Clinical evaluation and outcomes of children £10 years old involved in road traffic accidents presenting to Chris Hani Baragwanath Academic Hospital
Date
2020
Authors
Carreira, Jo-Anne
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Abstract
Background:
Road traffic injuries are a leading cause of injury and death globally, particularly amongst
children. Pedestrians are most often injured, particularly in middle and low income countries.
The epidemiology, patterns and severity of injuries of children involved in road traffic
accidents in our community are hard to come by.
Objectives:
The aim of the study was to evaluate the aetiological spectrum, injury characteristics and
treatment outcome of paediatric patients involved in road traffic accidents, presenting to a
Gauteng Tertiary Hospital in Soweto , Chris Hani Baragwanath Academic Hospital. This
research was conducted over 7 months 11 days (20/08/2017 to 31/03/2018).
Methods:
All patients under the age of 10 years seen at Chris Hani Baragwanath Academic Hospital
casualty, having been involved in a road traffic accident of any kind were included in the
study. A data sheet in the form of a questionnaire was completed by the doctors caring for the
children, recording various statistics such as: age, gender, mechanism, class of vehicle, adult
accompaniment, restrained, clinical presentation, investigations and procedures as well as the
injuries sustained.
Results:
The study was conducted over the period from 20/08/2017 to 31/03/2018. A total of 156
patients’ data was included. The ages ranged from 13 days to 10 years with 65% of the children
being male. Pedestrian vehicle accidents accounted for 78.8% (123/156) of the injuries with
60.8% of the children involved being unaccompanied by an adult. Motor vehicle accidents
accounted for 19.2% (30/156) of the injuries with 92% of the children in the vehicles being
unrestrained. Of the children who were included, 73.2% (112/153) of them had X-rays and
44.4% required CT scan, the majority being CT Brain for suspected head injuries. Soft tissue
injuries were sustained by the majority of the patients (78.9%), followed by head (39.7%) and
then limb (16%) injuries. Children accompanied by adults when involved in PVAs were
significantly less likely to obtain a head injury when compared to unaccompanied children (p = 0.037). Only 12% of patients required surgical intervention, with 42% of the surgeries being
for orthopaedic injuries.
Conclusion:
This study demonstrates that there is an overwhelming lack of use of child restraints for
children travelling as passengers in vehicles. It also shows an inadequacy of supervision of
the young children on and around the roads.
This study supports other evidence in suggesting that the paediatric population involved in
RTAs are largely injured as pedestrians. We showed, similarly to obtained literature, that
males tend to be involved in more RTAs than females. The majority of injuries sustained were
soft tissue injuries followed by head injuries.
Description
A research report submitted in partial fulfilment of the requirements for the degree of
Master of Medicine to the Faculty of Health Sciences, University of the
Witwatersrand, 2020