Furnival R A, Street K A, Schunk J E
Division of Pediatric Emergency Medicine, Primary Children's Medical Center, Salt Lake City, UT 84113, USA.
Pediatrics. 1999 May;103(5):e57. doi: 10.1542/peds.103.5.e57.
Recent reports note a dramatic increase in the number of pediatric trampoline injuries (PTI) during the past several years. In 1996, the US Consumer Product Safety Commission estimates that 83 000 patients received treatment for trampoline injuries in US hospital emergency departments (EDs), and that approximately 75% of these patients were <15 years of age. We sought to review our experience with PTI since our previous report (Pediatrics 1992;89:849), and to determine if the American Academy of Pediatrics' current (Pediatrics 1981;67:438) safety recommendations are adequate.
Retrospective medical record review of all PTI patients presenting to the pediatric ED from November 1990 through November 1997.
A total of 727 PTI patients were included; medical records were unavailable for 3 patients. The annual number of PTI nearly tripled during the study period, from 51 in 1991 to a peak of 148 in 1996. PTI patients were 53% female, with a median age of 7 years; 37% were <6 years of age. Privately owned trampolines accounted for 99% of PTI. Most injuries (66%) occurred on the trampoline, 28% resulted from falls off, and 4% from imaginative mechanisms. One hundred eleven patients (15%) suffered severe injury (1990 Abbreviated Injury Scale value >/=3), usually of an extremity (89 out of 111). Fractures occurred in 324 patients (45%). Spinal injuries were common (12%), including 7 patients with cervical or thoracic fractures, and 1 with C7 paraplegia. Fractures were more frequently associated with falls off the trampoline, whereas spinal injuries more frequently occurred on the trampoline. Eighty patients (11%) required prehospital medical transport to our ED, 584 (80%) had ED radiographs, and 382 (53%) required pediatric surgical subspecialty involvement. Seventeen percent of PTI patients (125 out of 727) were admitted to the hospital, including 9 to the pediatric intensive care unit; 99 (14%) required one or more operations. Mean hospital stay was 2 days (range, 1-63 days); 24 stays (19%) were for >/=3 days. We estimate that the hospital charges for the acute medical care of PTI study patients at our institution totaled approximately $700 000.
PTI are dramatically increasing in number, and result in considerable childhood morbidity. Most PTI occur on privately owned trampolines. Few, if any, safety recommendations for the trampoline are followed. We support recommendations for a ban on the recreational, school, and competitive pediatric use of trampolines.
最近的报告指出,在过去几年中,儿童蹦床损伤(PTI)的数量急剧增加。1996年,美国消费品安全委员会估计,在美国医院急诊科(ED)有83000名患者因蹦床损伤接受治疗,其中约75%的患者年龄小于15岁。我们试图回顾自我们之前的报告(《儿科学》1992年;89:849)以来我们在PTI方面的经验,并确定美国儿科学会当前(《儿科学》1981年;67:438)的安全建议是否足够。
对1990年11月至1997年11月期间到儿科急诊科就诊的所有PTI患者进行回顾性病历审查。
共纳入727例PTI患者;3例患者没有病历记录。在研究期间,PTI的年数量几乎增加了两倍,从1991年的51例增加到1996年的峰值148例。PTI患者中53%为女性,中位年龄为7岁;37%的患者年龄小于6岁。私人拥有的蹦床导致了99%的PTI。大多数损伤(66%)发生在蹦床上,28%是从蹦床上跌落所致,4%是由想象中的机制引起。111例患者(15%)遭受重伤(1990年简略损伤量表值≥3),通常为四肢损伤(111例中有89例)。324例患者(45%)发生骨折。脊柱损伤很常见(12%),包括7例颈椎或胸椎骨折患者和1例C7截瘫患者。骨折更常与从蹦床上跌落有关,而脊柱损伤更常发生在蹦床上。80例患者(11%)需要在院前接受医疗转运至我们的急诊科,584例(80%)进行了急诊科X线检查,382例(53%)需要儿科外科专科会诊。17%的PTI患者(727例中的125例)住院治疗,其中9例入住儿科重症监护病房;99例(14%)需要进行一次或多次手术。平均住院时间为2天(范围为1 - 63天);24例住院(19%)时间≥3天。我们估计我们机构PTI研究患者的急性医疗护理的医院费用总计约70万美元。
PTI的数量正在急剧增加,并导致相当多的儿童发病。大多数PTI发生在私人拥有的蹦床上。几乎没有遵循任何关于蹦床的安全建议。我们支持禁止在娱乐、学校和竞技活动中儿童使用蹦床的建议。