The Likelihood of Injuries When Children Fall Out of Bed

Nimityongskul, Prasit; Anderson, Lewis D.

doi:10.1097/01241398-198703000-00014

Cited by 144 publications

(60 citation statements)

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“…Studies of falls occurring in hospitals from an estimated height of 0.61 to 1.2 m (2-4 ft) do not show any case of SDH or death. 22,30,36 Other case studies have shown no incidence of SDH or death caused by falls from 0.9 m (3 ft). 48,55 To our knowledge, no case study contains a report of serious brain injuries or death caused by falls from 0.3 m (1 ft) or less.…”

Section: Discussionmentioning

confidence: 99%

“…Evidence exists to support the hypothesis that short falls do not cause serious injury and the critical height for a fall to cause death is substantial (Ͼ 10 ft). 4,10,34,36,49,55 Simultaneously, however, others contend that relatively short falls can occasionally cause injuries associated with high mortality rates, such as SDHs, epidural hematomas, and skull fractures. 8,18,19,21,40,43,44,46,54 Because the mechanical responses experienced by the head and the in-Object.…”

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confidence: 99%

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Anthropomorphic simulations of falls, shakes, and inflicted impacts in infants

Prange

Coats²,

Duhaime³

et al. 2003

Journal of Neurosurgery

165

117

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Object. Rotational loading conditions have been shown to produce subdural hemorrhage and diffuse axonal injury. No experimental data are available with which to compare the rotational response of the head of an infant during accidental and inflicted head injuries. The authors sought to compare rotational deceleration sustained by the head among free falls, from different heights onto different surfaces, with those sustained during shaking and inflicted impact. Methods. An anthropomorphic surrogate of a 1.5-month-old human infant was constructed and used to simulate falls from 0.3 m (1 ft), 0.9 m (3 ft), and 1.5 m (5 ft), as well as vigorous shaking and inflicted head impact. During falls, the surrogate experienced occipital contact against a concrete surface, carpet pad, or foam mattress. For shakes, investigators repeatedly shook the surrogate in an anteroposterior plane; inflicted impact was defined as the terminal portion of a vigorous shake, in which the surrogate's occiput made contact with a rigid or padded surface. Rotational velocity was recorded directly and the maximum (peak—peak) change in angular velocity and the peak angular acceleration were calculated. Analysis of variance revealed significant increases in the and associated with falls onto harder surfaces and from higher heights. During inflicted impacts against rigid surfaces, the and were significantly greater than those measured under all other conditions. Conclusions. Vigorous shakes of this infant model produced rotational responses similar to those resulting from minor falls, but inflicted impacts produced responses that were significantly higher than even a 1.5-m fall onto concrete. Because larger accelerations are associated with an increasing likelihood of injury, the findings indicate that inflicted impacts against hard surfaces are more likely to be associated with inertial brain injuries than falls from a height less than 1.5 m or from shaking.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Anthropomorphic simulations of falls, shakes, and inflicted impacts in infants

Prange

Coats²,

Duhaime³

et al. 2003

Journal of Neurosurgery

165

117

View full text Add to dashboard Cite

show abstract

“…39 Short falls can cause fractures, but they rarely result in additional significant injury (eg, neurologic injury). 11,[40][41][42] In a retrospective study of short falls, parents reported that 40% of the children before 2 years of age had suffered at least 1 fall from a height of between 6 inches and 4 feet. Approximately one-quarter of these children suffered an injury; bruises were the most common injury observed.…”

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confidence: 99%

Evaluating Children With Fractures for Child Physical Abuse

Peréz-Rosselló¹,

Levine²,

Hennrikus³

et al. 2014

Pediatrics

251

162

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Fractures are common injuries caused by child abuse. Although the consequences of failing to diagnose an abusive injury in a child can be grave, incorrectly diagnosing child abuse in a child whose fractures have another etiology can be distressing for a family. The aim of this report is to review recent advances in the understanding of fracture specificity, the mechanism of fractures, and other medical diseases that predispose to fractures in infants and children. This clinical report will aid physicians in developing an evidence-based differential diagnosis and performing the appropriate evaluation when assessing a child with fractures. Pediatrics 2014;133:e477-e489 INTRODUCTIONFractures are the second most common injury caused by child physical abuse; bruises are the most common injury. 1 Failure to identify an injury caused by child abuse and to intervene appropriately may place a child at risk for further abuse, with potentially permanent consequences for the child. 2-4 Physical abuse may not be considered in the physician' s differential diagnosis of childhood injury because the caregiver may have intentionally altered the history to conceal the abuse. 5 As a result, when fractures are initially evaluated, a diagnosis of child abuse may be missed. 3 In children younger than 3 years, as many as 20% of fractures caused by abuse may be misdiagnosed initially as noninflicted or as attributable to other causes. 3 In addition, fractures may be missed because radiography is performed before changes are obvious or the radiographic images are misread or misinterpreted. 2 However, incorrectly diagnosing physical abuse in a child with noninflicted fractures has serious consequences for the child and family. To identify child abuse as the cause of fractures, the physician must take into consideration the history, the age of the child, the location and type of fracture, the mechanism that causes the particular type of fracture, and the presence of other injuries while also considering other possible causes. DIFFERENTIAL DIAGNOSIS OF FRACTURES Trauma: Child Abuse Versus Noninflicted InjuriesFractures are a common childhood injury and account for between 8% and 12% of all pediatric injuries. [6][7][8] In infants and toddlers, physical FROM THE AMERICAN ACADEMY OF PEDIATRICSGuidance for the Clinician in Rendering Pediatric Care by guest on May 11, 2018 http://pediatrics.aappublications.org/ Downloaded from abuse is the cause of 12% to 20% of fractures. 9 Although unintentional fractures are much more common than fractures caused by child abuse, the physician needs to remain aware of the possibility of inflicted injury. Although some fracture types are highly suggestive of physical abuse, no pattern can exclude child abuse. 10,11 Specifically, it is important to recognize that any fracture, even fractures that are commonly noninflicted injuries, can be caused by child abuse. Certain details that can help the physician determine whether a fracture was caused by abuse rather than unintentional injury include the hist...

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“…Medical and social professionals have a heavy responsibility, not only to be aware of typical signs of child abuse (27)(28)(29) and of suicidal behaviour among parents, but also to take effective action against the problems, in order to give the children a better chance of survival.…”

Section: Discussionmentioning

confidence: 99%

Violent deaths in small children in northern Sweden

Björnstig

Ahlm

et al. 2006

International Journal of Circumpolar Health

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Objectives. To identify causes and trends of violent deaths among children younger than 4 years in a northern region. Study design. Retrospective analysis of medico-legal autopsy and police data. Methods. Data from all 72 deaths from "external causes " 1977-2004, in children < 4 years from the northern half of Sweden were analysed. Results. The death rate was 7.1 per 100,000 children and year during the first half of the study period, and 5.2 during the second half. Vehicle-and drowning-related deaths were halved. Fifteen were struck by motor vehicles (in 8 cases by heavy vehicles), 14 car occupants were killed in car crashes, 12 were killed by intentional violence inflicted by an adult, and 9 each were killed by (i) carbon monoxide/smoke inhalation, (ii) asphyxiation, or (iii) drowning. The boy:girl ratio was 1:1 in all groups, except in the groups "drowning" and "run over by motor vehicle", where boys dominated. Conclusions. Medical professionals have a difficult but important task in identifying and taking action against child abuse and in promoting child safety especially in the traffic and home environments. (Int J Circumpolar Health 2006; 65(1):28-34.)

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The Likelihood of Injuries When Children Fall Out of Bed

Cited by 144 publications

References 0 publications

Anthropomorphic simulations of falls, shakes, and inflicted impacts in infants

Anthropomorphic simulations of falls, shakes, and inflicted impacts in infants

Evaluating Children With Fractures for Child Physical Abuse

Violent deaths in small children in northern Sweden

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