A multicenter evaluation of pediatric emergency department injury visits during the COVID-19 pandemic.

BACKGROUND: Injuries, the leading cause of death in children 1-17 years old, are often preventable. Injury patterns are impacted by changes in the child's environment, shifts in supervision, and caregiver stressors. The objective of this study was to evaluate the incidence and proportion of injuries, mechanisms, and severity seen in Pediatric Emergency Departments (PEDs) during the COVID-19 pandemic. METHODS: This multicenter, cross-sectional study from January 2019 through December 2020 examined visits to 40 PEDs for children < 18 years old. Injury was defined by at least one International Classification of Disease-10th revision (ICD-10) code for bodily injury (S00-T78). The main study outcomes were total and proportion of PED injury-related visits compared to all visits in March through December 2020 and to the same months in 2019. Weekly injury visits as a percentage of total PED visits were calculated for all weeks between January 2019 and December 2020. RESULTS: The study included 741,418 PED visits for injuries pre-COVID-19 pandemic (2019) and during the COVID-19 pandemic (2020). Overall PED visits from all causes decreased 27.4% in March to December 2020 compared to the same time frame in 2019; however, the proportion of injury-related PED visits in 2020 increased by 37.7%. In 2020, injured children were younger (median age 6.31 years vs 7.31 in 2019), more commonly White (54% vs 50%, p < 0.001), non-Hispanic (72% vs 69%, p < 0.001) and had private insurance (35% vs 32%, p < 0.001). Injury hospitalizations increased 2.2% (p < 0.001) and deaths increased 0.03% (p < 0.001) in 2020 compared to 2019. Mean injury severity score increased (2.2 to 2.4, p < 0.001) between 2019 and 2020. Injuries declined for struck by/against (- 4.9%) and overexertion (- 1.2%) mechanisms. Injuries proportionally increased for pedal cycles (2.8%), cut/pierce (1.5%), motor vehicle occupant (0.9%), other transportation (0.6%), fire/burn (0.5%) and firearms (0.3%) compared to all injuries in 2020 versus 2019. CONCLUSIONS: The proportion of PED injury-related visits in March through December 2020 increased compared to the same months in 2019. Racial and payor differences were noted. Mechanisms of injury seen in the PED during 2020 changed compared to 2019, and this can inform injury prevention initiatives.

A brief history of Forging New Frontiers, the annual conference of the Injury Free Coalition for Kids.

The Injury Free Coalition for Kids Annual Conference has contributed to the dissemination of information pertaining to the development of the field of injury prevention. A content analysis was completed using conference agendas used during the span of 2005-2015, finding that more than 398 presentations covering a wide variety of injuries have taken place. Published work has appeared in the Journal of Trauma and there has been recognition of people who have contributed to the development of the field. Forging New Frontiers is a valuable tool for attendees to exchange information about injury prevention.

The impact of community-built playgrounds on the community.

BACKGROUND: Community-built playgrounds have been an integral component of Injury Free Coalition for Kids sites as they work with communities to provide safe places for children to play. The purpose of this pilot survey was to explore the potential impact of the community-built playground on the community. METHODS: A survey was developed and sent electronically via an Injury Free listserve to the Injury Free sites that had built one of the 29 Injury Free playgrounds between 2002 and 2007. Variables examined included condition and maintenance of the playground, vandalism, and community participation. Open-ended questions were used to examine the impact of the playground on the community and school. Descriptive statistics were used to describe quantitative data. Open-ended responses were collated and grouped into themes. RESULTS: Surveys were returned from 28 Allstate playground sites. The playgrounds were built within the last 6 years with the majority (64%) built 3 or more years ago. Although 17 of the playgrounds sustained minor vandalism, 11 of the sites reported the vandalism was corrected by the community. Community impact themes centered on revitalization and empowerment, safety, and social capital changes whereas school impact themes centered on socialization and health. CONCLUSIONS: From the perspective of the program coordinators, the playgrounds had a positive impact on the communities. Further research within this arena is needed to explore the relationship of community-built playgrounds and community development.