Childhood injury prevention
CMAJ 1997;156(4):480
In response to: P.C. Wing, M.E. Lower
Re: Childhood injury prevention: time for tougher measures, by I.
Barry Pless, CMAJ 1996;155:1429-31 [full text / résumé]
I agree with Dr. Pless' editorial wholeheartedly, but I am confused by the letter from Dr. Wing and Ms. Lower.
The field of injury prevention is anemic, and this anemia is chronic. To be effective, practitioners of injury prevention must join the mainstream and become part of a true injury-control system. Injury control encompasses injury prevention, emergency medical services, acute care (trauma) and injury rehabilitation, all working together. Obviously, we must try to prevent the injury in the first place, but if we cannot, then we need a proper emergency-medical-services system that can respond rapidly and that has appropriately trained providers who can treat children as well as adults. Patients whose injuries threaten life or limb need to be taken to a facility that can deal with trauma, and these patients need rehabilitation from the moment they are injured. The system must include the ability to collect injury data and analyse it to better develop programs to prevent future injuries and to improve the outcomes for those injured.
As it stands, anyone can say he or she is an injury-control specialist, injury-prevention expert or injury consultant, and no one can dispute such a claim. The injury-control field needs accredited practitioners, leadership at the federal and provincial levels and appropriate resources to match the billions of dollars spent on injuries each year.
What we do not need is yet another task force to tell us that we have a problem. The numbers are obvious. Who is going to lead us out of this sad situation? There is no existing foundation or organization that has the credibility or support to provide national leadership. The public, unfortunately, does not believe that injuries are a problem until they or their loved ones have been injured. We are all but a telephone call away from the devastating news that our son, daughter, mother, father, spouse or friend has been injured or killed. However, by then it is too late. Unlike the networking and cause development concerning chronic diseases, there is a lack of community-based advocacy groups for injury prevention, because injuries occur suddenly and in isolation.
So what needs to be done?
Actually, it is quite simple.
The federal minister of health should call Pless and ask him what needs to be done, what resources are required and what results we can expect. I cannot think of anyone more qualified and respected to lead us out of the quagmire in which we have stagnated for the last 20 years.
As Pless says, "Let's get on with it."
Louis Hugo Francescutti, MD, PhD, MPH
Assistant Professor
Department of Public Health Sciences and Emergency Medicine
University of Alberta
Edmonton, Alta.
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