(Suppl 1):7.
  • Kuppermann N, Holmes JF, Dayan PS, et all. Pediatric Emergency Care Applied Research Network (PECARN). Identification of children at very low risk of clinically-important brain injuries after head trauma: a prospective cohort study. Lancet. 2009 ;374:1160-70.
  • Simon TD, Bublitz C, Hambidge SJ. External causes of pediatric injury-related emergency department visits in the United States. Acad Emerg Med. 2004;11(10):1042-8.
  • Mathers LJ, Weiss HB. Incidence and characteristics of fall-related emergency department visits. Acad Emerg Med. 1998;5(11):1064-70.
  • Güzel A, Karasalihoğlu S, Küçükuğurluoğlu Y. Evaluation of the fall-related trauma cases applied to our pediatric emergency department. Turkish Journal of Trauma & Emergency Surgery 2007;13(3):211-6
  • Kılıç S, Taşkınlar H, Bahadır G, et all. Analysis of pediatric trauma patients falling down from height. Mersin Univ Saglık Bilim Derg 2016;(9)3:131-7
  • Kocak S, Dundar ZD, Yavuz K, et al. Etiologic factors in falls from height in pediatric cases. Eur J Trauma Emerg Surg. 2012;38(3):313-7.
  • Pressley JC, Barlow B. Child and adolescent injury as a result of falls from buildings and structures. Inj Prev 2005;11:267–733.
  • Babu A, Rattan A, Ranjan P, et al. Are falls more common than road traffic accidents in pediatric trauma? Experience from a Level 1 trauma centre in New Delhi, India. Chin J Traumatol. 2016;19(2):75-8.
  • MacInnes K, Stone DH. Stages of development and injury: An epidemiological survey of young children presenting to an emergency department. BMC Public Health. 2008;8:120.
  • Mack KA, Gilchrist J, Ballesteros MF. Injuries among infants treated in emergency departments in the United States, 2001-2004. Pediatrics. 2008;121(5):930-7.
  • Mamdani MM, Upshur RE. Fall-related hospitalizations: what's in season? Can J Public Health. 2001;92(2):113-6.
  • Razzak JA, Luby SP, Laflamme L. Injuries among children in Karachi, Pakistan — what, where and how. Public Health. 2004;118:114–20
  • Mariam A., Sadik M., Gutema J. Patterns of accidents among children visiting Jimma University Hospital, Southwest of Ethiopia. Ethiop Med J. 2006;44:339–45.
  • Bangdiwala SI, Anzola-Perez E, Romer CC. The incidence of injuries in young people: I. Methodology and results of a collaborative study in Brazil, Chile, Cuba and Venezuela. Int J Epidemiol. 1990;19:115–24.
  • Alexiou Ga, Sfakianos G, Prodromou N. Pediatric head trauma. J emergencies, trauma Shock. 2011;4(3):403–8.
  • Lam WH, Mackersie A. Paediatric head injury: incidence, aetiology and management. Paediatr Anaesth. 1999;9:377–85
  • Simon R, Gilyoma JM, Dass RM, et all. Paediatric injuries at Bugando Medical Centre in Northwestern Tanzania: A prospective review of 150 cases. J Trauma Manag Outcomes. 2013;7(1):10
  • Da Dalt L, Parri N, Amigoni A, et al. Italian guidelines on the assessment and management of pediatric head injury in the emergency department. Ital J Pediatr. 2018;44:7.
  • Kamboj A, Chounthirath T, Xiang H, et all. Traumatic brain injuries associated with consumer products at home among US children younger than 5 years of age. Clin Pediatr. 2017;56(6):545–54.
  • Jalalvandi F, Arasteh P, Safari Faramani R, et all. Epidemiology of Pediatric Trauma and Its Patterns in Western Iran: A Hospital Based Experience..Glob J Health Sci. 2015; 26;8(6):139-46.
  • Khosla S, Melton LJ , Dekutoski MB, et all. Incidence of childhood distal forearm fractures over 30 years: a population-based study. JAMA. 2003;17;290(11):1479-85
  • Wang H, Yu H, Zhou Y, et al. Traumatic fractures as a result of falls in children and adolescents: A retrospective observational study. 2017;96(37):e7879.
  • Siddiqui E, Ejaz K, Siddiqui U. Unintentional, paediatric domestic injury in a semi rural area of Karachi. J Pak Med Assoc. 2012;62(7):638-43
  • Hong J, Lee B, Ha EH, et all. Parental socioeconomic status and unintentional injury deaths in early childhood: consideration of injury mechanisms, age at death, and gender. Accid Anal Prev. 2010;42(1):313-9.
  • Brito MA, Melo AMN, Veras IC, et all. Risk factors in the domestic environment for falls in children under five years of age. Rev Gaucha Enferm. 2017;38(3):e2017-

Cases Admitted to Pediatric Emergency Service Due to Trauma Related to Fall

Year 2021, Volume: 9 Issue: 1, 5 - 10, 30.04.2021
https://doi.org/10.21765/pprjournal.874688

Abstract

Objective: We aimed to evaluate the accident mechanism and related disabilities and trauma cases who presented due to falls in the pediatric emergency service.
Material-Method: The study was conducted with a prospective method between 01.06.2009 - 01.02.2010 in Gazi University Medical Faculty Pediatric Emergency Service.
Results: A total of 210 cases, 126 (60%) of whom were men, were included in the study. The average age was 44.5 ± 45.01 (minimum: 1 month; maximum: 17 years) months. One hundred and fifty-seven patients (75%) were under the age of five. 149 (73.4%) of them fell inside the house; 90 cm below 91 (44.2%) of the cases falling inside the house; It was observed that 16 (7.6%) fell from a height above 90 cm. When the most injured body area was evaluated, it was seen that 142 (72.4%) patients had head-neck injuries. Of these cases, 76 (38.8%) had soft tissue trauma, 36 (18.4%) had laceration-incision. It was observed that direct radiography was performed in 141 (67.1%) patients, and cranial computed tomography (CT) was performed in 53 (25.2%) patients. Seventy-five patients (40.1%) were followed up in the emergency observation unit due to their current clinical condition. 54 (72%) of these cases were cases with head trauma. Sutures were performed in 30 (16%) of the cases due to the incision-laceration on the head and face. All evaluated patients were discharged after examination, treatment and / or observation without any mortality or morbidity.
Conclusion: Traumas caused by falls often occur at home. And the most common injuries are seen in the head and neck region. Families have many duties in preventing emergency room admissions due to fall-related traumas and children, whose living and playgrounds are houses, especially in the preschool period. Physicians should explain to families how to create a safe home environment and the measures to be taken.

Project Number

-

References

  • Zuckerbraun NS, Powell EC, Sheehan KM, et all. Community childhood injury surveillance: an emergency department-based model. Pediatr Emerg Care. 2004;20(6):361-6.
  • Scuffham P, Chaplin S, Legood R. Incidence and costs of unintentional falls in older people in the United Kingdom. J Epidemiol Community Health. 2003;57:740–4.
  • Zagory JA, McLaughlin C, Mallicote M, et all. Retrospective Cohort Comparison of Fall Height in Children in the Greater Los Angeles Area: Targeting Populations for Injury Prevention. J Community Health. 2018;43(5):986-92.
  • Laraque D, Barlow B, Durkin M. Prevention of youth injuries. J Natl Med Assoc. 1999 ;91(10):557-71.
  • Chaudhary S, Figueroa J, Shaikh S, et al. Pediatric falls ages 0-4: understanding demographics, mechanisms, and injury severities. Inj Epidemiol. 2018:10;5(Suppl 1):7.
  • Kuppermann N, Holmes JF, Dayan PS, et all. Pediatric Emergency Care Applied Research Network (PECARN). Identification of children at very low risk of clinically-important brain injuries after head trauma: a prospective cohort study. Lancet. 2009 ;374:1160-70.
  • Simon TD, Bublitz C, Hambidge SJ. External causes of pediatric injury-related emergency department visits in the United States. Acad Emerg Med. 2004;11(10):1042-8.
  • Mathers LJ, Weiss HB. Incidence and characteristics of fall-related emergency department visits. Acad Emerg Med. 1998;5(11):1064-70.
  • Güzel A, Karasalihoğlu S, Küçükuğurluoğlu Y. Evaluation of the fall-related trauma cases applied to our pediatric emergency department. Turkish Journal of Trauma & Emergency Surgery 2007;13(3):211-6
  • Kılıç S, Taşkınlar H, Bahadır G, et all. Analysis of pediatric trauma patients falling down from height. Mersin Univ Saglık Bilim Derg 2016;(9)3:131-7
  • Kocak S, Dundar ZD, Yavuz K, et al. Etiologic factors in falls from height in pediatric cases. Eur J Trauma Emerg Surg. 2012;38(3):313-7.
  • Pressley JC, Barlow B. Child and adolescent injury as a result of falls from buildings and structures. Inj Prev 2005;11:267–733.
  • Babu A, Rattan A, Ranjan P, et al. Are falls more common than road traffic accidents in pediatric trauma? Experience from a Level 1 trauma centre in New Delhi, India. Chin J Traumatol. 2016;19(2):75-8.
  • MacInnes K, Stone DH. Stages of development and injury: An epidemiological survey of young children presenting to an emergency department. BMC Public Health. 2008;8:120.
  • Mack KA, Gilchrist J, Ballesteros MF. Injuries among infants treated in emergency departments in the United States, 2001-2004. Pediatrics. 2008;121(5):930-7.
  • Mamdani MM, Upshur RE. Fall-related hospitalizations: what's in season? Can J Public Health. 2001;92(2):113-6.
  • Razzak JA, Luby SP, Laflamme L. Injuries among children in Karachi, Pakistan — what, where and how. Public Health. 2004;118:114–20
  • Mariam A., Sadik M., Gutema J. Patterns of accidents among children visiting Jimma University Hospital, Southwest of Ethiopia. Ethiop Med J. 2006;44:339–45.
  • Bangdiwala SI, Anzola-Perez E, Romer CC. The incidence of injuries in young people: I. Methodology and results of a collaborative study in Brazil, Chile, Cuba and Venezuela. Int J Epidemiol. 1990;19:115–24.
  • Alexiou Ga, Sfakianos G, Prodromou N. Pediatric head trauma. J emergencies, trauma Shock. 2011;4(3):403–8.
  • Lam WH, Mackersie A. Paediatric head injury: incidence, aetiology and management. Paediatr Anaesth. 1999;9:377–85
  • Simon R, Gilyoma JM, Dass RM, et all. Paediatric injuries at Bugando Medical Centre in Northwestern Tanzania: A prospective review of 150 cases. J Trauma Manag Outcomes. 2013;7(1):10
  • Da Dalt L, Parri N, Amigoni A, et al. Italian guidelines on the assessment and management of pediatric head injury in the emergency department. Ital J Pediatr. 2018;44:7.
  • Kamboj A, Chounthirath T, Xiang H, et all. Traumatic brain injuries associated with consumer products at home among US children younger than 5 years of age. Clin Pediatr. 2017;56(6):545–54.
  • Jalalvandi F, Arasteh P, Safari Faramani R, et all. Epidemiology of Pediatric Trauma and Its Patterns in Western Iran: A Hospital Based Experience..Glob J Health Sci. 2015; 26;8(6):139-46.
  • Khosla S, Melton LJ , Dekutoski MB, et all. Incidence of childhood distal forearm fractures over 30 years: a population-based study. JAMA. 2003;17;290(11):1479-85
  • Wang H, Yu H, Zhou Y, et al. Traumatic fractures as a result of falls in children and adolescents: A retrospective observational study. 2017;96(37):e7879.
  • Siddiqui E, Ejaz K, Siddiqui U. Unintentional, paediatric domestic injury in a semi rural area of Karachi. J Pak Med Assoc. 2012;62(7):638-43
  • Hong J, Lee B, Ha EH, et all. Parental socioeconomic status and unintentional injury deaths in early childhood: consideration of injury mechanisms, age at death, and gender. Accid Anal Prev. 2010;42(1):313-9.
  • Brito MA, Melo AMN, Veras IC, et all. Risk factors in the domestic environment for falls in children under five years of age. Rev Gaucha Enferm. 2017;38(3):e2017-
There are 30 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Original Articles
Authors

İlknur Fidancı 0000-0002-8640-297X

Okşan Derinöz 0000-0001-7348-0656

Aslıhan Tokgöz 0000-0001-9603-9468

Project Number -
Publication Date April 30, 2021
Acceptance Date February 9, 2021
Published in Issue Year 2021 Volume: 9 Issue: 1

Cite

Vancouver Fidancı İ, Derinöz O, Tokgöz A. Çocuk Acil Servise Düşmeye Bağlı Travma Nedeniyle Getirilen Olgular. pediatr pract res. 2021;9(1):5-10.