Injury is the leading cause of death and disability in childhood and early adult life. Trauma represents the largest loss of potential years of life1 and burdens the nation with enormous costs in terms of human suffering and disability, lost productivity, and medical services.2 In 1977, deaths from unintentional injuries ("accidents") accounted for nearly half of all deaths of children aged 1 to 14 years.3 Nonfatal, unintentional injuries, which are estimated to outnumber fatalities by 100 to 1,4 frequently result in permanent disability. Fatal inflicted injury (homicide) is a large and growing pediatric problem.5 Nonfatal child abuse and neglect affect more than 500,000 children per year,6 resulting in a progressive burden for its victims and society.
If those who are young are to be protected from life-threatening injury, a quickened pace of progress in injury care and prevention is needed. Efforts to build Emergency Medical Services were begun in the 1970s, but these services are not yet widely developed.2 Advances in other aspects of critical care for the injured have also evolved slowly. In the area of injury prevention, considerable progress has been made in the development of ways to understand and control childhood injury; this is evident by the reductions in certain types of childhood injury. The most notable successes have been the reduction of poisoning and flame burns as causes of death and disability in childhood.7,8 Important theoretic advances have been (1) the elimination of the term "accident," which suggests chaotic and random effects, and its replacement with the notion of "injury," which suggests the transfer of physical or chemical energy to a victim; (2) recognition that the types of interventions most likely to succeed are ones that require infrequent participation by the potential victim and his family (or none at all); and (3) awareness that different types of measures are needed to prevent different types of injury.9
- Copyright © 1983 by the American Academy of Pediatrics