Falls are risky for young and old
This story starts with a little girl chasing a cat.
It ends up in an emergency room, where 21-month-old Brianna Cruz was taken after falling two stories.
By the time Brianna’s father made it to the driveway, she was motionless and not breathing.
Brianna survived, but not before triggering a major dose of panic.
“When we were in the emergency room,” Brianna’s mother Beatrice Guerrier recalled, “I was so nervous I thought I would wind up in the bed next to her. I thought I was going to have a heart attack.”
Guerrier survived, too. But her daughter’s story underscores the anxiety produced by one of the most universal childhood problems.
Falls are the most common accidents in children age 14 and younger, and certain age groups are more prone to particular types of falls. Infants often sustain their injuries by falling off furniture, such as beds, couches or tables. Older children can hurt themselves on playground equipment.
Open windows pose a threat to toddlers.
Falls from windows are particularly dangerous and can be the most severe or fatal. It can take just 5 inches of open window to present a hazard.
The young are not the only age group prone to injuries from falling. On the other end of the spectrum are the elderly. Falls are the leading cause of injury deaths among older adults.
In 2005, almost 16,000 people age 65 and older died from injuries related to unintentional falls and about 2 million people in that age range were treated in emergency rooms for their nonfatal injuries from falls.
The consequence of falls in the elderly is particularly severe. “When a 40-year-old falls, he breaks his wrist,” said Dr. Selwyn O. Rogers Jr., chief of the Division of Trauma, Burns and Surgical Critical Care at Brigham and Women’s Hospital. “[But] when an elderly person falls, he can break his hip or suffer traumatic brain injury.”
In 2004, more than 320,000 seniors were admitted to hospitals for hip fractures, a number that is steadily increasing. More than 90 percent of hip fractures are caused by falling, and about 20 percent of hip fracture patients die within a year of their injury.
Furthermore, falls are the most common cause of traumatic brain injuries. According to the Centers for Disease Control and Prevention, in 2005, traumatic brain injuries accounted for 50 percent of deaths due to falls among the elderly.
By her own admission, Barbara Porter, 72, falls down a lot. Her balance is off because of a rare neurological condition called Chiari malformation in which brain tissue intrudes into the spinal canal. Some people have no symptoms at all, but in Porter’s case, she is often dizzy and unsteady on her feet.
“I do fall quite a bit,” she said. “I’ve fallen in my house, outside, especially on curbs. I fall everywhere. I even fell in the grocery store.”
Fortunately, Porter has not suffered any serious injuries from her falls. “But it’s embarrassing,” she said.
A retired Boston Medical Center nurse, Porter said she has high blood pressure and diabetes. And things got worse after she stopped directing community workshops for the Boston Public Health Commission and Massachusetts Department of Public Health.
“Once I stopped working, my physical and mental health began to go downhill,” she said. “Cardiovascular disease is a killer in my family. I have to be aware of it.”
She walks with a cane, and says she needs it most often when stepping off curbs or standing for a long period of time.
To improve her condition, Porter has joined Fit-4-Life, a program sponsored by Kit Clark Senior Services and the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University. The program is designed to reduce disability and other medical conditions prevalent among seniors. It also works to prevent falls and injuries that occur among the elderly.
Porter exercises to improve her strength, balance and coordination.
The good news is that the program is working. Since enrolling in the program six weeks ago, Porter said she hasn’t fallen once.
“I know I will never be 100 percent,” she said, “but I can get better.”
And she is determined to work on balance.
“There is still one test I cannot do yet,” she explained. “You’re supposed to stand with one foot directly in front of the other for at least three seconds. I can’t do that yet.”
Balance was not a problem for 21-month-old Brianna.
Her mother proudly says Brianna is a climber and has already learned to push doors open.
Such was the case with the door leading to the family’s second-floor porch. “I always keep it locked,” Guerrier said.
Unfortunately, Brianna’s father didn’t know the extent of Brianna’s curiosity.
Their porch does have barriers to prevent children from falling, but Brianna’s father had placed stereo speakers outside. When Brianna’s kitten ran onto the porch and climbed atop the speakers, so did Brianna.
By the time her father noticed Brianna had disappeared, she had already fallen two stories. Panicked, he rushed to the driveway and carried his lifeless daughter to her bedroom. He immediately called 911, and by the time they arrived, Brianna had started to breathe again.
The emergency crew took Brianna to nearby Brockton Hospital, but she was transferred to the Boston Medical Center because of the extent of her injuries.
According to Guerrier, she had swelling and bleeding of the brain.
She was initially in intensive care, but because she made a quick recovery, was transferred to the regular pediatrics ward. Two weeks later, she was transferred to Franciscan Hospital for Children, where she received physical, occupational and speech therapies. She was discharged nine days later.
“She is back to where she was before,” Guerrier said. “She is talking a lot again and singing. All that’s noticeable now are scratches on her face and elbow.” |
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Beatrice Guerrier (left) sits with her daughter, 21-month-old Brianna Cruz, who fell from her second-story porch. Falls are among the most common accidents and causes of serious injuries in toddlers.
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Barbara Porter participates in Fit-4-Life, a program sponsored by Kit Clark Senior Services and Tufts University to improve strength and balance.
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