Hazards Associated with Sitting and Carrying Devices for Children Two Years and Younger.

OBJECTIVE: To analyze reported mechanisms of injury and characterize risk factors for infants and young children ≤ 2 years of age who died in sitting and carrying devices. STUDY DESIGN: A retrospective review of deaths involving sitting and carrying devices (car seats, bouncers, swings, strollers, and slings) reported to the US Consumer Product Safety Commission between 2004 and 2008. RESULTS: Of the 47 deaths analyzed, 31 occurred in car seats, 5 in slings, 4 each in swings and bouncers, and 3 in strollers. The reported elapsed time between the last time a child was seen by a caregiver and found deceased varied greatly, with a mean of 26 minutes in slings; 32 minutes in strollers; 140 minutes in car seats; 150 minutes in bouncers; and 300 minutes in swings. The cause of death was asphyxiation in all cases except one. Fifty-two percent of deaths in car seats were attributed to strangulation from straps; the others were attributed to positional asphyxia. CONCLUSION: Infants and children 2 years of age and younger should be properly restrained and not be left unsupervised in sitting and carrying devices. Car seats should not be used as sleeping areas outside of the vehicle, and children should never be in a car seat with unbuckled or partially buckled straps. Infants in slings should have their faces visible and above the edge of the sling, should not have their faces covered by fabric, and their chins should not be compressed into their chests.

Unintentional paediatric ingestion poisonings and the role of imitative behaviour.

OBJECTIVE: To quantify the relationship between imitative behaviour and poisonings in children. SETTING: USA. METHODS: This study is based on the evaluation of a large national database of unintentional oral ingestion poisonings involving children aged <5 years treated in US hospital emergency departments during 2004 and 2005. It begins with the premise that, among other factors, oral drug poisonings can result from children observing and imitating adult behaviour, but that non-oral drug and non-drug poisonings (to be referred to as non-drug poisonings) generally do not, because children do not see adults ingesting non-drug products. The study then compares and contrasts the child poisonings between the two poisoning categories. Differences in the poisoning rate between the oral drug and non-drug categories are estimated by the age and sex of the children. A binary logistic regression analysis is also conducted using non-drug poisonings as a control group to compare against oral drug poisonings. RESULTS: There was a significant increase in the relative likelihood of oral drug poisonings beginning at age 20-23 months that is consistent with the expected onset of complicated imitative behaviours in children. Based upon our analysis, imitative behaviour may have contributed to about 17,300 child poisonings treated annually in the emergency department, possibly accounting for about 20% of poisonings involving children aged <5 years and 30% of the poisoning injuries involving children aged 20-59 months. CONCLUSIONS: Comprehensive efforts to prevent poisoning need to address the problem of imitative behaviour in children. Caregivers should never ingest medications in the presence of children.

American Academy of Pediatrics Recommendations for the Prevention of Pediatric ATV-Related Deaths and Injuries.

Since all-terrain vehicles (ATVs) were introduced in the mid-1970s, regulatory agencies, injury prevention researchers, and pediatricians have documented their dangers to youth. Major risk factors, crash mechanisms, and injury patterns for children and adolescents have been well characterized. Despite this knowledge, preventing pediatric ATV-related deaths and injuries has proven difficult and has had limited success. This policy statement broadly summarizes key background information and provides detailed recommendations based on best practices. These recommendations are designed to provide all stakeholders with strategies that can be used to reduce the number of pediatric deaths and injuries resulting from youth riding on ATVs.