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OBJECTIVE: To examine the prevalence of alcohol and/or other psychoactive drugs, such as marijuana and cocaine (AODs), involved in preteen trauma patients. METHODS: Toxicological testing results were analyzed for 1356 trauma patients aged 10-14 years recorded in the National Pediatric Trauma Registry for the years 1990-95. RESULTS: Of the 1356 patients who received toxicological screening at the time of admission, 116 (9%) were positive for AODs. AOD involvement increased with age. Patients with pre-existing mental disorders were nearly three times as likely as other patients to be AOD positive (23% v 8%, p < 0.01). AOD involvement was more prevalent in intentional injuries and in injuries that occurred at home. CONCLUSIONS: AODs in preteen trauma are of valid concern, in particular among patients with mental disorders or intentional injuries. The role of AODs in childhood injuries needs to be further examined using standard screening instruments and representative study samples. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To examine the epidemiologic characteristics and clinical outcomes of self inflicted pediatric injuries in relation to the method of suicide attempt. METHODS: Using data from the National Pediatric Trauma Registry Phase II, a comparative analysis was conducted for children under 15 years of age who were admitted from 1 October 1988 through 30 April 1996 because of self inflicted injury by firearm (n = 28), hanging (n = 38), or jumping from heights (n = 21). RESULTS: Of the 87 cases under study, 90% occurred at home, and 86% occurred between noon and midnight, with a peak in early evening (between 6 pm and 7 pm)-More than one quarter (29%) had preexisting mental disorders, such as disturbance of conduct and depression. Toxicological tests were conducted on admission on 40 (46%) of the patients; 20% tested positive for alcohol or other illicit drugs. The method of suicide attempt was associated with gender and age of the patients: 75% of the firearm cases and 82% of the hanging cases were boys compared with 29% of the jumping cases (p < 0.01); 79% of the hanging cases were aged 13 years or younger compared with 39% of the firearm cases and 48% of the jumping cases (p < 0.01). The mean injury severity score was 18.6 for the firearm cases and 16.3 for the hanging cases, significantly greater than 8.5 for the jumping cases (p < 0.02). Reflecting the differences in injury severity, firearm cases and hanging cases were more likely than jumping cases to be sent to intensive care units or operating rooms from emergency departments, and to develop complications during hospitalization. The case fatality rate was 50% for the firearm cases, 32% for the hanging cases, and 5% for the jumping cases (p < 0.01). On average, these patients stayed in hospitals for 11 days and 52% of those who were alive at discharge had at least one impairment in communication, cognition, or self care functions. CONCLUSION: Boys and older children tend to use more lethal methods in suicide attempts. Even in this age group, suicide attempts often involve psychiatric disorders and acute abuse of alcohol or other illicit drugs. Firearms are associated with significantly increased risk of inhospital fatality. The clinical outcomes of self inflicted injuries appear to be worse than other injuries treated in the same trauma centers. [ABSTRACT FROM AUTHOR]

Focuses on a retrospective review of medical charts on the wounds and injuries of children caused by toppling television sets. Outcome measure used in the study; Percentage of moderate to critical severity injuries of children; Average length of hospitalization.