Life on the farm-children at risk.
BACKGROUND
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.


METHODS
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.


RESULTS
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%).


CONCLUSIONS
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.
Texas A&M University System Health Science Center, Scott and White Memorial Hospital, Temple, TX, USA.
D C
DC
Little
J M
JM
Vermillion
E J
EJ
Dikis
R J
RJ
Little
M D
MD
Custer
D R
DR
Cooney
D000061:Accidents, Home / Q000145:classification / Q000401:mortality / Q000706:statistics & numerical data*; D000062:Accidents, Occupational / Q000401:mortality / Q000706:statistics & numerical data; D000293:Adolescent; D017677:Age Distribution; D000383:Agriculture; D002648:Child; D002675:Child, Preschool; D004651:Employment; D015600:Glasgow Coma Scale; D006801:Humans; D007223:Infant; D015601:Injury Severity Score; D014481:United States / Q000453:epidemiology