Assessment of injury potential in pediatric bed fall experiments using an anthropomorphic test device

• Published in: Accident analysis and prevention 2013-01, Vol.50, p.16-24
• Main Authors: Thompson, Angela, Bertocci, Gina, Pierce, Mary C.
• Format: Article
• Language: English
• Subjects: Acceleration; Accidental falls; Accidental Falls - statistics & numerical data; Accidents, Home - statistics & numerical data; Analysis of Variance; Anthropometry; Assessments; Beds; Biological and medical sciences; Biomechanical Phenomena; Biomechanics; Child; Child abuse; Child Abuse - diagnosis; Craniocerebral Trauma - diagnosis; Devices; Humans; Infant; Injuries; Injury assessment; Injury prevention; Leg Injuries - diagnosis; Linoleum; Manikins; Medical sciences; Miscellaneous; Neck injuries; Prevention and actions; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Public health. Hygiene; Public health. Hygiene-occupational medicine; Risk Assessment - methods; Surface Properties; Thresholds; Victimology; Wood
• ISSN: 0001-4575; 1879-2057
• DOI: 10.1016/j.aap.2012.09.011

► We investigated head, neck, and extremity injury potential in pediatric falls. ► An anthropomorphic test device was used to simulate bed falls. ► The potential for severe head and extremity injuries in evaluated falls was low. ► Results suggest that concussion and humerus fracture are possible in these falls. ► Neck injury potential in pediatric falls should be investigated further. Falls from beds and other furniture are common scenarios provided to conceal child abuse but are also common occurrences in young children. A better understanding of injury potential in short-distance falls could aid clinicians in distinguishing abusive from accidental injuries. Therefore, this study investigated biomechanical outcomes related to injury potential in falls from beds and other horizontal surfaces using an anthropomorphic test device representing a 12-month-old child. The potential for head, neck, and extremity injuries and differences due to varying impact surfaces were examined. Linoleum over concrete was associated with the greatest potential for head and neck injury compared to other evaluated surfaces (linoleum over wood, carpet, wood, playground foam). The potential for severe head and extremity injuries was low for most evaluated surfaces. However, results suggest that concussion and humerus fracture may be possible in these falls. More serious head injuries may be possible particularly for falls onto linoleum over concrete. Neck injury potential in pediatric falls should be studied further as limitations in ATD biofidelity and neck injury thresholds based solely on sagittal plane motion reduce accuracy in pediatric neck injury assessment. In future studies, limitations in ATD biofidelity and pediatric injury thresholds should be addressed to improve accuracy in injury potential assessments for pediatric short-distance falls. Additionally, varying initial conditions or pre-fall positioning should be examined for their influence on injury potential.