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Injury Prevention Supplement February 2011 Volume 17 Supplement I 17 Injury Prevention I Volume 17 Supplement I Pages i1–i76 INJURY PREVENTION February 2011 Contents February 2011 Volume 17 Supplement I Supplement i34 The US National Child Death Review Case Injury prevention in child death review Reporting System T M Covington i1 Injury prevention in child death review i38 The burden of childhood injuries and evidence INJURY B D Johnston , T M Covington based strategies developed using the injury surveillance system in Pasto, Colombia i4 Injury prevention in child death review: child V Espitia-Hardeman , N N Borse , A M Dellinger , pedestrian fatalities E Desapriya , M Sones , C E Betancourt , A N Villareal , L D Caicedo , C Portillo T Ramanzin , S Weinstein , G Scime , I Pike i45 Assessment of caregiver responsibility in i10 Paediatric low speed vehicle run-over fatalities unintentional child injury deaths: challenges in Queensland B Griffi n , K Watt , B Wallis , for injury prevention P G Schnitzer , T M Covington , L Shields , R Kimble Prevention R L Kruse i14 History of maltreatment among unintentional i55 Developing effective child death review: a injury deaths: analyses of Texas child study of ‘early starter’ child death overview fatality review data, 2005–2007 S E Parks , panels in England P Sidebotham , J Fox , J Horwath , G Mirchandani , S Rodriguez , J Hellsten C Powell Supplement i19 Role of a child death review team in a small i64 Assessing and improving child death review rural county in California N Keleher , D N Arledge team recommendations S J Wirtz , V Foster , Injury prevention in child death review i23 Use of child death review to inform sudden G A Lenart unexplained infant deaths occurring in a i71 Collaborative process improvement to large urban setting S N Brixey , B C Kopp , enhance injury prevention in child death A E Schlotthauer , A Collier , T E Corden review B D Johnston , E Bennett , D Pilkey , S J Wirtz , i28 Analysis of paediatric drowning deaths in L Quan Washington State using the child death review (CDR) for surveillance: what CDR does and does not tell us about lethal drowning injury L Quan , D Pilkey , A Gomez , E Bennett This article has been chosen by the Editor to be of special interest or importance and is freely available online. Articles carrying the Unlocked Logo are freely available online under the BMJ Journals unlocked scheme. See http://injuryprevention.bmj.com/info/ unlocked.dtl This journal is a member of and subscribes to the principles of the Committee on Publication Ethics www.publicationethics.org.uk injuryprevention.bmj.com injuryprevention.bmj.com Downloaded from injuryprevention.bmj.com on January 31, 2011 - Published by group.bmj.com Injury prevention in child death review Brian D Johnston and Theresa M Covington Inj Prev 2011 17: i1-i3 doi: 10.1136/ip.2010.031161 Updated information and services can be found at: http://injuryprevention.bmj.com/content/17/Suppl_I/i1.full.html These include: References This article cites 23 articles, 21 of which can be accessed free at: http://injuryprevention.bmj.com/content/17/Suppl_I/i1.full.html#ref-list-1 Email alerting Receive free email alerts when new articles cite this article. Sign up in the service box at the top right corner of the online article. Notes To request permissions go to: http://group.bmj.com/group/rights-licensing/permissions To order reprints go to: http://journals.bmj.com/cgi/reprintform To subscribe to BMJ go to: http://journals.bmj.com/cgi/ep Downloaded from injuryprevention.bmj.com on January 31, 2011 - Published by group.bmj.com Introduction Injury prevention in child death review Brian D Johnston,1,2 Theresa M Covington3,4 1Harborview Injury Prevention The death of a child is always a shocking and tragic existing systems function more accurately or effi- and Research Center, Seattle, event. But as human communities pass through the ciently. Federal law mandates this function in the Washington, USA 2Department of Pediatrics, epidemiologic transition, infant and child mortality USA for CDR teams organised through child 8 University of Washington, declines to a point where these events are also protective services. Seattle, Washington, USA unexpected and perceived as fundamentally Finally, there is a tertiary function of CDR that 3 National Center for Child Death unnatural. Due to improvements in public health, can, and should, extend its scope beyond the Review, Washington DC, USA 4 immunisations, sanitation and basic medical care, historical purpose and typical membership of the Michigan Public Health Institute, Okemos, Michigan, most parents, in most parts of the world, can review team: a focus on prevention. In the mid to USA expect a child born in the early years of the 21st late 1990s, the US Maternal and Child Health century to attain maturity. Thus, when a child does Bureau and other national organisations called for Correspondence to die, it is both profoundly disturbing and very likely this broader focus for CDR and expansion of Dr Brian D Johnston, d 9 Harborview Injury Prevention to be sudden and unexpected the consequence of reviews to all potentially preventable deaths. The and Research Center, 325 Ninth violence, injury or another external cause. US Healthy People 2010 and 2020 goals include Avenue e Box 359774, Seattle, review by a child death review team of all deaths to WA 98104, USA; [email protected] FUNCTIONS OF CDR children under age 18 that are due to external Faced with a child death, communities are causes.10 Thus, today, most CDR teams in the USA Accepted 9 December 2010 predictably interested in understanding what have broadened their membership, are reviewing happened, especially for violent deaths of young deaths from many causes, and are asking “what children. Communities demand the assignment of could be done to prevent future deaths of this an accurate cause and manner, with any evidence of nature in our community?”. intentional injury or criminal neglect addressed by law enforcement. This is the first level of death CDR AND PREVENTION review: ensuring justice for child victims and safe- CDR remains an inherently local process, guarding their survivors. informed by understanding of local resources and The formal, multidisciplinary process of child contexts and drawing on the experience and death review (CDR) was developed in the USA in reason of local professionals. An effective CDR the late 1970s as a direct response to this most includes the sharing of case records from multiple basic task.1 Communities became concerned that sources to create an understanding of the circum- cases of inflicted injury and child homicide were stances leading to a child’sdeaththatwouldnot being overlooked or misclassified. They reasoned be captured or reported by any single source. In that a process promoting information sharing most cases, the desired end products are effective among social services, law enforcement, child recommendations and actions ‘to prevent deaths welfare, public health, and the medical examiner or and to keep children healthy, safe and protected’.4 coroner might reduce the risk of misclassified child To be clear, however, most CDR teams do not have abuse deaths.23National expansion of the CDR adequate resources to conduct public health process was justified on the basis of this ‘critical campaigns in support of prevention objectives. need for the systematic evaluation and case Their role is to accurately and completely under- management of suspicious child deaths’.1 As stand the circumstances and risk factors leading to a result, there is now a CDR process in almost child death in their community, and to suggest every US state and similar programmes in many likely points of leverage and catalyse actions other countries, including the UK, Canada, where interventions might be both feasible and e Australia, and New Zealand.4 6 efficacious. Verifying that the cause and manner of death Because the majority of unexpected deaths after were properly assigned can be viewed as a primary infancy are due to unintentional injuries or function of CDR, butdin most jurisdictionsdit is violence, the promise of CDR as a driving force in unlikely that this role, alone, would justify the time injury prevention has not been overlooked.11 CDR and effort expended by CDR teams. With the findings have been used to clarify cause, manner, development and implementation of infant death and intent of injury death12 and to identify low investigation protocols, the risk of missing abusive volume, high lethality injury mechanisms.13 In infant fatalities continues to decline.7 However, addition, CDR activity has kindled or supported there is a secondary function that naturally arises in injury related interventions across the spectrum of the CDR team: verifying that the agencies and prevention, from individual case management to institutions charged with child protection acted community education, organisational change, and appropriately to safeguard the child. In this func- policy advocacy.14 The strength of the system is its tion, agencies represented in the CDR process can specificity and inherent humanity; every death tells streamline information sharing, coordinate proto- a story. But this granular, local and case based focus cols, and troubleshoot lapses in oversight or can dilute the apparent impact of the process. communication. This process involves making Interventions and policies catalysed by CDR may Injury Prevention 2011;17(Suppl 1):i1ei3. doi:10.1136/ip.2010.031161 i1 Downloaded from injuryprevention.bmj.com on January 31, 2011 - Published by group.bmj.com Introduction never be recognised as such or systematically reported in the We also asked authors to consider the process of CDR. What published literature. enhances or hinders an effective role in injury prevention? Schnitzer et al grapple with a controversial aspect of many CDR GOALS OF THE SUPPLEMENT discussions, that of ‘preventability’. Could this child’s death In this supplement to Injury Prevention, we sought to capture have been prevented? As injury control practitioners, we’d like the nature and breadth of CDR activities as these relate to to answer yes in every case.
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