Accidental trauma in children: “With these symptoms you need to go to the emergency room”

How many times did the parents go urgently to the emergency room or to your doctor after your child accidentally falls off the sofa, or down the stairs while crawling or trying to stand up? Or even while he was chasing his favorite toy and fell down the steps of the little park? We are every year in Italy as well 600 thousand accesses to the emergency room for these very reasons, it is therefore very important to provide information and allow families to activate preventive behaviors useful for avoiding accidental trauma as much as possible.

It is above all boys who incur similar accidents due to their predisposition to expose themselves to more risky playful behaviours, but it should be specified that there is no difference instead in the accidents which can occur around 4 months when, thanks to the acquisition of the ability to rolling and greater motor control, accidents occur such as falling from raised floors, such as from the changing table for example.

Because of this Grow up together, leader in childcare services for 0-6 years has launched a training project for all its kindergartens dedicated to families with the aim of addressing the issue of accidental trauma in children. The training project, held by Professor Giampiero Tamburrinihead of the Child Neurosurgery department of the Agostino Gemelli IRCCS Polyclinic Foundation, and organized in collaboration with the Gene APS Federation for prevention and information in schools, aims to raise awareness among families and educators to activate preventive behaviors useful for avoiding at most accidental trauma.

We asked Professor Tamburrini to explain to us how we should behave in the face of these accidents and how we can prevent them.

What are the most frequent accidental injuries in children?
During the first year of life, babies often experience injuries caused by falls, which can happen while they are on the changing table, in bed or learning to walk. Children aged two and over, on the other hand, suffer more road injuries, such as a fall from a bicycle, a pedestrian collision or a car accident while sitting in the passenger seat.

How to behave when these accidents occur?
There are some important rules that you should observe. First, it is useful to reconstruct the dynamics of what happened. This way you can find out from what height the fall occurred and, consequently, the impact speed. If the height is less than one meter it is highly unlikely that you will be faced with a head injury, just as it is unlikely that you will get seriously hurt if you ride a bicycle at the speed of a very small child.
Where on the body it impacted is also important, as regions such as the occipital or frontal regions are generally more resistant to impact than the parietal or temporal regions. Furthermore, it should be assessed whether the child has a prompt crying reaction and visible wounds.
There are, then, three response factors that are very simple to ascertain. The first is represented by the spontaneous opening of the eyes or by the prompt response to the call, secondly it is necessary to see if the child smiles, if he follows objects and sounds or if he is easily consoled despite the initial cry. Finally, it must be ensured that the child moves spontaneously and that, even with just a caress, he responds in such a way as to locate the stimulus. In a condition in which these responses are maintained, it is possible to avoid taking the child to the emergency room and to submit him to a period of observation at home.

When is it time to go to the emergency room?
Certainly whenever there has been an, even temporary, alteration in the child’s state of vigilance, with the exception of the immediate fright reaction, and in cases where, during home observation, the child’s reactivity, i.e. the common way of behaving on a daily basis, has changed.

How can parents make homes safer for children?
More than the houses in their entirety, they are the environments most commonly frequented by the childhow the room where he usually playsneed to be monitored. Some ways to limit the risks are: reduce furniture and furnishings with sharp edges, use mats in play areas, never leave the little ones on the changing table, even for a few seconds, apply any gates on the stairs, make sure that no there are dangerous entrances or bars separated from each other by spaces that exceed 20 cm. In addition, it is important that the height of the balcony railing is at least 1 to 1.5 meters.

What precautions should be taken when, on the other hand, you are away from home?
When in a car, rather than on the first bicycles, the use of protective systems is very important, such as a helmet, seat belts and the seat fastened correctly. To prevent falls related to the first experiences away from home, the use of the stroller is recommended (with the belts fastened). It is important to accompany the child if he walks holding him by the hand or at a safe distance that allows for prompt intervention.

Can you give parents any other advice to prevent accidental trauma that does not only concern the environment frequented by children?
It is essential to minimize moments of less control and consider adult environments as high-risk (buses, subways, shops, offices). On the road, maximum attention must be paid when crossing and it is advisable to keep the maximum distance from all moving vehicles, including bicycles, adults and children.

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Accidental trauma in children: “With these symptoms you need to go to the emergency room”

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