MCH Trauma Program's Clinical Research: Completed projects in 2010-2011
1. Trauma caused by motorized vehicles in children of Nunavik
Who were the researchers?
Francis Livernoche, Karine Pépin, Margaret Berry, Debbie Friedman, Johanne Morel
What was the research question?
What are the characteristics of trauma caused by motorized vehicles in children of Nunavik.
What were we doing?
We visited the regional hospitals of Nunavik as well as their pediatric trauma centre, The Montreal Children's Hospital (MCH). We identified and reviewed the charts of all patients from 0 to 18 years of age having been hospitalized for a trauma caused by a motorized vehicle between January 1st, 2004 and the March 1st, 2009.
How was this project funded?
No additional financing was requested.
What are the results?
We identified 140 patients with an average age of 12, 6 years and with a majority of them being females (54 %). The most common types of vehicles were: all-terrain vehicles (73; 52 %), snowmobiles (16; 11 %), mopeds (16; 11 %) and cars (6; 4 %). None of the patients wore a helmet. Patients for whom information was available, 30 (41 %) had consumed alcohol and 14 (21 %) had consumed drugs. Fractures (73; 53 %) and traumatic brain injuries (74; 53 %) were the leading types of injuries. The average length of hospitalization was 4 days. Eighty eight patients (64 %) required an air transfer to the MCH trauma centre.
What does it mean for practice?
This study underlines the impact of trauma caused by motorized vehicles on the communities of Nunavik and their children. Our study confirms the importance of the role of risk taking behaviors such as alcohol, drugs and not wearing a helmet in these traumas as well as the importance of the medical repercussions.
2. Trauma…Surviving, But in What State? Teen Driving Prevention Program
Who were the researchers?
Lisa Grilli, Debbie Friedman, Liane Fransblow, Natalie Auclair, Isabelle Gagnon
What was the research question?
Evaluate the effectiveness of the Trauma…Surviving, But in What State? Program on teens' knowledge and attitudes towards safe driving habits.
What were we doing?
The Montreal Children's Hospital Trauma Centre, ThinkFirst Quebec and the Service de police de la Ville de Montréal presented the Trauma…Surviving, But in What State? Program to grade 11 high schools students (2010-2011 school year) in the urban Montreal area. The Program was an injury prevention initiative for young drivers in their graduating year of high school in order to increase awareness of the consequences of risky road behaviours; increase knowledge and understanding of the outcomes of traumatic brain and spinal cord injuries and to empower teens to use the information to make smart choices. We evaluated the effectiveness of the Program through the use of a pre- and post- questionnaire measuring knowledge and attitudes towards risky driving behaviors which was completed by the students prior to and immediately following the presentation. In addition, students were asked to rate and to provide feedback regarding overall satisfaction of the content and presentation.
How was this project funded?
No additional financing was requested.
What are the results?
Questionnaires were filled out by 1149 grade 11 students from 11 high schools. The number of students who reported that they planned to always obey the speed limit doubled. Initially more than 50% of students reported texting while driving and after the presentation 68% plan to never text while driving. The majority of students will no longer tolerate driving impaired by alcohol use or drug use either as a driver or passenger. The students' knowledge of traumatic brain and spinal cord injuries increased by greater than 40% after the presentation. Ninety-nine percent of the students found the Program relevant and would recommend it to other grade 11 students.
What does it mean for practice?
This reality-based teen program had a short term positive influence on the attitudes and knowledge of teens towards safe and responsible driving. Futher work on the long term effectiveness of this program is planned for the next school year.
3. Outcomes of the MCH Trauma Centre's experience in conducting local car seat verification clinics.
Who were the researchers?
Liane Fransblow, Debbie Friedman, Lisa Grilli, Carlo Galli, Isabelle Gagnon
What was the research question?
How many children are properly installed in an appropriate car seat? Of those who are improperly installed, what are the most common installation errors?
What were we doing?
Over a three year period (2009, 2010, and 2011), the MCHTrauma Centre – MUHC in partnership with local fire and police departments and daycare directors participated in local community car seat verification clinics. During these clinics, a checklist provided by the provincial automobile insurance society (SAAQ) was initially filled out in order to keep track of the type of adjustments being made. Secondly, the appropriate adjustments were made as needed. In addition, the parents or caregivers were provided with a list of the locations of local provincially mandated car seat verification centres for future use once the child outgrows the current seat. From the perspective of a trauma centre involved in injury prevention, MCH trauma piloted a short questionnaire at the last 2 clinics in order to measure parental awareness and usage of local provincially mandated car seat verification centres.
How was this project funded?
No additional financing was requested.
What are the results?
A total of 252 car seats, including infant seats, child seats and booster seats, were verified at 4 car seat verification clinics in the greater Montreal area. The majority (78%) of car seats needed adjustments. More specifically, 80% of infant car seats, 87% of child seats and 45% of booster seats. The most common errors were both related to the installation of the seat within the car as well as the positioning of the child within the seat. Furthermore, of the 81 participants surveyed whether or not they had ever been to a provincially mandated car seat verification centre, 80% responded no.
What does it mean for practice?
This study suggests that a significant proportion of children in the greater Montreal area are not properly secured in their car seats and that provincially mandated verification centres are being underutilized. This suggests that parents have a false sense of security when they strap their children into their car seats. More effort is required to increase awareness of these verification centres.