Injury Prevention Flashcards Preview

CPS Injury > Injury Prevention > Flashcards

Flashcards in Injury Prevention Deck (107)
Loading flashcards...
1
Q

Which of the following statement is true?

a) drowning is the leading cause of non intentional injury and death in age 1-4 year olds Canada
b) no evidence that swimming lessons lead to long term improvement in swimming skills and deck behaviour
c) significant evidence that swimming lessons prevent drowning in age 2-4 age group
d) children can master water skills by 3 years of age
e) personal flotation devices do not need to be used routinely

A

b) is true

rest false

a) second most, in this group more than 1/5 of deaths in this age group. drownings in this group occur mostly around the home.
c) no evidence that it prevents drowning in this age group.

d) earliest is age 4 for mastery of water confidence and basic locomotive skills, regardless of when the lessons started, front crawl by age 5.5, few studies have looked at effectiveness of swimming lessons in infants only a few months of age.
e) PFDs should be used by all young children and those who cannot swim, not a substitute for supervision

no young child (especially preschool) should ever be considered water wave.

2
Q

Which of the following is a requirement of a safe home pool?

a) 4 sided fence
b) self latching gate
c) self closing gate
d) pool alarms

A

d) pool alarms may give parents a false sense of security

the rest are requirements
height and fencing type, as well as other requirements, should be checked with the municipality.
parents should have CPR training, first aid and an emergency action plan

3
Q

Which of the following is not an increased risk from swimming?

a) hypothermia
b) otitis externa
c) hypernatremia
d) infections including hepatitis A, gastroenteritis, skin infections

A

c) in fact water intoxication hyponatremia and seizures,

the rest are true for young children
constant arms length supervision for toddlers and infants near water, infants placed in water need to be held by an adult at all times

4
Q

Which of the following age groups has the highest restraint use in cars?

a) 4-8 year old
b) 9-14 year olds
c) infants

A

b) 9-14 year old, 98.9% seatbelt use
4-8 year old - 28% in forward facing seat or booster seat
infants - 63% restrained
when used properly, child seat reduce fatality by 71% and significant injury by 67%
booster seat instead of seatbelt alone reduces chance of injury by 59%

5
Q

Which of the following statements is true?

a) children are able to be restrained by a seat belt alone by age 6
b) most car seats and booster seats are used correctly
c) demerit points or fines rarely occur for using car seats incorrectly
d) all Canadian provinces and territories have legislation in place requiring the use of child safety seats

A

d) true

more than 53% of parents believe that kids can be restrained by seat belt alone (no booster seat) by age 6

misuse rates - 44-81% for car seats, 30-50% for booster seats
c) incorrect, can get these fines/demerit points

6
Q

Which of the following is the most common error regarding infant child seat misuse?

a) incorrect seat for weight/height of the child
b) seat too loose - can move >1 inch in each direction
c) harness straps too loose, more than a finger width between the strap and the baby
d) chest clip not at armpit level

A

a) is the top error, mostly in the form of premature graduation

the other 3 options are the next 3 most common errors

other common errors:

  • not anchoring the tether strap for forward facing seats
  • rear facing seat in front of an airbag
  • wrong angle of infant seats (should be 45 degrees)
  • not using a locking clip on the vehicle seat belt
  • routine seat belt/harness straps through an incorrect slot of the infant/child restraint
  • using recalled or otherwise unsafe seats (>10 year old, beyond expiry date, previously in an accident)
  • failure to restrain a child
7
Q

Which of the following children can ride in a forward facing car seat?

a) 13 month old who weighs 11 kg and able to walk
b) 1.5 year old who weighs 8.5 kg and able to walk
c) 11 month old who weight 11 kg and able to walk
d) 1 year old who weights 10 kg and not yet able to walk

A

a) can ride in a rear facing car seat

criteria - at least 10 kg, age 1, and can walk
if doesn’t meet one of these criteria, need to continue using rear facing

should continue using rear facing as long as the height/weight limits on the seat allow it, they are safe, encourage parents to continue using rear facing as long as the equipment allows

after graduation from the infant seat (rear facing), move to infant/child seat

8
Q

Which of the following is not an appropriate way to secure a rear facing infant seat?

a) UAS system
b) LATCH system
c) tether strap
d) seat belt

A

c)

the other 3 are appropriate, tether strap is for booster seats onwards
UAS (vehicles after Sept 1 2002) and LATCH system are the same thing

prems/small infants should not use any restraints with abdominal pads, shields, arm rests, since could cause injury, for prems, need to find car seat that works for kids <5 lbsAAP statement/special guidelines for this

9
Q

Which of the following is false?

a) a forward facing car seat can be used until 30 kg (65 pounds) with a tether strap
b) the use of child restraint systems falls under national jurisdiction
c) the maximum height of forward facing car seats is 48 inches (122 cm) depending on the manufacturer
d) forward facing car seats should be secured by tether strap, as well as UAS or seatbelt

A

b) provincial jurisdiction

the rest are true
the new laws allow child restraint systems with harness and tether strap that accommodates until 30 kg (65 pounds) and therefore increases the capacity of these restraint systems
tether strap limits forward yea emotion in a sudden stop/crash

integrated car seats may be an option for forward facing riders >9 kg

10
Q

Which of the following is correct regarding who can use a booster seat?

a) at least 4 feet 9 inches and 36 kg
b) at least 10 kg and 30 inches
c) at least 4 years old
d) at least 18 kg - 36 kg

A

d)
and who have passed the requirements of their infant seats
always check since the requirements vary considerably for different models

**see the chart of different seats as there is considerable overlap

11
Q

Which of the following is not a criteria for seatbelt use?

a) at least 8 years old
b) at least 36 kg (80 pounds)
c) at least age 6
d) at least 145 cm (4 feet 9 inches)

A

C) is the answer

more than age or any of the other criteria, the fit of the child in the adult seat belt (based on proportions, etc) must be looked at before graduating from booster seat to seat belt

12
Q

Please match the car/ booster seat with the name for it (look at figure 2 in statement)

a) high back booster
b) low back/backless booster
c) infant/child/booster seat
d) infant seat

A

high back - provides head and neck restraint
low back/backless - can be used when the car has adjustable head/neck support, must have shoulder/lap belt and adjustable head/neck support

abdominal shield booster no longer available in Canada

13
Q

Which province was the first to implement booster seat legislation?

a) Ontario
b) British Columbia
c) Quebec
d) Nova Scotia

A

c) Quebec was the first in 2002, after that Ontario, BC, Nova Scotia, Newfoundland, PEI, New Brunswick passed laws recently, the rest of the provinces do not have specific laws or laws which are pending

between 1997-2001, death in children < 8 year old very common, include internal injuries and spinal cord injuries from ill fitting seat belt

Ontario - no sales tax for seats
aftermarket products not approved, need to have booster seat for proper securing, may increase lap belt syndrome, not approved

14
Q

Which of the following statements is false?

a) rear seat positioning decreases risk of death by 36% independent of restraint use
b) the rear middle seat is the safest position in a vehicle
c) rear seating reduces the chance of fatal/severe injury 1.7 x
d) children should be seated in the rear of the vehicle until age 11

A

d) false, age 13

the rest are true
the exception is for extended pick up trucks, safer in the front (but remember that car seat should never be in front of airbag), only exemption where rear centre is safest

booster seat, shoulder portion not in contact with neck, should keep shoulder belt over middle of clavicle and chest, and lap belt over pelvic bone/below abdomen, bend knees over edge of vehicle while sitting straight (so that they don’t slouch to get comfy)

15
Q

At what age to the majority of choking and suffocation related deaths occur?

a) 9-11 months
b) <6 year olds

A

a) is the answer

greatest chance of death 9-11 months
greatest hospitalizations < 3 year old
increased hospitalization until 6 years of age
age<3 greatest chance of choking
choking and suffocation is 40% of unintentional injuries in Canadian children
death occur in the home environment in 85% of cases, more risk if older siblings present

16
Q

Which group of children was most at risk of strangulation in one study?

a) infants
b) >1 year old
c) school age children
d) teenagers

A

b) >1 year old were at greatest risk of injury from strangulation, infants at risk for other injury types

in this study (Australia) of children 0-14
38% - strangulation
31% - head and neck entrapment
19% - FB
12% - facial occlusion
non fatal injures were majority for aspiration, food and non food equal for hospitalization, food and coins for ED visits

17
Q

Which non food item is related to the most choking deaths?

a) buttons
b) coins
c) balloons
d) examination gloves

A

c) balloons
non-food item related to the most choking deaths
food is related to significant number of choking deaths, especially when < 4 cm that are round and smooth (hot dogs, grapes, carrot slices, peanuts, seeds and hard candy)
latex balloons - 29% of non food choking deaths in USA between 1972 and 1992
coins are leading non food product in foreign body ingestion, but doesn’t usually lead to death, usually go to hospital to have it removed
anything that can pass through an empty toilet paper roll is a choking hazard

18
Q

Which of the following is a not a risk for strangulation/suffocation or choking?

a) plastic bags
b) apples
c) grapes
d) 6 inch pull cord

A

d) risk if over 8 inch (20 cm)

the rest are risk, see table for details

entrapment risk is spaces between 9-22.9cm between rails

19
Q

Which of the following foods does not need to be avoided for children < 4 years of age?

a) kabobs
b) sunflower seeds
c) grated carrots
d) fish with bones

A

c) is okay

avoid - candy, chewable vitamins, peanuts, sunflower seeds, fish with bones, snacks on toothpicks or skewers
special preparation - grapes slice lengthwise, hot dogs - slice length wise, raw carrots/apples - grate/chop
small parts standards identify toys that are choking risks, although can still choke on objects that pass these tests . 3.17 cm x 2.54-5.71cm (approx toilet paper roll)

20
Q

Which of the following is the most common mechanism of unintentional suffocation in infants?

a) wedging
b) facial occlusion
c) overlying
d) hanging

A
a) most common  
infants suffocate in te sleeping environment
-wedging 40%
-facial occlusion - 24$
-overlying 8%
-entrapment with suspension 7%
-hanging 5%

older kids - hanging
toys that are hemispherical are very dangerous.

21
Q

Which of the following is not true of strangulation hazards?

a) blinds sold since 1995 don’t have outer cord that forms a loop
b) blinds sold since 2000 have been redesigned so inner cord cannot form a loop
c) companies are legally required to follow guidelines regarding drawstrings on children’s clothing
d) pull cords >8 inch (20 cm) are the greatest risk

A

c) false
CPSC published guidelines in 1996 for drawstring and closures on children’s outerwear, incorporated into a VOLUNTARY, american society for testing and materials (standard) but variable compliance, no regulated in Canada

window blind cords and drawstrings on children’s clothing are prominent causes of strangulation
parents need to cut cord short and anchor the remaining
(pull cords longer than 8 inch (20 cm) or any dangling cords

older children - hanging, getting drawstrings caught

CPS recommends amending the Hazardous Products Act to include product that are associated with near misses - i.e. drawstrings, bunk beds, toddler beds, window covering cords

22
Q

Which of the following is not a regulation in Canada?

a) bags that have an opening of 14 inches or larger must have a warning and not be made of flexible film
b) any toy box large enough for a child to enter must have openings on 2 adjacent sides
c) any toy used on

A

d) false, 9kg for 5 minutes

warnings needed for toys on crib/playpen

federal regulations have lead to decrease in deaths from choking, suffocation, might also be related to increase in supervision etc.

provincial - daycare should implement safety guidelines to prevent strangling choking suffocating

local - should implement standards for playground equipment (which are now voluntary)

23
Q

Which of the following is false?

a) consumers are more likely to avoid buying a toy when a specific hazard (i.e. choking) is on the label, rather than a recommended age of use
b) a Canadian multi centre trial showed long term adoption of home safety behaviours after home visits implemented
c) parental education by physicians can improve safety practices, especially when combined with strategies to change behaviour
d) general childproofing education doesn’t seem to be as effective as physician parental education

A

b) false
this trial showed that RCT of home visit, coupons and counselling showed decrease injury visits, but didn’t result in long term adoption of safety measures

the rest true

c) shown to improve MV restraint use, hot water temperature regulation in faucets, instal smoke alarms
d) although individual studies have shown benefit

CPS recommends that manufacturers use iso Guide 50 which summarizes risks associated with different products

24
Q

Which of the following is not an appropriate safety measure?

a) keeping a bicycle helmet on when playing on playground equipment
b) switching to a teething ring if baby starts chewing on pacifier
c) t be on top bunk of bunk bed
d) remove crib toys when baby is 4 months old
e) tie plastic bags in a knot and remove out of sight

A

a) false, remove it, risk of getting caught on equipment

the rest are true

see table for details
bunk beds should meet safety standards - ASTM and 16 CFR

children 4 cm
toy box with air holes and light weight lid with supporting hinges

crib - 1986, and permanent label with the manufacturer’s name, the model number or name, date of manufacture, instructions for assembly, and a warning statement about mattress size and proper crib use, are not safe to use.

25
Q

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

A

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

26
Q

Which of the following is false?

a) there is mixed evidence of reduction in bicycling after implementation of helmet laws
b) bicycle helmet legislation can increase helmet use even without significant enforcement, at least for a few years
c) all Canadian provinces have legislation regarding helmet use
d) Canada-wide legislation for all ages is the best way to legislate helmet use

A

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

27
Q

Please order the following provinces in terms of best helmet legislation to worst:

a) Ontario
b) Newfoundland and Labrador
c) Quebec
d) Nova Scotia

A

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

28
Q

Which of the following sports was related to the most emergency department visits related to snow and ice activities?

a) skiing
b) hockey
c) snowboarding
d) snowmobiling

A

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

29
Q

Which of the following is false?

a) skiing is more risky than snowboarding
b) most skiing injuries happen in age 7-17 year olds
c) the risk of TBI and spinal injury in skiing is increasing worldwide
d) lower extremity injuries in skiing is the most common injury

A

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

30
Q

Which of the following is not a risk factor for ski/snowboarding injury?

a) youth
b) female sex
c) beginner skier
d) rented equipment

A

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

31
Q

Which of the following regarding ski equipment is false?

a) improvement in bindings over past several decades has lead to decreased injuries including foot, ankle and lower tibial injuries
b) a professional should adjust children’s binding at the beginning of a lesson
c) studies have shown that youth with poorly adjusted bindings have higher chance of injury
d) changes in equipment have reduced the occurrence of knee sprains and upper extremity injury in skiing

A

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

32
Q

Which of the following is not supported by research studies?

a) helmets decrease head injuries in skiing
b) skiers are more likely to wear helmets than snowboarders, with increase in younger and older skiers, and more experienced participants
c) helmets increase spinal injuries in skiing/snowboarding
d) helmets don’t lead to riskier behaviour in skiing/snowboarding

A

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.

33
Q

Which of the following has not been shown to reduce skiing/snowboarding injuries?

a) wrist guards
b) presenting a safety video on buses
c) falls training

A

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%

34
Q

Which of the following is false?

a) grass protects against playground injury suffered by falls
b) 5-9 year olds have the highest risk of injury on playground equipment
c) most common cause of playground injury is falls
d) most common playground injury is upper extremity fractures

A

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

35
Q

Which of the following about the Canadian Safety Standards is false?

a) requires loose fill around and under play structures to depth of at least 15 cm for preschool equipment and 30 cm for full sized equipment
b) playgrounds legally required to follow them
c) reduce risk of falling with protective guardrails and vertical bars
d) playgrounds modified to meet the CSA standard reduces injuries by as much as 49%

A

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

36
Q

Which of the following is true for snowmobiling in Canada?

a) near drowning events from falling through the ice are common in youth
b) associated with the highest rate of injury of all winter sports
c) there has been a significant decline in snowmobile injuries in the last 10 years
d) girls are more likely than boys to be victims

A

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

37
Q

Which of the following provinces does not have a minimum age for snowmobiling?

a) British Columbia
b) Alberta
c) Newfoundland and Labrador
d) Yukon

A

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

38
Q

Which province requires the use of helmets?

a) British Columbia
b) Alberta
c) Newfoundland
d) Ontario

A

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

39
Q

Which of the following is not consistent with CPS recommendations about snowmobiling?
a) should not snowmobile

A

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

40
Q

Which of the following statements is false?

a) child death reviews don’t identify specific children but rather identify common themes that lead to death
b) in Canada, death investigation is chartered by the Canadian federal courts
c) unintentional injuries are the leading cause of death of children in Canada
d) Canada doesn’t have a formalized child death review process
e) For children in care or receiving services from a child welfare agency, all death and serious injuries must be investigated

A

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

41
Q

Which of the followingCanadian Provinces does not have a formal child death review processes?

a) Ontario
b) British Columbia
c) Manitoba
d) Newfoundland
e) Alberta

A

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.

42
Q

What is the leading cause of injury related deaths in <1 year olds in Canada?

a) falls
b) MVC
c) drowning
d) threat to breathing

A

d)in <44 years old

43
Q

What is the leading cause of injury related deaths in 1-4 year olds in Canada?

a) falls
b) MVC
c) drowning
d) threat to breathing

A

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

44
Q

What is the leading cause of injury related deaths in 5-9 year olds in Canada?

a) falls
b) MVC
c) drowning
d) threat to breathing

A

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

45
Q

What percentage of injury related deaths in 15-19 year olds is caused by poisoning?

a) 40%
b) 27%
c) 17%
d) 7%

A

d) 7% caused by poisoning of unintentional injury related deaths

#1: MVC (71%)
#2: poisoning (7%)
#3: drowning (6%)
46
Q

What percentage of injury related deaths are caused by drowning in the 10-14 year old age group?

a) 5%
b) 13%
c) 43%
d) 53%

A

b) 13% in 10-14 year olds

#1: MVC (55%)
#2: drowning (13%)
#3: fall (7%)

**table with all these stats, know it

47
Q

Overall, what is the most common cause of injury related deaths in Canadian youth?

a) falls
b) MVC
c) drowning
d) threat to breathing

A

b) MVC most common cause of death

48
Q

Overall, what is the most common cause of injury related hospitalization in Canadian youth?

a) falls
b) MVC
c) drowning
d) threat to breathing

A

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!)

49
Q

What is the injury pyramid?

A

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

50
Q

Please fill in the following matrix (Haddon’s matrix) for MVCs

Pre Event:
Host: 
agent: 
environment: 
Event:
Host: 
Agent: 
Environment: 
Post Event:
host: 
Agent: 
environment:
A

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
51
Q

Name 3 reasons that injury related death and disability rates have declined in recent years

A
  1. less risks taken
  2. education for risk reduction such as helmets
  3. better trauma care
52
Q

Between 1994-2003, how much did the overall death rate for childhood injury decline in Canada?

A

by 37%

53
Q

Between 1994-2003, how much did the overall hospitalization rate for childhood injury decline in Canada?

A

by 34

54
Q

True or false - MVC death and hospitalization rates between 1994-2003 declined by 46% in children aged 0-14

A

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

55
Q

True or false - car seats reduce the chance of death in an MVC

A

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)

56
Q

True or false - many car seats are installed incorrectly

A

true between 44-81% of car seats are used incorrectly

nearly 3/4 of children between 5-9 are not in booster seats

57
Q

true or false - most children injured in MVCs are restrained appropriately at the time of the crash

A

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

58
Q

Which of the following factors does not increase the risk of unintentional injury?

a) male sex
b) aboriginal
c) urban settings
d) lower SES

A

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

59
Q

how many unintentional injuries can likely be prevented

A

90% can likely be prevented according to research

60
Q

Please describe important components of injury prevention?

A

Education, Enforcement/legislation and Engineering

think of active and passive measures (i.e. seat belts, active), passive - i.e. airbags, detectors etc)

61
Q

How did Canada rank in the OECD review of child injury rates?

A

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.[

62
Q

What is the maximum engine size for <12 years olds?

What do the Canadian ATV industry say should be the minimum age?

A

<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

63
Q

What is the primary reason for using ATVs in the Canadian population?

A

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

64
Q

True or false - surveys have shown that most people do risky use of ATVS

A

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

65
Q

How much did ATV related hospitalizations rise between 1996-2004

A

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

66
Q

Name some risk factors which increase the risk of an ATV accident

A
  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
67
Q

True or false - smaller youth models are safer than adult models when used by children

A

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

68
Q

What should be the recommended minimum age for ATV use?

A

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

69
Q

Name 4 types of protective equipment that an ATV operator should wear at all times

A
  1. helmet (government certified)
  2. eye protection
  3. footwear
  4. protective clothing
70
Q

True or false - single rider vehicles should NEVER carry a passenger

A

true - they are not designed for this

these recommendations apply to all ATV operators >16 years old

71
Q

True or false - All ATV drivers should pass a mandatory course which includes training and testing components

A

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.

72
Q

What should be included in the legislation passed by provinces in off-road vehicle registration?

A
  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
73
Q

Which provinces do NOT have mandatory helmet use on ATVs?

A

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

74
Q

Which province does not have any restrictions on minimum age for ATV use?

A

BC no minimum age anywhere

75
Q

Which provinces have an explicit minimum age for ATV use?

A

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

76
Q

Which provinces have no minimum age for ATV use (although may have some supervision guidelines)?

A

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

77
Q

What were three interventions that played a role in making baseball and softball safer for children?

A
  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.

78
Q

What approximate proportion of all sports related injuries involve baseball and softball?

A

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

79
Q

Which age group has the highest proportion of injuries from baseball?

A

11-14 year olds

however, this group also has the highest participation in these sports

80
Q

Which part of the body was most injured in baseball injuries from the data above?

A
#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%)
81
Q

Which age group gets the most softball injuries?

A

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

82
Q

What is the reported injury rate of baseball?

A

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

83
Q

True or false - as age increases, the proportion of injuries to catchers increases , whereas proportion to fielders decreases

A

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

84
Q

True or false - most injuries in younger baseball players happen during games

A

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

85
Q

What type of injury is more likely to happen to a pitcher in a younger age group?

A

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

86
Q

What is the most common injury to batters?

A

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

87
Q

What is the rate of catastrophic injury in baseball?

A

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

88
Q

What were the two main causes of death in baseball?

A
  1. impact to head causing IC bleed

2. impact to chest causing v fib or systole (commotio cords)

89
Q

True or false - commotio cords almost exclusively occurs in paediatrics

A

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

90
Q

True or false - AEDs can help prevent death from commotio cords

A

true - death from commotio cords is potentially preventable

should activate for help ,try to get an AED within 3 minutes if possible

91
Q

What is the rate of concussion in baseball?

A

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

92
Q

Which baseball players at the most risk of overuse injuries of the arm?

A

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

93
Q

Which ligament attaches the scapula to the distal end of the clavicle?

A

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

94
Q

Which muscle is most important to ensure safe pitching?

A

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

95
Q

What are the 4 rotator cuff muscles:

A
  1. supraspinatus
  2. infraspinatus
    3.teres minor
    4.subscapularis
    keep the humeral head in the glenoid socket
96
Q

What is little league shoulder?

A

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

97
Q

What is little league elbow?

A

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.

98
Q

What is the main consequence of little league elbow?

A

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

99
Q

What is a common indicator of an elbow overuse injury?

A

inability to extend the elbow - indicator of elbow overuse injury

100
Q

What is Tommy John surgery

A

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

101
Q

What is the guideline for maximum pitches in a day for <1 0 year olds?

A

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

102
Q

asdf

A

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

103
Q

Please name some safety equipment for baseball players:

A

(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.

104
Q

True or false - chest barriers and protection can prevent commotio cordis

A

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

105
Q

Ideally, how quickly should an AED be accessed and EMS called if a baseball player is having cardiac arrest

A

3 minutes

106
Q

How can baseball and softball players protect their eyes?

A
  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

107
Q

Who should use low-impact balls when playing baseball?

A

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