Gary A. Smith

Bio: Gary A. Smith is an academic researcher from Ohio State University. The author has contributed to research in topics: Poison control & Injury prevention. The author has an hindex of 42, co-authored 226 publications receiving 6076 citations. Previous affiliations of Gary A. Smith include The Research Institute at Nationwide Children's Hospital & Boston Children's Hospital.

Incidence of pediatric traumatic brain injury and associated hospital resource utilization in the United States.

Abstract: OBJECTIVE: The goal was to examine the influence of sociodemographic characteristics and health care system factors on the utilization of hospital resources by US children Language: en

Firearm-Related Injuries Affecting the Pediatric Population

Abstract: * Abbreviations: AAP — : American Academy of Pediatrics NVDRS — : National Violent Death Reporting System The absence of guns from children’s homes and communities is the most reliable and effective measure to prevent firearm-related injuries in children and adolescents. Adolescent suicide risk is strongly associated with firearm availability. Safe gun storage (guns unloaded and locked, ammunition locked separately) reduces children’s risk of injury. Physician counseling of parents about firearm safety appears to be effective, but firearm safety education programs directed at children are ineffective. The American Academy of Pediatrics continues to support a number of specific measures to reduce the destructive effects of guns in the lives of children and adolescents, including the regulation of the manufacture, sale, purchase, ownership, and use of firearms; a ban on semiautomatic assault weapons; and the strongest possible regulations of handguns for civilian use. Although rates have declined since the American Academy of Pediatrics (AAP) issued the original policy statement in 1992, firearm-related deaths continue as 1 of the top 3 causes of death in American youth.1 As shown in Fig 1, the firearm-associated death rate among youth ages 15 to 19 has fallen from its peak of 27.8 deaths per 100 000 in 1994 to 11.4 per 100 000 in 2009, driven by a decline in firearm homicide rates.1 No single study has adequately explained the decline in firearm-related homicide rates. Postulated reasons include improved socioeconomic conditions, violence prevention programs, decline in the crack/cocaine market, changes in legislation, declines in firearms availability for other reasons, and community policing. Nevertheless, firearm-associated death and disability rates remain unacceptably high. FIGURE 1 Firearm-related death rates per 100 000 people 15 through 19 years of age in the United States, 1995–2009. (Adapted from National Center for Injury Prevention and Control, US Centers for Disease Control and Prevention. Web-Based Injury Statistics Query & Reporting System (WISQARS) Injury Mortality Reports, 1999–2009, for national, regional, and …

Wheelchair related injuries treated in US emergency departments

Abstract: Objective: To characterize the trend of wheelchair related injuries over time, and describe the demographics and characteristics of wheelchair users’ injuries by age group. Methods: Data from the National Electronic Injury Surveillance System (NEISS) were analyzed. Results: In 2003, more than 100 000 wheelchair related injuries were treated in emergency departments in the US, double the number reported in 1991. Tips and falls accounted for 65–80% of injuries across all age groups of wheelchair users. The majority of children’s injuries occurred at locations outside of homes and institutions/hospitals in environments with stairs, ramps, and curbs (57.3%). In contrast, injuries among adult users were more likely to occur in homes, hospitals, and institutions (45–90%). Conclusions: Wheelchair related injuries may have increased in the US during the past decade. Prevention efforts should address the interacting complex factors that influence risk of injury while using a wheelchair.

Prescription Opioid Exposures Among Children and Adolescents in the United States: 2000–2015

Abstract: OBJECTIVES: This study analyzes and compares exposures to prescription opioids among children and adolescents younger than 20 years old in the United States. METHODS: Data from the National Poison Data System for 2000 through 2015 were analyzed. RESULTS: Poison control centers received reports of 188 468 prescription opioid exposures among children aged CONCLUSIONS: Prescription opioid–related HCF admissions and serious medical outcomes were higher among teenagers. Contrary to trends for other prescription opioids, exposures to buprenorphine have increased in recent years; children aged 0 to 5 years accounted for almost 90% of buprenorphine exposures. These findings indicate that additional prevention efforts are needed.

American Society for Testing and Materials

Abstract: The American Society for Testing and Materials (ASTM) is an independent organization devoted to the development of standards.

Traumatic brain injury.

Abstract: In childhood, traumatic brain injury (TBI) poses the unique challenges of an injury to a developing brain and the dynamic pattern of recovery over time, inflicted TBI and its medicolegal ramifications. The mechanisms of injury vary with age, as do the mechanisms that lead to the primary brain injury. As it is common, and is the leading cause of death and disability in the USA and Canada, prevention is the key, and we may need increased legislation to facilitate this. Despite its prevalence, there is an almost urgent need for research to help guide the optimal management and improve outcomes. Indeed, contrary to common belief, children with severe TBI have a worse outcome and many of the consequences present in teenage years or later. The treatment needs, therefore, to be multifaceted and starts at the scene of the injury and extends into the home and school. In order to do this, the care needs to be multidisciplinary from specialists with a specific interest in TBI and to involve the family, and will often span many decades.

Traumatic brain injury-related emergency department visits, hospitalizations, and deaths - United States, 2007 and 2013

Abstract: PROBLEM/CONDITION: Traumatic brain injury (TBI) has short- and long-term adverse clinical outcomes, including death and disability. TBI can be caused by a number of principal mechanisms, including motor-vehicle crashes, falls, and assaults. This report describes the estimated incidence of TBI-related emergency department (ED) visits, hospitalizations, and deaths during 2013 and makes comparisons to similar estimates from 2007. REPORTING PERIOD: 2007 and 2013. DESCRIPTION OF SYSTEM: State-based administrative health care data were used to calculate estimates of TBI-related ED visits and hospitalizations by principal mechanism of injury, age group, sex, and injury intent. Categories of injury intent included unintentional (motor-vehicle crashes, falls, being struck by or against an object, mechanism unspecified), intentional (self-harm and assault/homicide), and undetermined intent. These health records come from the Healthcare Cost and Utilization Project's National Emergency Department Sample and National Inpatient Sample. TBI-related death analyses used CDC multiple-cause-of-death public-use data files, which contain death certificate data from all 50 states and the District of Columbia. RESULTS: In 2013, a total of approximately 2.8 million TBI-related ED visits, hospitalizations, and deaths (TBI-EDHDs) occurred in the United States. This consisted of approximately 2.5 million TBI-related ED visits, approximately 282,000 TBI-related hospitalizations, and approximately 56,000 TBI-related deaths. TBIs were diagnosed in nearly 2.8 million (1.9%) of the approximately 149 million total injury- and noninjury-related EDHDs that occurred in the United States during 2013. Rates of TBI-EDHDs varied by age, with the highest rates observed among persons aged ≥75 years (2,232.2 per 100,000 population), 0-4 years (1,591.5), and 15-24 years (1,080.7). Overall, males had higher age-adjusted rates of TBI-EDHDs (959.0) compared with females (810.8) and the most common principal mechanisms of injury for all age groups included falls (413.2, age-adjusted), being struck by or against an object (142.1, age-adjusted), and motor-vehicle crashes (121.7, age-adjusted). The age-adjusted rate of ED visits was higher in 2013 (787.1) versus 2007 (534.4), with fall-related TBIs among persons aged ≥75 years accounting for 17.9% of the increase in the number of TBI-related ED visits. The number and rate of TBI-related hospitalizations also increased among persons aged ≥75 years (from 356.9 in 2007 to 454.4 in 2013), primarily because of falls. Whereas motor-vehicle crashes were the leading cause of TBI-related deaths in 2007 in both number and rate, in 2013, intentional self-harm was the leading cause in number and rate. The overall age-adjusted rate of TBI-related deaths for all ages decreased from 17.9 in 2007 to 17.0 in 2013; however, age-adjusted TBI-related death rates attributable to falls increased from 3.8 in 2007 to 4.5 in 2013, primarily among older adults. Although the age-adjusted rate of TBI-related deaths attributable to motor-vehicle crashes decreased from 5.0 in 2007 to 3.4 in 2013, the age-adjusted rate of TBI-related ED visits attributable to motor-vehicle crashes increased from 83.8 in 2007 to 99.5 in 2013. The age-adjusted rate of TBI-related hospitalizations attributable to motor-vehicle crashes decreased from 23.5 in 2007 to 18.8 in 2013. INTERPRETATION: Progress has been made to prevent motor-vehicle crashes, resulting in a decrease in the number of TBI-related hospitalizations and deaths from 2007 to 2013. However, during the same time, the number and rate of older adult fall-related TBIs have increased substantially. Although considerable public interest has focused on sports-related concussion in youth, the findings in this report suggest that TBIs attributable to older adult falls, many of which result in hospitalization and death, should receive public health attention. PUBLIC HEALTH ACTIONS: The increase in the number of fall-related TBIs in older adults suggests an urgent need to enhance fall-prevention efforts in that population. Multiple effective interventions have been identified, and CDC has developed the STEADI initiative (Stopping Elderly Accidents Deaths and Injuries) as a comprehensive strategy that incorporates empirically supported clinical guidelines and scientifically tested interventions to help primary care providers address their patients' fall risk through the identification of modifiable risk factors and implementation of effective interventions (e.g., exercise, medication management, and Vitamin D supplementation). Language: en