1. Prevention of TBI Joshua Rocker, MD Pediatric Emergency Medicine Fellow Long Island Jewish Hospital

2. Summary: TBI Significant Public Health Concern

3. Public Health Concern An estimated 80,000 to 90,000 experience the onset of long-term or lifelong disability per year secondary to TBI. Public Health Concern

4. Public Health Concern It is estimated that 5.3 million U.S. citizens (2 percent of the population) are living with disability as a result of a traumatic brain injury.

5. Prevention: SAFE KIDS The National SAFE KIDS Campaign is the first and only national non-profit organization dedicated solely to the prevention of unintentional childhood injury

6. Safe Kids Study: “A National Study Of Restraint Use” 2/2002 Methods: 9300 kids <14 y/o observed in 6300 vehicles 174 sites, 48 states Results: 53% restrained appropriately 33% restrained inappropriately 14% unrestrianed

7. Safe Kids Study: “A National Study Of Restraint Use” 2/2002, cont. Of the 14% unrestrained By age 20% 5-9 y/o 24% 10-14 y/o Risk Factors 40% if driver unrestrained v 5% if driver restrained Minority children- 23% unrestrained v 10% white

8. Safe Kids Study: “Headed for Injury”, 5/2004 Methods 549 sites, 46 states 8160 kids, 1400 adults Results 39 % adults with helmets 41% children with helmets 1/3 wore incorrectly 67% wore if riding with a helmeted adult 50% wore if riding with an unhelmeted adult

9. Safe Kids Study: “Stop Sign Violators put Children Pedestrians at Risk” 10/2003 45% of vehicles observed did not come to a complete stop at stop signs in school zones or residential areas 47% violated sign when children were not present 32% violated sign when children were present If stopped, 25% stopped beyond the boundries of the crosswalk.

10. Prevention: MVAs Transportation crashes #1 cause of TBI-associated death in women and kids <15 y/o The rate of TBI-associated death in MVAs has decreased approximately 40 percent since 1980. Number of factors: an increase in seat belt and child safety seat use an increase in the number of vehicles equipped with air bags a decrease in the incidence of DWI

11. Prevention: Violence Violence is a leading cause of TBI-especially among males-and violence with firearms is the leading cause of TBI-associated death. Needs: Effective programs designed to decrease the occurrence of interpersonal and self-directed violence

12. Prevention Education, consistency and vigilance.

13. Prevention… The parent’s JOB!!! The pediatrician’s job!!!

14. Thank you