Taking control of injury prevention

THE WORLD IS A DANGEROUS PLACE. It can be a very nice place, but nevertheless each of us spends countless hours of psychic energy trying to improve the chances of survival and safety for ourselves and our loved ones. This is because we, as pediatricians and emergency medicine practitioners, realize that injury is the leading cause of morbidity and mortality for our children, and that up to 35% of the kids that we see in our emergency departments arrive there because of an injury.1 As a consequence, many of us already apply “injury prevention and control” strategies in our personal lives. In a way, the “control” aspect of this term connotes that, through our activities and endorsements, we have some command over how we can keep our own families safe.

We can transfer this “psychic energy” to our patients by providing them, along with our lawmakers and administrators, with specific, targeted strategies to help reduce the risk of childhood injury. This is easy to say, but harder to do. One must identify the patients that are at risk for a specific injury, further assess the barriers to behavioral and systematic change, and then execute interventions in a culturally relevant, socially acceptable, and timely manner.

The goal of this issue of Clinical Pediatric Emergency Medicine is to provide a case-based approach to understanding certain injury patterns, circumstances that can lead to these injuries, and demographics of populations most at-risk for these injuries. Notably, each article also discusses how we can use this information to help us prevent future morbidity. This is essential if we want to “put a dent” in pediatric injury rates.

In our increasingly time-pressured environment, we must carefully choose what we offer our patients and their families. My recommendation for this challenge is simple. As you read through each article in this issue, choose one or two of the recommendations that you feel you can add to or alter your practice. Then implement them, one at a time. The articles may encourage you to join committees, support legislation, or help sustain grass roots community based efforts that advocate for childhood injury prevention. They may also convince you to enhance your chart documentation to assist with injury surveillance. Perhaps you may choose to assess and screen for domestic or interpersonal violence or suicide risks, educate prehospital providers, trainees, and colleagues regarding correct child passenger safety techniques, or design a program to provide car seats or bicycle helmets from the emergency department.

Injury prevention is a team effort. In turn, I would like to thank the team of superb authors who transferred their potential energy into tremendously kinetic, salient, and timely contributions.