Women's and children's hospital grand round


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Women's and children's hospital grand round

  1. 1. Child Injury Prevention in SA – community consultation to underpin the way forward for Kidsafe SA.<br />Associate Professor Anne Johnson<br />
  2. 2. Introduction<br />22,865 children 0-4 years of age were admitted to hospital for injury (including accidental poisoning) across Australia (AIHW 2008). <br />This was second only to admissions to hospital for respiratory conditions.<br />Unintentional injuries are a major cause of disability, which can have a long-lasting impact on all facets of a child’s life; relationships, learning and play (WHO & UNICEF 2008).<br />
  3. 3. Preventable injuries <br />are higher amongst children compared with <br />other <br />age groups <br />(ABS 2007).<br />Photo by Anne Johnson 2008 <br />
  4. 4. More children die from injury in Australia (36%) <br /> than cancer (19%), and <br /> diseases of the nervous system (11%) <br /> combined.<br />(ABS 2006).<br />Photo by Anne Johnson 2008<br />
  5. 5. Child <br />death rates from <br />injuries <br />have declined <br />by over <br />60% <br />since <br />1983 <br />(AIHW 2005) <br />Photo by Anne Johnson 2008<br />
  6. 6. Reduction of child death rates<br />This reduction in child deaths provides evidence that dramatic success in reducing child injuries and deaths is possible through using multiple strategies such as: <br />legislative changes<br />environmental changes <br />community action <br />information <br />education and training. <br />It is imperative to continue this downward trend of child deaths from injuries, and to reduce preventable and unintentional child injuries. <br />
  7. 7. Child deaths<br />Child deaths impact not only on the family, but also the community. <br />“Every day around the world the lives of …families are torn apart by the loss of a child to unintentional injury or so-called ‘accidents’ that could have been prevented. The grief that these families suffer – mothers, fathers, siblings, grandparents and friends – is immeasurable and often impacts on entire communities. Such tragedy can change lives irrevocably” (WHO & UNICEF 2008 p vii). <br />The pain is even greater if simple measures could have prevented the incident. <br />
  8. 8. Characteristics of child injuries<br />There is a strong association between the type of injury a child sustains and the:<br /> age of a child <br />developmental stage <br />how the child interacts with their environments <br />the type of activities the child undertakes <br />socio-economic status, and <br />gender.<br />(WHO & UNICEF 2008) <br />
  9. 9. Children <br />0-4 years <br />of age are particularly vulnerable <br />to injuries <br />as they begin to explore <br />their environment.<br />Highest injury rates 1-2 year olds. <br />Photo by Anne Johnson 2008<br />
  10. 10. The Child-Injury Pyramid<br />1 death<br />45 hospitalisations<br />1,300 treated and discharged from ED<br />Unknown number require first aid at home, early childhood setting, GP, Pharmacist, Phone advice, etc. <br />(Gallagher 1984). <br />
  11. 11. child injury pyramid<br /><ul><li>Difficult to get a true picture of child injuries.
  12. 12. There are many injuries that are unaccounted for in the child injury data.
  13. 13. Some insights gained in the area of poisoning.
  14. 14. For example:
  15. 15. SA data from the Department of Health indicated that in 2006-2007 there were 549 children 0-4 years of age hospitalised for poisonings.
  16. 16. Data from the Poison’s Information Centre in WA indicated that in 2008 there were 5,119 telephone calls to the Centre from SA for children 0-4 years of age.</li></ul>(NB. unable to get 2008 data from the SA Dept of Health to compare admissions to hospital from poisoning for that year with Poison Information Centre data)<br />
  17. 17. Main injuries for children 0-4 years of age admitted to South Australian hospitals 2006-2007 (combined metropolitan and country; excluding deaths): <br />Falls 1090<br />Burns and scalds 589<br />Poisonings 549<br />Vehicle Accidents (car occupant) 79<br />Drowning 39<br />Cyclist 34<br />Pedestrian 26<br />
  18. 18. Main injuries by age for children 0-4 years of age admitted to South Australian hospitals 2006-2007 (combined metropolitan and country; excluding deaths):<br />
  19. 19. In the state of South Australia in 2006 10 children died in the 0-4 year age group:<br />Three children died from transport related injuries<br />Three from drowning <br />Four from accidental asphyxia.<br />(Government of South Australia 2007)<br />
  20. 20. 10 deaths in 2007 in the 0-4 year age group were caused by:<br />Three children died from transport related injuries<br />Five children died from accidents. Four of these children died from either accidental hanging or asphyxia. The fifth child died from head injuries sustained when an object fell on the child.<br />Two children drowned.<br />(Government of South Australia 2008)<br />
  21. 21. 14 deaths in 2008 in the 0-4 year age group were caused by:<br />Two children died from transport related injuries.<br />Two from drowning.<br />Two children died from ‘accidents’. One child suffocated from entrapment in a filing cabinet and one child was strangled by a window blind cord.<br />Eight children died from associated unsafe sleeping situations.<br />(Government of South Australia 2009)<br />
  22. 22. Nearly <br />60% of injuries in children <br />0-4 years happen <br />in the home <br />and backyard<br />Photos by Anne Johnson 2007<br />
  23. 23. Falls are <br />1.5 times <br />greater in country <br />areas <br />than metropolitan areas<br />(AIHW 2008)<br />Photo by Anne Johnson 2008<br />http://www.sportmanawatu.org.nz/images/custom/<br />Active%20movement/climbing%20tree.JPG<br />http://www.worldofstock.com/slides/PCH5614.jpg<br />Photo by Anne Johnson 2008<br />http://www.amcgltd.com/archives/brokenarm.jpg<br />
  24. 24. Poisonings <br />are <br />1.9 times greater <br />in country areas <br />than metropolitan areas <br />(AIHW 2008)<br />http://healthfoodheroes.files.wordpress.<br />com/2009/06/alcohol-bottles-drinking-colorful.jpg<br />Photo Anne Johnson 2008<br />http://www.wisebread.com/files/fruganomics/<br />imagecache/blog_image_full/files/fruganomics/<br />blog-images/cleaning-bottles.jpg<br />http://blog.luckyvitamin.com/wp-content/uploads/<br />2009/05/lots-of-tablets2.jpg<br />
  25. 25. Conducted a statewide consultation for KidSafe SA:<br />17 focus groups<br />Several interviews<br />Several telephone discussions with families living on remote outback stations <br />*<br />*<br />*<br />*<br />* *<br />* *<br />*<br />*<br />*<br />*<br />*<br />*<br />
  26. 26. Met some amazingly talented and committed people<br />Photos by Anne Johnson 2008<br />
  27. 27. Safety hazards for young children in country SA – Perspectives of Families of Children 0-4 years of Age<br />
  28. 28. Playgrounds<br />
  29. 29. Lack of footpaths<br />Photo by Anne Johnson 2008<br />
  30. 30. Children in cars<br />Keys left in the ignition<br />Children left in cars when parents shopping or using ATM<br />Children not being restrained in cars or farm vehicles<br />People using inappropriate types of child restraints<br />
  31. 31. Roads and road safety<br />Traffic<br />Speeding on unfamiliar back roads (city people/tourists/contract workers)<br />Increasing heavy vehicles through towns<br />‘local drivers pretty bad’<br />Speeding on country roads, especially past farm entrances<br />Seasonal – harvest time; silo run through town; tourist season<br />Older drivers continuing to drive due to lack of local public transport or limited community buses<br />
  32. 32. Roads and road safety<br />Pedestrian crossing issues<br />Road safety<br />Teaching children road safety<br />Children not wearing bike helmets<br />Poor condition of roads<br />Kangaroos and emus<br />Lack of child friendly environments<br />Dangers in the community<br />Entertainment venues<br />Shops and supermarkets<br />
  33. 33. Farm issues<br />Dangers in the environment<br />Not having secure fences and gates to isolate farmhouse and children from working areas of farm<br />Heavy farm machinery<br />Big sheds/workshops and equipment<br />Chemicals<br />Hay bales<br />Silos for grain storage<br />Different practices<br />More outdoor activities – greater risks<br />More open spaces – wander off and get lost<br />Commonplace to start riding horses and motor bikes at a younger age<br />Economic issues<br />Not able to afford to update infrastructure e.g. build chemical shed or purchase extra child restraint for farm vehicle<br />
  34. 34. Snakes and animals<br />Always have to be vigilant during snake season for snakes<br />Children interact with a wide range of animals from a young age<br />Wandering dogs<br />Tying dogs up in the front of shops and leaving them there<br />Lack of access to dog education programs<br />
  35. 35. Others<br />Motor bikes - begin riding between 2-4 years<br />Open access to wide range of water areas<br />Too trusting<br />Service model of Kmart and Target<br />Council issues<br />Parks/public spaces<br />Hot environment<br />Rental properties<br />Unfamiliar environment - visiting children from city; and country children visiting city<br />
  36. 36. Knowledge<br />What were three of the most frequently occurring types of unintentional injury for children 0-4 years of age that required hospitalisation in SA over the past two years?<br />
  37. 37. What influenced the participants most in their approach to child safety?<br />Friends<br />Family<br />Groups<br />Children<br />Experiences<br />Local stories<br />
  38. 38. Where did participants source information about child safety?<br />Written information sources<br />Books<br />Magazines<br />Pamphlets<br />Media<br />Internet<br />Commercial sites<br />Safety-oriented sites<br />Health-oriented sites<br />
  39. 39. Where did participants source information about child safety?<br />Education/training<br />Safety-oriented organisations<br />Health professionals and health services<br />Child care, kindergarten and school<br />Speciality stores<br />Community events<br />
  40. 40. You can find the link to it on:<br />www.kidsafesa.com.au<br />
  41. 41. The Kidsafe SA Strategy<br />14 recommendations<br />Raising awareness (3)<br />Workforce development (1)<br />Advocacy (3)<br />Supporting legislation (1)<br />Strategic partnerships (7)<br />
  42. 42. Any questions?<br />Photo from Kidsafe Vic<br />