Bunk bed accidents

Objective. It is the aim of this study to examine causes and accident mecha nisms which lead to injuries in childhood involving bunk beds in order to e stablish strategies for accident prevention. Method. Ina retrospective study, we identified infants and toddlers who att ended the department of paediatric surgery of the university of Graz after a bunk bed accident between January 1990 and September 2000. Time of the ac cident and type of injuries sustained were abstracted from the case records . Telephon interviews using a standarized questionnaire inquiring about the place and circumstances of the accident aswell as injury prevention measur es used by parents were conducted with families of these children whenever possible. Random sample interviews with families of children aged between 2 and 15 years were done to evaluate the bunk bed use rate and the use of pr eventive measures. Results. A total of 239 children were included in the retrospective study, 112 girls (46,9%), 127 boys (53,1%).59,4% were below 6 years of age at the time of the accident, among them 19,4% younger than 3 years. 1,5% of childr en had sustained multiple injuries,3,3% skull fractures, 19,2% a minor head injury, 0,8% splenic lacerations, 15,9% long bone fractures, 9,2% other fr actures, 1,3% tooth injuries, 7,9% lacerations of scalp or facial skin and 41,0% contusions or sprains. The results of 155 telephone interviews demons trated that 35,5% were injured in a fall from the top bunk while sleeping, 34,8% in a fall from the top bunk while playing, 23,2% when falling off the ladder and 5,8% when jumping from the top bed. The random sample survey re vealed that in relation to age more than one quarter of children had been u sing bunk beds. 75,9% of these beds were equipped with side-rails and 58,4% of families had placed carpets alongside the bunk bed. Conclusion. The use of adequate, closed side-rails (height above mattress > 160 mm) and placement of carpets or mattresses alongside the bunk bed seem to be the most promising injury prevention strategies. Children aged <6 ye ars should not be allowed to use bunk beds.