Childhood farm injuries

During a recent 6-year period (1991-1997), 143 children and adolescents les s than 18 years of age were admitted to a Level I trauma center for agricul ture-related trauma. Mechanized pieces of equipment were responsible for ha lf of the injuries. The pattern of injury was clearly seasonal and a daytim e occurrence. Half of the patients came from the scene and half from rural hospital emergency rooms, with only 25 per cent being transported via advan ced life support. Rural geography led to both long distance (mean, 55 miles ) and long transport time to definitive care (mean, 2 hours, 15 minutes). T here was a predilection for fractures, amputations, head injuries, and soft -tissue infections. Operative intervention was required immediately in two- thirds, and one-third were admitted to an intensive care unit. Whereas hosp ital mortality was low at 1.4 per cent, most childhood farm deaths during t he study period occurred in the field. Severe permanent disability was pres ent in one-third of children, and 7 per cent incurred a second injury durin g the study period. Using this review, prevention programs have been develo ped to minimize death and disability in children sustaining farm injuries.