The 130th Annual Meeting of APHA

Abstract #48464

Robert Brison, MD, MPH, FRCP(C), Dept. of Emergency Medicine, Kingston General Hospital/Queens University, 76 Stuart St, Kingston, ON K7L 3V2, Canada, William Pickett, PhD, Emergency Medicine Research, Queen's University, Angada 3, Kingston General Hospital, 76 Stuart Street, Kingston, ON K7L 2V7, Canada, Barbara Marlenga, PhD, National Children's Center for Rural and Agricultural Health and Safety, 1000 North Oak Avenue, Marshfield, WI 54449, 715-389-3021, brisonr@KGH.KARI.NET, and Richard Berg, MS, Marshfield Medical Research and Education Foundation, 1000 North Oak Avenue, Marshfield, WI 54449.

As rural areas continue to struggle to provide timely prehospital care and hospital-based trauma services during the “golden hour” post injury, it would be helpful to assess whether enhanced trauma care would result in improved survival rates among farm injury victims. A retrospective review of Canadian farm fatalities to children 0-6 years for the period 1990 through 2000 were studied in order to: 1) describe the anatomical site, nature, and severity of fatal injuries sustained by farm children, 2) estimate proportions of victims who died either at the scene or were declared dead upon arrival to an emergency department, and 3) evaluate each case individually to determine whether any intervention would have likely resulted in survival to hospital discharge. There were 82 children aged 0-6 killed in farm-related injury events during the study period. Anatomic injuries responsible for death were major head injury (55%), abdominal injury (9%), chest injury (5%), and asphyxia by drowning (24%). Twenty four percent of the children were pronounced dead at the scene and 40% were pronounced dead upon arrival to medical care. A trauma physician reviewed each record to assess the likelihood of short-term survival and in only one case (1%) was it thought that a child might have survived were enhanced services available. These results suggest that the rapid provision of any post-event intervention would be unlikely to have an impact upon survival rates amongst these victims. Therefore, primary prevention must be focused on keeping young children away from the farm worksite.

Learning Objectives: Participants will learn about

• the nature and anatomical site of fatal injuries experienced by very young farm children,
• the lethality of these injuries through examining the proportions of victims who died at the scene or on presentation to medical care, and
• the potential roles of primary vs. tertiary prevention for these injuries.

Presenting author's disclosure statement:
Disclosure not received
Relationship: Not Received.