Campaign needed to avoid traumatic injuries among children, doctors hear

A nationwide campaign to promote safety in the home and avoid traumatic injuries among young children is needed if Ireland is to reduce the number of young children ending up in hospital every year, doctors have heard.

Speaking at the launch of the National Office of Clinical Audit’s (NOCA) Major Trauma Audit, Professor Conor Deasy, clinical lead on the audit, said a campaign similar to the national road safety messaging could greatly reduce the number of children who suffer traumatic injuries annually.

The NOCA report, published on Tuesday, looked at data from 1,382 cases of paediatric major trauma between 2014 and 2019 across 26 hospitals.

It found that low falls, road traffic collisions and burns accounted for 71 per cent of all paediatric major trauma patients. The audit showed the home was the most common place of serious injury and that more than one-quarter of all serious injuries in children occurred during the first two years of life.

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It found the highest number of injuries recorded were among children who suffered “low falls” (a fall of two metres or less) with a high proportion of these falls occurring among babies aged one or younger.

Road trauma was the second most frequent cause of major trauma among children while a third of the deaths identified during the audit were caused by road incidents.

Burns were also a common reason for injury although the type of burn was found to change according to a child’s age. Younger children were more likely to be scalded by hot water in the home while older children were more likely to suffer aerosol burns or injuries through experimenting with fire.

The limbs and the head were found to be the parts of the body mostly likely to be injured, and presentations were more common in the afternoon in the summer.

‘More independent’

Dr Ciara Martin, consultant in paediatric emergency medicine with Children’s Health Ireland, noted that the highest number of paediatric traumatic injuries occurred among children aged 6-10 when they are becoming “more independent but are still less road savvy, less cautious and starting to explore and take more risks”.

Some 10 per cent of paediatric traumatic injuries occur among babies under one year of age, she added.

The fact that almost two-thirds of major trauma happened to boys was not surprising as boys between 6-15 tend to be “more impulsive” than their female peers, said Dr Martin.

Dr Martin warned that rehabilitation services in Ireland continue to be extremely under-resourced, particularly for children. Rehabilitation support is an important part of ensuring a child who has suffered a serious injury can get home, she said.

Dr Martin underlined the importance of collecting further data on traumatic injuries and called on the HSE to make use of the NOCA findings to improve paediatric trauma care pathways in hospitals around the country. The report also calls on the HSE to promote more targeted messages about the risk of traumatic injuries in the home including burns and falls.

Dr Warwick Teague from the Royal Children's Hospital in Melbourne, Australia, underlined that injuries sustained by children were always preventable.

“Injury is inevitable only if we act to keep it so – if our kids still keep reaching out to get hot drinks, or venturing into unfenced pools or are not supervised in high-risk places.

“People say it could happen to anyone. That’s not true, it could have not happened at all had our actions been taken to reduce the danger and reduce the risk of injury.

“By repeating safer actions we become injury preventing, we create personal habits and we foster a community expectation. Injury is preventable.”