When It Comes To Stair Injuries, Not Just Children Are Falling

Here’s something you probably know if you work in a pediatric emergency department or a regular ED that treats a lot of kids: Children younger than 5 commonly seek emergency treatment for stair-related injuries. In fact, nationwide, one of those cases walks in the door of an ED every six minutes.  Not only does a new study find that stair-related mishaps are declining, it also offers some surprising reassurance you can offer to the hysterical parents. Read more to find out what...

In 2008, nearly 90,000 young children required treatment in an ED following a fall down stairs. While high, that number reflects a drop of 11.6% compared to 10 years earlier. Overall, stair-related injuries declined from 53 per 10,000 children to 42.4 over the decade, according to a study in the journal Pediatrics.

The best news for parents, though, is that less than 3% of stair injuries require hospitalization. Children under the age of 1 accounted for nearly one-third of the injuries and were most likely to be seriously hurt. Fully one-quarter (53,147) of injuries occurred when children were being carried by caregivers who tripped or fell—and those injuries were 3 times as likely to require hospitalization, probably as a result of the additional force involved with the adult landing on the child.

In more than 10,000 instances, children were injured when they were in strollers or carriages that fell down stairs. Strapping the child into the stroller was insufficient to prevent injury.

Head and neck injuries were most common in stairway mishaps, but falls were associated with fractures to the humerus or femur in more than 8,000 cases. Researchers noted that while certain falls, particularly those in which the caretaker stumbles while holding the child, can generate broken bones, “multiple injuries do not commonly result from stair-related falls” and, when multiple injuries occur, “more investigation to rule out intentional injury” is warranted. Less than 1% of the children in the study sustained injuries to more than 25% of the body.

This is definitely a case where boys will be boys: They had a higher rate of injury than girls in every age group, with overall rates of 57% compared to 43%.

The study provides some good news in addition to declining overall rates and relatively low prevalence of serious injury: The education campaign discouraging the use of baby walkers has clearly been effective. Only 1352 injuries were associated with baby walkers in 2008. Before 1994, about 20,000 infant-walker-related injuries involved falls down stairs each year.

View other topics in this week's edition of Pertinent Practice Pearls (free for everyone):

• Normal-Looking Radiographs Can Delay Pneumonia Diagnosis
• It Looks Like a Duck, Quacks Like a Duck, but….
• What’s to Gain from Aggressive Treatment of Severe TBI?

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• The Initial Assessment And Management of Pediatric Knee, Ankle, And Wrist Injuries (free for everyone)
• Emergency Evaluation Of The Pediatric Cervical Spine (free for everyone)