Trauma Prevention and the Montreal Children s Hospital

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1 Fast Facts About Trauma Trauma Prevention and the Montreal Children s Hospital Every year in Canada more kids and teens are hospitalized or die from trauma related injuries than from any other cause Trauma is the leading cause of death & disability in the 1-44 age group Common causes of trauma: falls, sports (see Appendix for breakdown), recreational activities, motor vehicle collisions, impact with an object, intentional trauma (abuse & violence), hire, hot liquids, poisonings, drowning Annual patient volumes at the MCH Trauma Centre: ER Department : > 17,500 Hospitalizations : > 400 Regional Centre transfers : 150 Concussion Clinic : > 900 Orthopedic Trauma Clinic : > 8,000 The primary goals of the MCH s trauma program are to provide world class care to trauma patients thanks to a dedicated multi-disciplinary team AND to prevent trauma and injury among children and adolescents through community outreach, education, and lobbying.

2 Trauma and Injury Prevention at the Children s 90% of injuries are preventable Dynamic program involves: injury prevention recommendations; development of educational resources; public awareness; community out-reach; partnership development; networking; knowledge sharing(website); and research. Close affiliation with the Public Health Agency of Canada s Canadian Hospitals Injury Reporting and Prevention Program. Our approach balances activity while promoting awareness of risks encouraging informed choices Acknowledged by accrediting bodies as the leaders in Quebec (only comprehensive program of its kind at a pediatric hospital) Education about reducing the risks of injury through partnerships and diffusions of key messages to community MDs, health professionals, schools, summer camps, sports associations, community organizations, and policy makers Primary Prevention - Outreach events Press conferences Presentations &talks Conferences Schools (high school, CEGEP) Summer camps Sporting associations (coaches, parents, athletes, trainers) Community Physicians Northern Community projects Salon Maternité-Paternité Osler Medical School Volunteer Program In-house prevention days Car seats clinics Community events Sports tournaments Bike rodeos Ski days Award-winning website ARRIVE ALIVE TEEN PROGRAM ( ): - Funding from Aviva Insurance Company - Video presentation followed by interactive discussion and demonstration - Designed to encourage teens to be informed, reflect on risks and make smart choices - The theme of shared responsibility and impact on family, and community - permeates the discussion

3 - Plans in place for parent presentations Accomplishments Advocating for legislation and regulations: - no checks to the head rule (hockey) - reduce head-to-head contact (football) - enforce rules - respect and fair play - protective equipment - skill training - encouraging environmental measures Legislation and regulations no checks to the head rule (hockey) reduce head-to-head contact (football) trampoline ban from schools ban on baby walkers helmet legislation reduction of legal BAC in Quebec turban safety in soccer diving boards in municipal parks Legislation and regulations anchoring soccer nets playground equipment removing Brault and Martineau ad showing an unattended baby on a washing machine mandatory fencing surrounding all home swimming pools conditions of terrain toy recalls & testing helmets for go-karting Thanks to its leadership role as an advocate for trauma prevention, the MCH has been able to help implement a number of measures aimed at decreasing trauma and injuries among young people These efforts have led to a lessening in the severity of trauma cases seen at the hospital

4 Challenges New trauma risks arise continuously, requiring constant updating of educational information (brochures, website, etc.) and proactive lobbying with all levels of government and larger associations With limited resources available, efforts are concentrated on organizations with the most potential impact on large numbers of people Annual Budget ($135,000) An amount of $100,000 per year is required to simply maintain the programs ongoing activities in terms of community outreach, government relations and education A further $35,000 is needed to publish the third edition of the hospital s widely distributed Concussion Kit

5 APPENDIX Mechanism of Injury

6 Research Project: Treating and preventing brain trauma The most common cause of brain injury in children after the perinatal period is traumatic brain injury, the mildest and most common form of which is concussion. The MCH Concussion Clinic is extensively recognized as a Canadian leader in concussion prevention education. The clinic receives around 800 referrals per year, most from the MCH Emergency Department, but also from community physicians. Dr. Isabelle Gagnon and Ms. Debbie Friedman, Director of MCH s clinical trauma program, have developed recommendations for parents, health care providers, schools, and athletic coaches for the monitoring and care of children following concussion. These recommendations have been adopted as the standard by Quebec s Institut national d excellence en santé et en services sociaux (INESS) and are widely distributed through a concussion kit. To further the Children s research in this area, funds are required to purchase two Neurotrackers, an innovative perceptual-cognitive training system. Early data suggests that this tool has the ability to change brain function in healthy kids and Dr. Gagnon will use it to study its effect on an injured brain. One machine will be for routine clinical use and the second unit will be used to provide longitudinal data on vestibular (balance) and visual function in a randomized trial of 100 children with concussions. Fifty patients would be randomized to routine care (according to the current concussion kit), the other 50 to routine care plus the Neurotracker. Time to full neurological and psychological recovery will be compared in the two groups, with results expected to yield an immediate impact on the care of children with concussion. Positive results from Dr. Gagnon s research could significantly change outcomes for a significant number of children each year, as there is currently very little to offer children to help them recover from a concussion. Dr. Gagnon s research activities are fully integrated with the concussion clinic, where she sees approximately 800 children each year. She has already completed the imaging part of her research on memory tasks (visual, auditory and spatial) and is now working on an intervention study. Proposed Budget Recruit, observe and treat 100 children for the sample $25,000 Two neurotrackers ($10,000 each) $20,000 Statistical analysis of all neurotrackers data $10,000 Total $55,000

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