Little D C, Vermillion J M, Dikis E J, Little R J, Custer M D, Cooney D R
Texas A&M University System Health Science Center, Scott and White Memorial Hospital, Temple, TX, USA.
J Pediatr Surg. 2003 May;38(5):804-7. doi: 10.1016/jpsu.2003.50171.
More than 1 million children live, play, and work on farms, surrounded by animals and machinery. This symbiotic relationship between work and home exposes children to unique risks.
Children presenting with a farm-related injury (November 1994 to August 2001, 82 months) were included. Trauma registry parameters included injury severity score (ISS); Glascow Coma Scale (GCS); time to presentation; season and day of injury; emergency room, intensive care unit, and total length of stay type; and mechanism of injury; and operations.
A total of 1,832 pediatric trauma patients were evaluated. Ninety-four children were identified with farm-related injuries. Mean age was 10.75 years. Mean ISS was 7.38. Three children died. Four children wore protective equipment. Forty-four percent of injuries occurred during summer, 31% during spring, and 55% on weekends. Average time to initial presentation was 39 minutes. A total of 177 minutes elapsed before transfer to regional trauma center. Seventy-two children required admission. LOS was 0 to 28 days, mean, 2.76 days. Twenty-six children (28%) required operations. Injuries included dislocations/fractures (52%), lacerations/avulsions (38%), concussions (31%), contusions (30%), and burns (14%). Mechanism included animals (41%), falls (34%), motor vehicles (28%), all-terrain vehicles (20%), and firearms (4%).
Farm injuries occur most commonly during weekends, summer, and spring months, resulting in significant morbidity. Most injuries required hospitalization. Unless unstable, initial transfer to a regional pediatric trauma center should result in the most cost-effective, prompt, and highest quality of care.
超过100万儿童在农场生活、玩耍和劳作，周围有动物和机械。工作与家庭之间的这种共生关系使儿童面临独特的风险。
纳入1994年11月至2001年8月（82个月）出现与农场相关损伤的儿童。创伤登记参数包括损伤严重程度评分（ISS）；格拉斯哥昏迷量表（GCS）；就诊时间；损伤季节和日期；急诊室、重症监护病房及住院总时长类型；损伤机制；以及手术情况。
共评估了1832例儿科创伤患者。94名儿童被确定有与农场相关的损伤。平均年龄为10.75岁。平均ISS为7.38。3名儿童死亡。4名儿童佩戴了防护装备。44%的损伤发生在夏季，31%发生在春季，55%发生在周末。首次就诊的平均时间为39分钟。转至区域创伤中心前共耗时177分钟。72名儿童需要住院。住院时长为0至28天，平均为2.76天。26名儿童（28%）需要手术。损伤类型包括脱位/骨折（52%）、撕裂伤/撕脱伤（38%）、脑震荡（31%）、挫伤（30%）和烧伤（14%）。损伤机制包括动物（41%）、跌倒（34%）、机动车（28%）、全地形车（20%）和枪支（4%）。
农场损伤最常发生在周末、春季和夏季，导致明显的发病率。大多数损伤需要住院治疗。除非情况不稳定，最初转至区域儿科创伤中心应能实现最具成本效益、最迅速且最高质量的护理。
