Injury Prevention Flashcards

Question

Systematic reviews have shown all but the following? a) helmets reduce head injuries in cyclers b) legislation increases helmet use c) helmet legislation reduces head injuries in cyclers some recent studies have not found this d) helmet use leads to increase risk taking

Answer 1

d) very conflicted evidence about whether using helmets increase the amount of risk taken the rest are true helmets and head injuries - Cochrane review - helmets reduce head injuries by 69%, severe brain injuries by 74% and facial injuries by 65%, similar across age groups -another study - reduce head injuries by 60%, brain injury by 58%, facial injuries by 65%, fatal injuries by 75%, did show increase in neck injuries (but might not apply to lower weight helmets used today), applied to all age groups and different collisions, attenuated when this study reviewed in 2011 helmet legislation - helmet use increases post legislation - >1/2 of studies showed increase of 30% -helmet use quadrupled with legislation, same in areas where t show reduction in risk not known if people with head injuries wore helmet, weaker studies risk compensation - conflicting evidence if bicyclists wearing helmets take /allowed to take more risks

Answer 2

c) false , varies per province perfect legislation - all cyclists must wear helmets, with fines for non compliance, parents are responsible for ensuring their child wears a helmet good - province has legislation that all cyclists

Answer 3

d) excellent, all ages a) good, only < 18 c) no laws, some education programs (poor) b) no laws poor Excellent: BC, Nova Scotia, PEI, New Brunswick Good: (<18 year old) Ontario, Manitoba, Alberta Poor: Quebec, Yukon, NWT, Nunavut, Newfoundland and LAbrador should use social marketing to raise awareness of bicycle helmet efficacy, accessibility and importance, sales exceptions and federal tax credits should be adopted

Answer 4

b) hockey leading, snowboarding and skiing are 2nd and 3rd however more hospitalizations from skiing(12.6%) and snowboarding (11.3%) than hockey (3.6%) snowboarding responsible for 25% of nonfatal outdoor recreational injuries needing emergency care snowboarding injuries are leading cause of hospitalization in winter (18%) and spring (10%) in Ontario, skiing/snowboarding are second

Answer 5

a) opposite, snowboarding is riskier the rest are true 2-4 injury / 1000 participant days in skiing and snowboarding more serious injuries these days deaths 0.5-1.9/1000 participant days head injuries cause most deaths, skiing you collide, snowboarding, falls alpine skiing - most common injury location is lower extremity (40-60%), more common in younger children upper extremity (15-25%) head and neck (10-20%) thumb (10-20%) snowboarding: - upper extremity injuries (50%), wrist (22%) head injuries more common than in skiers, 10% of ER visits and up to 30-40% of trauma admissions

Answer 6

b) male sex is a risk factor youth - higher risk of ski and snowboarding injuries, including lower extremity, head and neck, and severe (predominantly head) injuries; majority of injured snowboarders are male (70-80%), males also more risk of severe injury skill level - 40-50% of injures in young skiers in beginners, often on first day; experts lower risk of injury but higher risk of severe injury equipment - <13 year old, more chance of being injured with rented equipment , lack of quality control

Answer 7

d) false - knee sprains and upper extremity injuries remain common, overall lower extremity equipment related (LEER) injuries have declined with equipment changes LEER injuries - 40% - most common are knee sprains youth at risk of LEER injuries - skeletal immaturity, boot design, don't activate self release technology as well one adult study - 96% of LEER injuries bindings did not release the rest are true grooming of the ski hill - lowest risk of snowboarding injury on deep snow, as grooming hours decreased increased injury rates, more severe injuries/head injuries on runs designed for snowboarding

Answer 8

c) false - not supported by multiple studies the rest true decrease head injuries, most in t support increased risk of cervical spine injury, no evidence that riskier behaviour so far limited studies about ways to increase helmet use, and no legislation in N.A as of yet.

Answer 9

c) falls training - inconsistent evidence, one study showed more injuries after falls training (LEER injuries), wrist guards - snowboarding, mostly wrist injuries, recent systematic review showed that it decreased wrist injuries, low use of wrist guards, some people say it might increase upper arm, elbow, shoulder injury but evidence is conflicted. presenting an alpine skiing instruction and safety video on buses resulted in fewer injuries (16 vs 23%) video on ACL injuries reduced them by 62%

Answer 10

a)false - sand or pea gravel (impact absorbing) offer better protection than grass for playground injuries, one study showed that it reduces risk of injury 1.7x. fall height (>4 ft 11 inches) 4x the risk of injury the rest causes - falling (75%), impact with obstacle (11%), body part being crushed, pinched or cut (8%), entrapment (1%) -falls from climbing structure most common (vs from swing/slide) -head injuries 15% of ER injuries, more likely from swing fall -fractures is most common injury and also most common cause of hospitalization, head injury 2nd cause of hospitalization -hospitalizzation rates declined by 27% between 1994-2003 (likely from better safety standards) - home playground equipment - 20% of injuries, children 1-4 more likely to get injured at home, deaths rare, usually from strangulation

Answer 11

b) not legally required, voluntary standards loose fill includes - coarse sand or pea gravel, wood chips, synthetic surfaces the rest true vertical bars discourage climbing peaked/curved surfaces for guardrails active supervision important - kids less likely to take risks when parent is nearby decrease strangulation - neck warmer (no scarf), no drawstrings HCP should report playground injuries to playground operators

Answer 12

b) is true - head injuries and injuries from being towed on snowmobile are the most significant, often after running into things the rest are false c) false - no decline in injury in the last 10 years in US study 10% in younger than 15 and 25% 15-24 year old, young people very likely to be injured d) false - boys are more likely to be victims a) false - not common in youth, more likely in older people, frostbite is infrequent hazard in CHIRPP data: some kids also while being towed, mechanism of injury from running into things or flipping over , children

Answer 13

a) B.C. is the answer, no minimum age, need license to cross the highway the others: Alberta - private property no age restriction, public, need to be with adult Saskatchewan - 12-15 year old need to do safety course, be with someone with driver's license, ; > 16 year old safety course Manitoba - <14 need adult supervision, remote exception Ontario - etc etc - read the table in the statement all provinces say that snowmobiles need to be registered

Answer 14

d) Ontario, the other 3 are the only provinces that don't require helmet use other rules all provinces need head lights, tail lights and stop lamps, most need mufflers, a few need breaks, only Ontario needs a mirror, only 3 provinces have drug and alcohol limits, PEI is the only one with rules about snowmobiling on private property

Answer 15

c) SHOULD consider graduated licensing, but no evidence for snowmobile accidents, more an extrapolation from MVC accidents helmets should be approved by Snell, shouldn't tow people, if necessary should attach sled or cutter attached by rigid bar to reduce risk of injury

Answer 16

b) false - Provincial courts and the Canadian criminal law america has standardized child death review canada doesn't have that yet typical case review process includes the relevant history, discussion of the death or injury investigation, and an examination of services and systems involved before death. Consideration is then given to: 1) identifying potentially modifiable risk factors, both specific to the case and systemic; and 2) reviewing agency policies and practices to prevent the occurrence of similar events in future. goals are to help with prevention, identify problems, advocate for children etc. provincial death review include safe sleep advocacy, youth suicide prevention initiatives and the safer operation of motor vehicles

Answer 17

d) Newfoundland the other provinces do Ontario and BC - chief coroner report Alberta all death<18 year old evaluated by committee chaired by medical examiner Manitoba - Children’s Inquest Review Committee and the Child Health Standards Committee under the provincial College of Physicians and Surgeons. CDR has lead to safe sleep recommendations, etc some others things incorporated into the CDR should include: - broad representation, structured process, linkable databases, evaluative mechanism, financial support from all levels of government Ideally, review processes should be developed with provincial/territorial chief coroners or medical examiners.

Answer 18

d)in <44 years old

Answer 19

b) MVC in 1-4 year olds #1 MVC (22%) #2: drowning (21%) #3: threat to breathing (19%)

Answer 20

b) in 5-9 year olds: #1: MVC (58%) #2 drowning, fall fire/flame (6%) each #3 threat to breathing (5%)

Answer 21

d) 7% caused by poisoning of unintentional injury related deaths ``` #1: MVC (71%) #2: poisoning (7%) #3: drowning (6%) ```

Answer 22

b) 13% in 10-14 year olds ``` #1: MVC (55%) #2: drowning (13%) #3: fall (7%) ``` **table with all these stats, know it

Answer 23

b) MVC most common cause of death

Answer 24

a) falls account for most of the hospitalizations (37%); all other causes account for <1 year old: #2 is threat to breathing/fire/hot surface, #3 is poisoning in 1-4 year old : #2 is poisoning, #3 is fire/hot surface in the older kids, getting struck by things/car accidents are #2 and 3 in varying orders (look at the table!)

Answer 25

refers to the incidence and severity rate of different injuries looks at the relationship between deaths, admission to hospital and ER visits exact ratio depends on the mechanism of injury and population studied - >however in general, more ER visits than hospitalizations than deaths

Answer 26

In 1949, John Gordon demonstrated that injuries are the result of harmful interactions between the host, the disease vector and the environment.[15] William Haddon later proposed examining these entities at each of three temporal phases of an injury: pre-event, the injury event itself and post-event. He produced a “phase-factor” matrix of nine cells for which various strategies to prevent or control injuries could be developed ``` Pre Event: Host: alcohol, speed agent: tires, brakes environment: signs, signal, roads Event: Host: belt use, helmet use Agent: seat belt, airbags Environment: side slope, guardrails Post Event: host: heath and age Agent: fuel system, flammable materials environment: ems response, road shoulders ```

Answer 27

1. less risks taken 2. education for risk reduction such as helmets 3. better trauma care

Answer 28

true - likely combo of Better engineering, car seat legislation and enforcement, and social marketing are widely credited with increasing rates of seat belt and car seat use, saving thousands of lives. hoever, injuries still remain the leading cause of death in people under 45

Answer 29

true reduce the risk of death in <1 year old by 71% and in 1-4 year old by 67% booster seat provide better protection than seatbelt alone (59% more)

Answer 30

true between 44-81% of car seats are used incorrectly | nearly 3/4 of children between 5-9 are not in booster seats

Answer 31

false - most are restrained inappropriately at the time of a crash. recent analysis of child passengers sustaining severe MVC-related injuries revealed that 92% of infants, 74% of toddlers and 96% of school-aged children were not restrained appropriately at the time of the crash. also, not all provinces have mandatory car and booster seats, different policies across provinces

Answer 32

c) rural settings in fact more likely - including children < 10, brought onto work sites , guidelines available male sex more - 63% vs 37% girls SES - risks of falls, burns, motor vehicle injuries, poisonings, as well as with intentional injuries such as assault and homicide

Answer 33

90% can likely be prevented according to research

Answer 34

Education, Enforcement/legislation and Engineering | think of active and passive measures (i.e. seat belts, active), passive - i.e. airbags, detectors etc)

Answer 35

Not good, ranked 18/26 of the nations Canada doesn't have a integrated system to keep track of data regarding injuries/surveillance , should include outpatient, trauma, death cases right now, very fragmented A long-term strategy is needed that is comprehensive, sustainable and adequately resourced.[

Answer 36

<12 years old, minimum age 6 years old (WE DO NOT AGREE) engines can be up to 700 cc statement only talks about single user ATVs - recently some on the market that can carry up to 6 people kid models (for 14 and older) - max speeds: up to 32 kph official, can adjust to 61 kph); for 10-14 year old, max speed set to 24 kph, can adjust to 48 kph

Answer 37

vast majority in Canada is still used for recreation/fun | there is lots of use in rural remote communities as well as by first nations, including for transport to work

Answer 38

true - i.e. not wearing helmets, carrying young passengers, riding after dark

Answer 39

rose by 57% hirty-four per cent of these incidents involved children and youth 0 to 19 years of age, with 16% aged five to 14 years and just over 17% aged 15 to 19 years numbers have continued to rise fatalities have also risen

Answer 40

1. more in males vs females 2. more in older youth Carrying or being a passenger, driver error, poor judgment and loss of control are commonly cited as contributing causes in ATV crashes, with rollovers, falling off a vehicle and colliding with an obstacle being the most commonly cited mechanisms of injury [11][15][16]. Some studies have found a higher risk of severe injuries, including traumatic brain injuries, among youth (when compared with adults), citing driving inexperience and lack of supervision as contributing factors

Answer 41

little evidence that children/youth models are safer this vehicles are still heavy and can travel pretty fast other risk factors for young people include: inexperience, smaller size/weight, immature motor and cognitive development, tendency to engage in risk taking behaviours. higher centre of gravity - US CPSC injury data from 2001 showed that the risk of injury per number of driving hours for an operator under the age of 16 is reduced by only 18% when driving a youth-model ATV with an engine size of 200 cc [19]. - level of risk for child/teen on a youth model ATV still almost 2x as high as adult on a larger machine - risk of injury on a smaller machine is 5x higher than adult on same size machine

Answer 42

16 years old all the associations say so this applies to ALL models of ATVs, including the youth models, since we know that the youth models don't reduce the risk of injury or death

Answer 43

1. helmet (government certified) 2. eye protection 3. footwear 4. protective clothing

Answer 44

true - they are not designed for this these recommendations apply to all ATV operators >16 years old

Answer 45

true - Training should have both theoretical and practical components and include mandatory testing to pass the course. Postcourse evaluations should be instituted to ensure that training courses are producing safer riders.

Answer 46

1. minimum age 2. restrict the number of passengers to the number for which the vehicle was designed 3. compulsory helmet use with no restrictions 4. training courses, licensing and registration * **NO province currently reflects all of these requirements

Answer 47

Alberta and BC don't have mandatory helmet use the other provinces and territories do for Saskatchewan and Ontario, on public land only

Answer 48

BC no minimum age anywhere

Answer 49

NWT: 14 years old to drive on highways Nunavut: 14 to drive on highways Quebec: 16 for adult size ATVs, <16 year old need adult supervision at all times PEI: minimum age 14 year old, adult supervision 14-15 year old Newfoundland and Labrador - 16 for adult models, 14 for youth models with adult supervision for 14-15 year old

Answer 50

Manitoba: <12 year old to ride on public property need adult supervision **giant table, see for details

Answer 51

1. lightening detectors that produce a clear warning signal 2. AEDs 3. better equipment overall baseball and softball relatively safe, however because of highly publicized catastrophic injuries as well as shoulder/elbow injuries, has gotten some bad rap.

Answer 52

approximately one tenth based on US data 1 million injuries - 109000 from these spots overall however, quite safe spots, we should encourage them

Answer 53

11-14 year olds | however, this group also has the highest participation in these sports

Answer 54

``` #1: head - 44% involved head and neck and face (highest in 9-11 year olds) #2: upper extremities - 1/4-1/3 #3: lower extremities (20%) ```

Answer 55

13-16 years highest bell curve from 5-18 more in girls than boys

Answer 56

very low 1.26/1000 athletic exposures overall the their safest high school sport, however the severity of the injuries is often higher i.e.: - higher percentage of injuries is fractures - more time lost from spot >7 days most head and face injuries from being hit by a ball - many need surgery

Answer 57

true -across all age groups, the injuries amongst pitchers, catchers, and fielders have a relative frequency of injury in a season comparable to batters and base runners, the exception is as age increase,more injuries to catchers and less to fielders

Answer 58

false - in younger kids, more likely to get injured in practice higher injuries before/after play

Answer 59

younger group more likely to have injury from getting hit by a batted or thrown ball older group - more likely to have overuse injuries

Answer 60

most likely to be hit by a ball as they get older, more likely to have non-contact injuries - i.e. overs wining etc *they talk about most likely injury for other positions to

Answer 61

very low, 1/1 million Such injuries may be caused by trauma related to participating in the skills of the sport, such as contact with a bat, baseball, or softball (direct catastrophic injury), by a body system failure resulting from exertion while participating in a sport or activity (eg, cardiac collapse or heat stroke) or by a complication that resulted from a nonfatal injury (indirect catastrophic injury) classifed as fatal, nonfatal (permanent disability) and severe (no permanent functional injury) fatality rate 0.05/1 00000 participants

Answer 62

1. impact to head causing IC bleed | 2. impact to chest causing v fib or systole (commotio cords)

Answer 63

true - it is the second highest cause of death in athletes <16 years old chest wal more easily compressed, may be more vulnerable

Answer 64

true - death from commotio cords is potentially preventable | should activate for help ,try to get an AED within 3 minutes if possible

Answer 65

0.2/1000 lowest rate out of the major sports surveyed, softball was 7th out of 9 therefore unlikely to get a concussion in baseball compared to other spots most likely in batting/running bases in baseball; vs catching, fielding in softball concussion return to play guidelines are important

Answer 66

overuse arm injuries mostly affect pitchers repetitive stress leads to muscle fatigue and then to muscle, tendon and ligament damage speed circular during pitching very fast - in pros, 20revs /second more range of motion in the shoulder - therefore less joint stability; therefore when the muscles are tired, the shoulder becomes a more unstable joint

Answer 67

the broad acroclavicular ligament and 2 coraclavicular ligaments that arise from hooklike coracoid need to have strength and endurance of extrinsic shoulder girdle muscles are needed to ensure safe pitching (particularly of the serratius anterior) legs and core muscles generate much of the force for pitching in baseball

Answer 68

serratius anterior especially (extrinsic shoulder girdle muscles)ften responsible for injuries to the rotator cuff muscles, biceps, and elbow signs of weakness of the serratious anterior: 1. scapular winging 2. scapular depression 3. scapular protraction scapular dyskinesis

Answer 69

1. supraspinatus 2. infraspinatus 3.teres minor 4.subscapularis keep the humeral head in the glenoid socket

Answer 70

widening of the proximal humeral physis resulting from chronic recurrent traction stress across the growth plate. This lesion is felt to be primarily the result of throwing a large number of pitches or maximum-effort throws or insufficient rest between pitching assignments, but can also be related to improper mechanics or premature attempts with certain pitch types. When unrecognized, or when recognized in an advanced stage of overuse, Little League shoulder can lead to chronic pain with throwing, early shoulder instability, or degenerative arthritis.39

Answer 71

medial elbow pain in skeletally immature athletes resulting from throwing issues similar to those mentioned in the description of “Little League shoulder.” Pitchers are most likely to be affected by this condition, but it can also occur in other players at positions requiring frequent and forceful throwing. Traction forces occur on the medial elbow and compression forces laterally. The medial traction forces can cause separation or avulsion of the humeral medial epicondyle apophysis and overuse injury to the common flexor tendon.

Answer 72

osteochondritis dissecans- collapse and deformity of the humorous (capitellum) in adolescentsc ompression forces laterally can cause this in children <10, this collapse is known as Panner disease

Answer 73

inability to extend the elbow - indicator of elbow overuse injury

Answer 74

for repair of the ulnar collateral element, which is a type of injury that is increasing in significant proportions

Answer 75

for <10 year old : 75/day for 11-12 year old : 85/day for 13-16: 95/day 17-18: 105/day the other guidelines talk about how much people need to rest after doing certain number of pitches

Answer 76

Parents, coaches, and players should be educated about the early warning signs of elbow and shoulder overuse injuries as well as the importance of parascapular muscle strength. Athletes should cease pitching immediately when signs of arm fatigue or pain occur; they should be encouraged to seek timely and appropriate treatment of significant or persistent pain

Answer 77

(a) for hitters, approved batting helmets with face protection; (b) for catchers, helmets, masks with throat guards, chest protectors, and shin guards; (c) for all male players, hard plastic athletic cup; and (d) for all baseball and softball players, rubber-spiked soles. In light of the relatively high percentage and severity of head, face, and mouth injuries in baseball, strong consideration should be given to head and facial protection for pitchers and infielders, especially in younger age groups and for less-skilled players. Protective equipment should always be properly fitted, well maintained, and clean.

Answer 78

false - not sufficiently effective at preventing this, so not recommended for baseball players at this time catchers do need to continue wearing an approved protector

Answer 79

1. cage on their batting helmet 2. polycarbonate eye protection for kids with only one eye (worse eye<20/50)and those with eye surgery or previous eye injuries, wear eye protection at all times when batting or fielding

Answer 80

lowest skill level younger than 10 years old should use low impact (level I) balls level 2 low impact balls also for 10-12 year old with moderate skill level for <10 year old with moderate skill level - use level 1 or 2 low impact balls level 3 balls: for adults, 12 years and older with advanced skills prevent lightening - be aware of lightening patterns and how to warn people of lightening

Injury Prevention Flashcards

(107 cards)