Identifying Unintentional Injury Risks Among Patients Visiting a Pediatric Urgent Care

Elizabeth C. Lendrum, MD
Kristen Peterson, MD
Mike A. Gittelman, MD
Melissa D. Klein, MD, MEd
Wendy J. Pomerantz, MD, MS
Andrew F. Beck, MD, MPH

Injury is the leading cause of death and disability in US children >1 year of age, with highest risk among lower socioeconomic families who also frequently visit urgent care (UC) settings. Limited data exist assessing unintentional injury risks in patients presenting to UC settings. The aim of this study was to characterize injury risks of children aged 1-5 years presenting to an urban pediatric UC and determine associations between risks and sociodemographic characteristics of presenting patients.

This was a cross-sectional study that surveyed guardians of patients aged 1-5 years who presented to the UC of a freestanding children’s hospital between 9/21 and 11/21. The tablet-based survey included a standardized screening tool [Safe Environment for Every Kid] assessing unintentional injury risks. Guardians ?18 years of age who lived with the patient >4/7 days per week were included. Guardians whose primary language was not English or were unable to read the survey were excluded. The number of unintentional injury risks were tabulated. Our primary outcome was the number of positive responses to unintentional injury risk questions (?3 vs 1-2 vs 0). Assessed sociodemographic characteristics included race/ethnicity, patient age, insurance status, and neighborhood deprivation index, calculated from census tract-level socioeconomic measures linked to the child’s geocoded address (index range 0-1, higher indicates more deprivation). Frequencies were calculated; associations were assessed using Chi square, ANOVA, and Pearson’s correlation test statistics.

A total of 152 Guardians (50% non-Hispanic Black, 90.8% female, 87.5% biological mother) were enrolled. Nearly all (92.8%) reported ?1 injury risk; 56.6% identified ?3 injury risks. No significant differences were identified based on patient age, race/ethnicity, insurance type, or guardian age or race. Home and car seat safety concerns were the most common unintentional injury risks. There was no difference in injury risk between those who presented to UC with an injury and those who presented for other reasons. There was a significant correlation between more injury risks and a higher deprivation index (p=0.03, r=0.177).

Unintentional injury risks are high among young patients seeking care in an UC, and most guardians endorse multiple risks. Identifying unintentional injury risks through screening may allow for tailored education and resource provision in the UC setting.

1) Unintentional injury risks are high among young patients visiting an urgent care
2) Unintentional injury risks at an urgent care were higher than what has been previously reported in primary care settings
3) Routine screening for unintentional injury risks in the urgent care setting is warranted