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A Comprehensive Approach to Pediatric Injury Prevention in the Emergency Department

Zonfrillo, Mark R. MD, MSCE*; Melzer-Lange, Marlene MD; Gittelman, Michael A. MD

doi: 10.1097/PEC.0000000000000070
Review Article

Injury is the leading cause of pediatric mortality and long-term disability. Although the primary care setting has traditionally been considered as the main venue to address injury anticipatory guidance, an emergency department (ED) visit may serve as a “teachable moment” because most injured children are cared for in this setting and the experience may elicit a greater chance of behavior change. However, EDs can also provide additional information and services beyond counseling to prevent injuries. These adjunct efforts and activities focus on primary injury prevention (screening for and promoting safe behaviors and collecting data to survey high-risk community locations), secondary prevention (use of safety products to mitigate injury), and tertiary prevention (maximizing injury care and minimizing injury sequelae). This review will describe several ways an ED can help to mitigate the epidemic of pediatric injuries through surveillance, screening, education, product disbursement, community engagement, and quality improvement efforts.

From the *Division of Emergency Medicine, Center for Injury Research and Prevention, The Children’s Hospital of Philadelphia, Philadelphia, PA; †Division of Emergency Medicine, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI; and ‡Division of Emergency Medicine, Comprehensive Children’s Injury Center, Cincinnati Children’s Hospital, Cincinnati, OH.

Disclosure: The authors declare no conflict of interest.

This study was presented in part at the 2012 American Academy of Pediatrics National Conference and Exhibition and at the joint program of the Section on Emergency Medicine and the Council on Injury, Violence, and Poison Prevention.

Reprints: Mark R. Zonfrillo, MD, MSCE, Division of Emergency Medicine, Children’s Hospital of Philadelphia, 34th and Civic Center Blvd, Philadelphia, PA 19104 (e-mail:

© 2014 Lippincott Williams & Wilkins, Inc.