TOO much prevention NOT enough risk taking - what a joke !

As a trauma centre, we at the Montreal Children’s Hospital of the MUHC are continually faced with the challenge of finding an effective way of conveying the important message of balancing activity and fun with safety. According to the World Health Organization, prevention strategies should be developed through a combination of education, environmental measures, and in some cases enforcement. Endless legislation is not always the most well received and effective strategy. Likewise the important message of preventing injuries should also not lead to a generation of overweight couch potatoes.

Therefore the message promoted by the MCH Trauma Care & Injury Prevention Program is: “be active and play, but be informed and play safely.” In any of our public awareness campaigns, educational materials developed or the many media interviews given, the objective is always to make kids, teens, parents, coaches, teachers, municipalities etc. aware of the potential hazards, familiar with the recommendations, and encourage smart choices.

There is nothing more tragic than standing at the bedside of a permanently injured or dying child following a preventable traumatic injury, with a family laden with guilt telling you that “they never thought of or realized the potential risks”. The devastating effects of traumatic injuries have an impact on the entire family. As experts in trauma care, we see first hand the results of lack of knowledge, poor judgment, limited allocation of governmental resources, and of course immature attitudes of invincibility.

It is discouraging when I hear people express the sentiment that children are not allowed to take sufficient risks in their developing years and that their environment is being made too safe. If you look up the term “accident” in the dictionary you will find that it implies “an act of fate”. In reality most traumatic injuries are not “accidents” as at least 90% of them are preventable. 

Quite frankly, it seems irresponsible to conveniently ignore the fact that trauma is the leading cause of death & disability in children and teens. 

Many skeptics only realize the importance of: using a seatbelt, wearing a sport appropriate helmet, not buying a backyard trampoline, upholding a baby walker ban, or installing a fence with a locked gate around a home pool after experiencing a close call. Unfortunately when it comes to trauma not everyone gets a second chance to make a smarter choice!  

As a Trauma Centre our reality includes seeing;
  • a toddler badly burned while in a baby walker on wheels,
  • a 5 year old child having sustained a severe brain injury resulting from a fall from a bunk bed,
  • the faces of over 80% of participants in a car seat verification clinic who find out that the car seats are installed incorrectly
  • an injury while using a backyard trampoline resulting in a teen sustaining a spine fracture and coming within 2mm of being a paraplegic,
  • a baby dying in a car crash because he was in his mother’s arms and not restrained in a car seat, 
  • kids out on the toboggan hill ending up in the crash room with life-threatening brain injuries, or sustaining leg fractures or abdominal trauma after colliding full speed with an obstacle in an area that should not have been designated for this activity,
  • a 10 year old boy having sustained a serious eye injury resulting in significant visual deficits from a blow to his eye in a paintball range at a friend’s birthday party.

I could go on and on.

The point is that all of these and many of the other injuries we see on a regular basis could have been prevented. It should not take hundreds and in some cases thousands of cases to identify the risks involved. It is important to find intelligent ways to address the problem while still ensuring kids are not denied a healthy, active childhood. Injury data is not just provided to garner headlines; behind every statistic there is a child and a family with hopes, dreams and a future. Furthermore, not all serious trauma results in death. In fact with the excellent trauma care available today many survive but are left with life long disabilities, and require costly long-term interventions.  

Let’s face it, the Department of Public Health does not wait for 1,000 cases of meningitis before developing a vaccination program. It is time for preventable traumatic injuries to be treated seriously and not be simply dismissed as mere unfortunate “accidents”. Awareness, education, environmental changes, resources, and yes in some cases even legislation are important.

Debbie Friedman
Trauma Care & Injury Prevention Programs
The Montreal Children’s Hospital
McGill University Health Centre