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As reported by the Advanced Trauma Life Support Course (2010), “Injury mortality and morbidity surpass all major diseases in children and young adults, making it the most serious health care problem in this population.”

Injury is the number 1 cause of death and long-term disability in the children older than 1 year (Table 22–1). It is estimated that for one child’s death from an injury, 34 children are admitted to the hospital for treatment of a nonfatal injury, and 1000 children are seen in the emergency department and discharged home following evaluation for an injury. Data from the Centers for Disease Control and Prevention (CDC) confirm that injury, both intentional and unintentional, accounts for more than one-half of pediatric deaths per year.

Table 22–1.Ten leading causes of death, the United States 2007, all races, both sexes.


Unintentional injury is the leading mechanism of injury followed by homicide and suicide (Table 22–2).

Mechanism rate of occurrence varies by locale. The most frequent unintentional injury event is motor vehicle-related, followed by drowning, fire/burns, and poisonings. Deaths following accidents on motorized land vehicles such as ATVs are increasing. Blunt trauma is the major mechanism of injury in children with penetrating trauma accounting for 10-20% of injury events. The injured child dies from head injury, with and without other major trauma, accounting for greater than 80% of fatalities.

Table 22–2.Ten leading causes of unintentional injury deaths, the United States 2007, all races, both sexes.

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