The history of paediatric trauma care in Cape Town

Trauma is a leading cause of morbidity, mortality and disability in childhood. In most developed countries where 18% of the population are in the age group 0 - 15 years, injury exceeds all other causes of childhood mortality. In the developing countries of Africa, however, children aged 0 - 15 years constitute 43% of the population and trauma has an even bigger impact on child health.There is an erroneous perception that trauma is not a major health problem in Africa, derived from undue emphasis on mortality statistics alone. Yet, the impact of trauma ought to be measured not only in terms of death, but also the tremendous morbidity and disability caused by injuries, and their socioeconomic consequences

Profile of children with head injuries treated at the trauma unit of Red Cross War Memorial Children's Hospital

Objective. To describe the profile of childhood head injury patients treated in a trauma unit. Design. A retrospective record-based study. Setting. The trauma unit of the Red Cross War Memorial Children’s Hospital. Subjects. Children (under 13 years of age) presenting with head injuries between January 1991 and December 2001. Results. Of the almost 94 000 records, more than one-third were children presenting with head injuries. Fifty-nine per cent were boys, with more than half the sample under 5 years of age. The majority of children presented with superficial lacerations and abrasions, mostly affecting the scalp and skull. Injuries were mainly caused by falls from a variety of heights, and traffic-related injuries. Almost twothirds of traffic-related injuries involved children as pedestrians being struck by a motor vehicle. More than 60% of injuries occurred in or around the child’s own home. Conclusions. Head injuries in children are a significant cause of morbidity. Prevention, especially in the home and on the streets, needs urgent attention

From the pursuit of excellence to the quest for significance: Promotion of a Childsafe South Africa

Trauma represents a major burden of disease in South Africa. Children are disproportionately affected by trauma; rightly, childhood trauma can be referred to as ‘the neglected childhood killer disease’. Unlike the field of infectious diseases, where vaccinations and prevention are the norm, paediatric trauma is usually ignored and prevention strategies are scarce. In this article, we review paediatric trauma and its effect on our society in light of the development of more effective child safety promotion strategies

Animal attacks - a red herring of child abuse?

Injuries sustained as a result of attacks by domestic animals, particularly canines, are occasionally encountered at the Red Cross Children’s Hospital Trauma Unit in Cape Town. Less than 1% of admissions are directly attributable to animal attacks. Animal attacks causing lethal injuries are very rare and should be assessed carefully. We recently dealt with two fatalities attributed to animal attacks

Bifocal Spinal Cord Injury without Radiographic Abnormalities in a 5-Year Old Boy: A Case Report

We present the extremely unusual case of a 5-year-old boy with a bifocal (cervical as well as lumbar) spinal cord injury without radiographic abnormalities (SCIWORAs). The MRI showed cord oedema at the level of C2 and T10. We propose that during the motor vehicle crash severe propulsion of the head with a flexed lumbar region resulted in a traction injury to the lower thoracic and lumbar spine and maximum flexion caused SCIWORA in C2