Best Practices for Discussing Injury Prevention With Pediatric Patients and Families

Abstract Pediatric emergency centers treat millions of unintentional injuries cases every year, and many of these injuries could have potentially been avoided by proper counseling about trauma safety and prevention. Through such discussions, clinicians have the ability to meaningfully decrease the number of these unintentional injuries. Not enough attention has been placed on critically injured children and adolescents who have a substantial burden on health care resources and morbidity. Motor vehicle collisions cause 20% of all child and adolescent deaths. Emergency medicine providers and pediatricians have the responsibility to educate patients and families about proper child passenger safety and to remain up to date on this information. Firearm-related unintentional injuries, suicide rates, and homicide rates among the pediatric age group have increased substantially in recent years. However, numerous barriers still exist for physicians to fully counsel patients and their families about firearms. The exposure of children to poisons almost exclusively (93%) occurs at home, and oral supplements and medications cause 60% of unintentional poisonings. However, the morbidity and mortality of pediatric poisonings can be decreased by child-resistant packaging. Approximately 8000 children are treated in emergency departments daily for fall-related injuries. Bicycling remains a popular form of exercise and recreation in children and adolescents. The use of helmets can effectively prevent the occurrence of 88% of traumatic brain injuries sustained during bicycle use. Pediatric emergency medicine physicians can play a foundational role in the safety, prevention, and treatment of childhood injuries. Clinicians can become effective instructors for injury prevention by using the Haddon Matrix: host, agent, and environment; and the 3 Es of injury prevention: education, engineering, and enforcement of strategies. Legislative changes, educational approaches, and product modifications must come together to effectively achieve this goal. Although the idea of educating families in the emergency department may seem ideal because the immediacy of the current injury may make the families more receptive to the counseling, the integration of primary care physicians is beneficial for regular follow-ups and maintenance.