Pediatric Injury

Injuries are a leading cause of death and disability among U.S. children. Injuries in children can range from mild, which may not require a healthcare provider visit or treatment, to severe, life-threatening, or fatal.

Severe or life-threatening pediatric injury is sometimes called pediatric trauma and can result from a variety of unintentional and intentional causes, such as vehicle accidents, falls, poisoning, drowning, and suffocation.

NICHD supports research on pediatric injury within a continuum of care, from prevention to intervention, treatment, and care as well as recovery and psychological support.

About Pediatric Injury

Pediatric injury is a broad category that refers to physical harm to a child, typically defined as someone between 1 year and 18 years of age.

Pediatric injuries have many different causes, severities, and effects.1,2

  • Some—like insect bites—can be relatively mild and may not require medical attention. Others—like motor vehicle crashes—can be severe, life-threatening, or life-changing.
  • Injuries can be unintentional or accidental, such as those resulting from a fall off a bicycle. They can also be intentional or done on purpose, such as homicides, suicides, maltreatment, and violence.
  • In some cases, injuries are so severe that they are fatal. When they aren’t fatal, they may lead to lifelong physical or mental health problems and disabilities, requiring intense or specialized care.

NICHD studies different factors related to pediatric injury and trauma, their causes, and different types of care required for treatment and recovery. The institute does not collect statistics on pediatric injuries but does fund studies that use statistics in developing prevention programs.

The Centers for Disease Control and Prevention (CDC) leads efforts to count pediatric injuries, their common causes, their severity, and other details. For more information on the most common types of pediatric injuries and on ways to prevent certain types of these injuries, visit the CDC Child Safety and Injury Prevention Center webpage.

What is pediatric emergency medicine?3,4

Pediatric emergency medicine focuses on the immediate care of infants, children, and adolescents with acute illness or injuries that require urgent medical attention. Treatment and care provided in hospital emergency departments are generally not long term or continuing. Pediatric emergency medicine physicians consult with physicians from other specialties to resuscitate and stabilize children who are seriously ill or injured.

What are emergency medical services for children (EMSC)?

EMSC is care that aims to reduce children’s disability and death from severe illness or injury by increasing awareness and enhancing capabilities among pre-hospital, health systems, healthcare providers, and the general public of the special (physiological and psychological) needs of children receiving emergency medical care.

What is pediatric critical care?

Children who have severe or life-threatening injuries need critical care, which includes constant monitoring and specialized treatments. Critical care happens in hospital pediatric intensive care units (PICUs). PICUs are staffed by physicians with specialized training to care for children with traumatic injuries; these specialists are often called pediatric intensivists.

Because injuries can affect many parts of the body at once, PICUs have access to many healthcare providers who specialize in many types of medicine. These specialists may include emergency medicine physicians, surgeons, anesthesiologists, cardiologists, neurologists, and others. PICUs may also have access to pediatricians, nurses, social workers, psychologists, physical and occupational therapists, speech therapists, pharmacists, and others who help injured children and their families heal and recover.2

Citations

  1. Centers for Disease Control and Prevention (CDC), National Center for Injury Prevention and Control, Division of Unintentional Injury Prevention. (2019). Protect the ones you love: Child injuries are preventable. Retrieved January 13, 2020, from http://www.cdc.gov/safechild
  2. CDC, National Center for Injury Prevention and Control, Division of Unintentional Injury Prevention. (2012). Vital signs: Child injury. Retrieved January 13, 2020, from http://www.cdc.gov/vitalsigns/ChildInjury/index.html
  3. McDermott, K. W., Stocks, C., & Freeman, W. J. (2018). Overview of pediatric emergency department visits, 2015 (HCUP Statistical Brief #242) (PDF 171 KB). Rockville, MD: Agency for Healthcare Research and Quality. Retrieved February 19, 2020, from http://www.hcup-us.ahrq.gov/reports/statbriefs/sb242-Pediatric-ED-Visits-2015.pdf (PDF 171 KB)
  4. Albert, M., & McCraig, L. F. (2014). Injury-related emergency department visits by children and adolescents: United States, 2009–2010 (NCHS Data Brief No. 150). Hyattsville, MD: National Center for Health Statistics. Retrieved February 19, 2020, from https://www.cdc.gov/nchs/products/databriefs/db150.htm

What causes pediatric injury?

NICHD research related to pediatric injury and trauma includes both fatal and non-fatal childhood injuries.

These studies include the type of care the child receives at the scene, in emergency departments, and in the pediatric intensive care unit (PICU) at children’s hospitals; how parents and families receive information about the injury; common medical and care practices within the PICU; and the processes of treatment and recovery.

The Centers for Disease Control and Prevention (CDC) is the federal government resource for statistics about common causes of pediatric injury. Visit CDC’s Safe Child website and its Vital Signs: Child Injury issue for more details. NICHD does not collect national statistics and should not be cited as the source for statistical information.

Some common causes of non-fatal pediatric injury, as reported by CDC, include1,2:

  • Motor vehicle crashes3: According to CDC, nearly 150 children ages 0 to 19 are treated every hour in U.S. emergency departments for crash-related injuries.
  • Suffocation (being unable to breathe): This category includes strangulation and choking on food and other objects.
    • Accidental suffocation or strangulation in bed (ASSB) is a leading cause of sudden unexpected infant death (SUID), a category of causes of death that includes previously called sudden infant death syndrome (SIDS). CDC notes that about 26% of all SUID in in 2017 resulted from ASSB.4 You can learn more about SIDS and SUID from the NICHD-led Safe to Sleep® campaign.
    • Injuries have also been reported from improper use of infant sitting devices, such as car seats, swings, and bouncers—especially when they are used for routine sleep.5
  • Drowning: CDC notes that about one-half of children treated for drowning in emergency departments require hospitalization or transfer for further care, and many are left with permanent disabilities from brain injuries.6
  • Poisoning: Common sources of poisoning include household cleaners and medicines.7
  • Burns8: According to CDC:
    • Younger children are more likely to be burned by hot liquids or steam.
    • Older children are more likely to be burned from direct contact with fire.
  • Falls: CDC reports that falls are the most common cause of nonfatal injuries for children ages 0 to 19.9
  • Violence: According to CDC, about 1,300 young people are treated in emergency departments each day for nonfatal assault injuries.10

Please note that causes of nonfatal pediatric injury are not necessarily the same as causes of fatal pediatric injuries. Injuries resulting from the causes listed here can be fatal, but they are not necessarily the most common causes of pediatric death. CDC has information on pediatric death.

The Consumer Product Safety Commission website also offers product safety information, recommendations and warnings, and recalls of unsafe products.

The National Highway Traffic Safety Administration website provides information on child safety, pedestrian safety, teen driving, and other resources related to traffic-related injuries and injury prevention.

Citations

  1. CDC. (2018). 10 leading causes of injury deaths by age group highlighting unintentional injury deaths, United States—2017. Retrieved April 3, 2019, from https://www.cdc.gov/injury/images/lc-charts/leading_causes_of_death_by_age_group_unintentional_2017_1100w850h.jpg (JPG 301 KB)
  2. CDC. (2019). Nonfatal injury data: Leading causes of nonfatal injury reports, 19992017. Web-based Injury Statistics Query and Reporting System (WISQARS). National Center for Injury Prevention and Control. Retrieved May 15, 2019, from https://webappa.cdc.gov/sasweb/ncipc/nfilead.html
  3. CDC. (2019). Road traffic safety. Retrieved May 15, 2019, from https://www.cdc.gov/safechild/road_traffic_injuries/index.html
  4. CDC. (2019). Sudden Unexpected Infant Death and Sudden Infant Death Syndrome: Data and statistics. Retrieved January 21, 2020, from https://www.cdc.gov/sids/data.htm#breakdown
  5. Liaw, P., Moon, R. Y., Han, A., & Colvin, J. D. (2019). Infant deaths in sitting devices. Pediatrics, 144(1), e20182576. https://pediatrics.aappublications.org/content/144/1/e20182576 external link
  6. CDC. (n.d.). A National Action Plan for Child Injury Prevention: Reducing Drowning Injuries in Children (PDF 1.1 MB). Retrieved January 21, 2020, from https://www.cdc.gov/safechild/pdf/NAP_Drowning_Injuries-a.pdf (PDF 1 MB)
  7. CDC. (2019). Poisoning prevention. Retrieved May 15, 2019, from https://www.cdc.gov/safechild/poisoning/index.html
  8. CDC. (2019). Burn prevention. Retrieved May 15, 2019, from https://www.cdc.gov/safechild/burns/index.html
  9. CDC. (2019). Fall prevention. Retrieved May 15, 2019, from https://www.cdc.gov/safechild/falls/index.html
  10. CDC. (2019). Violence prevention: Preventing youth violence. Retrieved January 21, 2020, from https://www.cdc.gov/violenceprevention/youthviolence/fastfact.html
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