Child's play

Many children are killed or injured unintentionally each year. Beverley Almeida and Philip Smith describe an initiative to tackle the problem

In 2004 about 230 children died as a result of unintentional injury in the United Kingdom. This is four times as many children as were killed by family abuse or neglect, and 12 times as many children as were killed by strangers. Unintentional injuries also cause more children to be admitted to hospital than any other cause. About 300 children and young people are admitted to hospital because of their injuries every day -more than 100,000 every year.

Unintentional injuries are clearly a serious public health problem, resulting in high mortality and morbidity, personal costs, and costs to society. In the 1990s, to reduce unintentional injury became a government target for the next decade. It was felt that by equipping children with appropriate skills and knowledge the number of deaths caused by these injuries might be reduced and the extent of an injury minimised. This remains a key health target today, with organisations such as the Child Accident Prevention Trust lobbying the government.

The Injury Minimisation Programme for Schools (IMPS) began in 1994 in response to the government's Health of the Nation document. It gives schoolchildren aged 10-11 years the opportunity to learn measures that prevent injury and basic life support skills. It was developed in Oxford by a group of healthcare professionals, but the scheme has been adopted by many institutions, including some in Bradford, Hull, Manchester, and Nottingham, and it has even crossed the world to Hong Kong.

IMPS is a registered charity, gaining income from fundraising activities, commercial services, and other organisations. The scheme's main goals are to reduce ill health, disability, and death caused by unintentional injury.

Programme overview

The current national school curriculum highlights the need for children to be aware of health risks and the prevention and minimisation of unintentional injury. IMPS is taught within the infrastructure of this curriculum. At 10-11 years old children are more likely to engage in risky behaviour but also have the cognitive and physical skills to gain most from the programme.

IMPS offers children the unique experience of being taught within both school and hospital environments, using an experiential child centred learning approach, linking prevention of unintentional injury to the national curriculum. It is designed as a three stage programme:

(1) A specifically designed resource pack for completion within schools

(2) A hospital based visit

(3) A formal evaluation for audit purposes.

In Nottingham, the trainers for the second stage have traditionally been paediatricians and nurses, but now include medical students. All trainers have been instructed on how to teach the programme in a fun and engaging way while it remains highly educational. Medical students are well placed to train these children as the programme conveys two important health messages that we are also taught during the course of our degrees-that is, how to prevent unintentional injury and what to do if one does occur-basic life support skills.

Enjoy a hospital visit

The children are taught a simple mnemonic to help them remember what to do in any situation: "One, two, three, A, B, C." One means check for danger; two means check whether the injured person needs your help; three means shout for help. And "A, B, C" is the fundamental and universal approach to resuscitation-airway, breathing, circulation. As well as participating in basic life support and cardiopulmonary resuscitation, the children watch an interactive video that shows common injuries to stimulate ideas about how to safely approach such an incident. The visit ends with a tour of the emergency department, where the children can apply the knowledge they have learnt, looking at x ray films and even having their fingers plastered.

Being an IMPS trainer is fun, educational, and allows us to express our enthusiasm for paediatrics. As medical students we are well qualified to be IMPS trainers, being medically trained, familiar with the hospital surroundings, and formally taught the basics of communicating with children. We also have much to gain from the experience, enabling us to converse with a subset of the population that we have limited exposure to, also allowing us to practise our own life support skills, which are often neglected during the course of our training.

IMPS's mission is "to develop a generation of children who as adult citizens have a different attitude to injury prevention and the immediate care of their neighbour." And the benefits have already been shown by reports of children saving lives because of the knowledge that they gained in IMPS training. Involving children in preventing and minimising injury can be viewed only as a positive intervention, which through the help of many different health professionals must continue.

We thank the IMPS coordinators Lynn Pilgrim, at Oxford, and Kathy Rosenburg, at Nottingham.

Competing interests: None declared.

For more information visit www.impsweb.co.uk.

       

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