Introduction: Television (TV) tipovers cause significant injury and death (1 fatality every 2 weeks) to young children, particularly to =2 year olds. The objectives of this study are to describe the experience with TV tipover injuries at Children’s Medical Center Dallas (CMCD) and to identify characteristic injury patterns that may help expedite treatment and improve patient outcomes.
Methods: An IRB approved, retrospective chart review was completed using records from the Trauma Registry of Children’s Medical Center Dallas, Dallas, Texas. Patients admitted between January 2000 and July 2012 with TV tipover-related injuries were included. Data collected were demographic (age, gender), initial GCS, length of hospital stay, injuries sustained, operative and radiographic procedures, presenting and discharge neurologic exam and discharge disposition. Charts were reviewed for specific details of the TV tipover event.
Results: An average of 8.69 patients/year with TV tipover injuries were admitted to CMCD, which is higher than reported by other institutions (0.78-5.20 patients/year) within a comparable time frame. Extensive head trauma caused the death of 5 patients (4.3%). Of 116 patients, 72 required neurosurgical evaluation. Fifty-five percent of those evaluated suffered an intracranial bleed and 96% had a skull fracture. Fifty-three fractures were skull base, of which 66% involved the petrous temporal bone requiring CTA/MRA for 25 patients. Seventeen (68%) patients imaged had arterial or venous injuries. Neurosurgery performed 4 craniotomies, placed 6 external ventricular drains and 2 lumbar drains.
Conclusions: Injuries from TV tipover events still cause significant morbidity and mortality in young children. We found that intracranial bleeds, skull fractures and skull base fractures and related sequelae (CSF leak, cranial nerve palsy, pneumocephalus and vascular injury) were injury patterns resulting from TV tipovers. Recognition of pattern type injuries within this mechanism may help practitioners expedite appropriate evaluation of the suspected injury and consulting and ancillary resources to best improve patient outcomes.
Patient Care: Recognition of pattern type injuries related to television tipovers may help practitioners expedite appropriate evaluation of the suspected injury and consulting and ancillary resources to best improve patient outcomes.
Learning Objectives: By the conclusion of this session, participants should be able to: 1) Describe the significance of injuries from television tipovers in the young pediatric population, 2) Identify characteristic injury patterns that result from television tipover events