Abstract
Unintentional injuries are a leading cause of death in childhood globally. Injuries lead to emotional trauma and financial burden for children, parents, and society. Here are the frequencies of unintentional injuries in children presented to the emergency and paediatric surgery clinics of the Aga Khan University Hospital, Karachi, Pakistan, from January to December 2012. Aretrospective chart review of children aged 0 day to 14 years presented with falls, burns, foreign body ingestion or inhalation, poisoning, fingers caught in doors, electrocution injuries and drowning, was conducted. Atotal of 165 children were included. Domestic injuries were frequently occurring injuries in our set-up which could be prevented by doing small adjustments to make the home safe for childre

Faruque, Ahmad Vaqas

Khan, Muhammad Arif Mateen

English

eCommons@AKU

eCommons@AKUDepartment of Surgery Department of SurgeryMay 2016Unintentional injuries In children: are our homessafe?Ahmad Vaqas FaruqueAga Khan UniversityMuhammad Arif Mateen KhanAga Khan University, arif.mateen@aku.eduFollow this and additional works at: http://ecommons.aku.edu/pakistan_fhs_mc_surg_surgPart of the Pediatrics Commons, and the Surgery CommonsRecommended CitationFaruque, A., Khan, M. (2016). Unintentional injuries In children: are our homes safe?. JCPSP: Journal of the College of Physicians andSurgeons Pakistan 2, 26(5), 445-446.Available at: http://ecommons.aku.edu/pakistan_fhs_mc_surg_surg/573An injury is the physical damage that results when ahuman body is suddenly subjected to intolerable levelsof energy. Childhood injuries are a leading cause ofdeath in the world.1 Injuries lead to emotional traumaand financial burden for children, parents, and society.Although children less than 14 years are 45% ofpopulation in developing countries;1 but still in Pakistandata regarding injuries in children less than 14 years,age, is very scarce. Home is the place of childhoodwhere children spend most of their time.2 Most of theseinjuries result in mild to moderate accidents, but still it isbelieved that some injuries are under-reported, possiblybecause of the current medical system and being morecommon in low socioeconomic group.3There are two broad arms of injury classification:intentional and unintentional injuries. Further divide it inroad traffic injuries and domestic injuries; later include allthe injuries that occur in home as home is the mostcommon place of injury (53%).4 Rehmani et al.mentioned the most frequent mechanism of injurieswere falls from height (44%), burns (7.7%), and foreignbody (6.5%).4 The common site of injuries were headand face (28%), trunk (3%), upper limb (25%), and lowerlimb (30%).4 According to a recent review, the mostcommon risk factors for domestic injuries are lowmaternal education and overcrowding.4The United Nations Convention on the Right of Childstates that the child has a right to the highest attainablelevel of health and a right to safe environment. Injuriesare the leading cause of death and accounts for morethan 5 million deaths per year. A bulk of these injuriesoccur in developing countries. Among those, childhoodinjuries are the fourth leading cause. Very limited workabout domestic injuries is done in the developingcountries. The aim of this study was to determine theburden of domestic injuries in children.After taking approval from the Hospital Medical RecordTeam, a retrospective chart review of record fromJanuary to December 2012 was conducted, at The AgaKhan University Hospital. It included all children whopresented to the emergency / paediatric surgery clinicswith domestic injuries including fall, burns, foreign bodyingestion or inhalation, poisoning, fingers caught indoors, electrocution, and drowning. Injuries occurringoutside home settings and in road traffic accidents wereexcluded. Cases of injury were identified by means ofthe International Classification of Diseases, 9th Revision(ICD-9) codes listed on hospital discharged records.Data was analyzed on SPSS version 16. Categoricalvariables were reported in terms of percentages andfrequencies.A total of 3,023 admissions were identified; 419 wereidentified as trauma/injury victims and 165 children wereincluded in the study who matched the inclusion criteria.The age ranged from 0 day to 14 years. The mostcommon age of presentation was 1 - 3 years. Therewere 131 (79%) boys and 34 (21%) girls. Thecommonest mechanism of injury was fall 64 (39%),followed by foreign body injuries 60 (36%). Head andneck was the most common site of injury 64 (39%)followed by extremities which were 49 (30%). Thecommonest place of injuries was bedroom 61 (37%)cases followed by living room 43 (26%) cases (Table I).One hundred and fourteen out of 165 (69%) of motherswere illiterate compared to literate mothers which were51/165 (31%). Domestic injuries were more common inchildren of working mothers 93/165 (56%) as comparedto non-working mothers. Most of the children (92%) wereadmitted and majority of them (99%) were discharged instable condition. The mortality rate was 1% as thereJournal of the College of Physicians and Surgeons Pakistan 2016, Vol. 26 (5): 445-446 445SHORT COMMUNICATIONUnintentional Injuries In Children: Are Our Homes Safe?Ahmad Vaqas Faruque and Muhammad Arif Mateen KhanABSTRACTUnintentional injuries are a leading cause of death in childhood globally. Injuries lead to emotional trauma and financialburden for children, parents, and society. Here are the frequencies of unintentional injuries in children presented to theemergency and paediatric surgery clinics of the Aga Khan University Hospital, Karachi, Pakistan, from January toDecember 2012. A retrospective chart review of children aged 0 day to 14 years presented with falls, burns, foreign bodyingestion or inhalation, poisoning, fingers caught in doors, electrocution injuries and drowning, was conducted. A total of165 children were included. Domestic injuries were frequently occurring injuries in our set-up which could be preventedby doing small adjustments to make the home safe for children.Key Words: Injury.   Unintentional injury.   Domestic injury.   Children.Section of Paediatric Surgery, Department of Surgery,The Aga Khan University Hospital, Karachi.Correspondence: Dr. Muhammad Arif Mateen Khan,Head, Section of Paediatric Surgery, Department of Surgery,The Aga Khan University Hospital, Karachi.E-mail: arif.mateen@aku.eduReceived: November 05, 2014;   Accepted: January 06, 2016.were two deaths; both had history of fall with severehead injuries.The children were divided in to two groups, one before5 years and other after 5 years, and both the groups haddifferent presentations (Table II). Domestic injuries,especially foreign body accidents, were more commonin pre-school children 52/117 (50%) as compared toschool going children as they have more time to spendat home. Similarly, there were higher proportion of headinjuries in children less than 5 years as their head tobody ratio is larger. On the contrary, school-going-agechildren of more than 5 years of age were highlyinfluenced by their surrounding as the commonest wayof presentation was fall from height (34/48, 78%, Table II).Overall fall (39%) was the most common mechanism ofinjury. This is consistent with a previous study,5 followedby foreign body ingestion or inhalation, corrosiveinjury and burn. Infant walker was a strong contributorof toddlers, fall. Foreign body injuries, i.e. ingestion orinhalation was the other frequent mode of presentationof domestic injuries in this study (36%). The commonlyingested foreign body was coin followed by beetle nutinhalation, possibly because of easy access.Bedroom (37%) followed by living room (26%) wasfound to be commonest place of injury. This is contraryto the western literature where the most common placeof injury is kitchen, probably because in our society,children used to be with mothers, who were usuallyspending their daily domestic activities in these places athome.These injuries are a real burden to our economy as it isone of the largest non-communicable diseases. With agrowth in industries and technological advancement,occurrence of injuries especially among children areshowing an ascending trend. By providing bettereducation to family and parents, the overall burden ofchildhood injuries can be decreased. It is suggestedthat public awareness, regarding this very importantand partially neglected aspect of injuries, should beprovided through the media, and safety talks should beencouraged. Parents should be aware of safety guide-lines with an emphasis regarding the safety kit formationand its use.It is not a population-based study as only those caseswere recorded that came to the Hospital Emergency andPaediatric Surgery Clinics. Although it is a retrospectivestudy but the authors believe that its findings haveimportant implications both for the health authorities andthe government. There is a need for standardization ofdata so that all the injuries should be documented in auniform format. Parents should be encouraged not toleave their children unattended. One should realize thatchild injury would be the last thing in child's mind butshould be first in parents’.REFERENCES1. Rehmani R. Childhood injury prevention. J Pak Med Assoc2008; 58:293-4.2. Sim TP, Ng KC. Childhood injuries: prevention is always betterthan cure. SMJ 2005; 46:103-5.3. Watson M, Kendrick D, Coupland C, Woods A, Futers D,Robinson J. Providing child safety equipment to preventinjuries: randomized controlled trial. BMJ 2005; 330:178.4. Rehmani R. Childhood injuries seen at an emergencydepartment. J Pak Med Assoc 2008; 58:114-8.5. Schnitzer PG. Prevention of unintentional childhood injuries.Am Fam Physician 2006; 1864-9.Ahmad Vaqas Faruque and Muhammad Arif Mateen Khan446 Journal of the College of Physicians and Surgeons Pakistan 2016, Vol. 26 (5): 445-446Table I: Frequencies of various mechanisms domestic Injures.Variables n (Percentage) Mechanism of injuryFall 64 (39%) Foreign body 60 (36%)Corrosives 16 (10%)Burns 13 (08%)Doors 10 (06%)Electrical appliances 02 (01%)Site of injuryHead and neck 64 (39%)Extremities 49 (30%)Thorax 29 (17%)Abdomen 13 (08%)Neck 08 (05%)Pelvis 02 (01%)Place of injuriesBed room 61 (37%)Living room 43 (26%)Kitchen 32 (19%)Stairs 22 (13%)Bath room 07 (04%)Level of mother's  educationIlliterate 114 (69%)Literate 51 (31%)Working mothers 93 (56%)Non-working mothers 72 (44%)Table II: Different modes of injuries according to age.Mode of injury 0  - < 5 years 5 - 14 years N = 117 N = 48Foreign body 58 (50%) 02 (04%)Fall 30 (26%) 34 (71%)Corrosives 12 (10%) 04 (08%)Burns 10 (08%) 03 (06%)Doors 06 (05%) 04 (08%)Electrical appliance accidents 01 (01%) 01 (02%)

Unintentional injuries In children: are our homes safe?

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Unintentional injuries In children: are our homes safe?

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