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Unintentional injuries, suicide, and homicide were the leading causes of deaths among US individuals ages 10 to 24 years in 2017. Motor vehicle crashes are the leading cause of death by unintentional injury among US adolescents. Family physicians can encourage adolescent patients who drive to use safe driving practices (eg, seat belt use, cell phone-free driving, sober driving). Poisoning and drowning are the second and third most common causes of death by unintentional injury among adolescents, respectively. Suicide is the second overall leading cause of death among adolescents and is a growing problem. Depression is a risk factor. The Ask Suicide-Screening Questions (ASQ) suicide risk screening tool has been validated for use in patients ages 10 to 21 years in all medical settings. Screening, diagnosis, treatment, and follow-up of adolescent patients for depression and development of safety plans are key to suicide prevention. Homicides are the third leading cause of death among adolescents, and firearms are a clear contributor. Family physicians should assess adolescent patients for risk factors for violence, provide trauma-informed care, promote resilience and strong relationships with adults, and empower adolescents to use their strengths and skills to reduce their risk of involvement in violence.

Case 2. CD is a 17-year-old adolescent boy (pronouns: he/him) who presents today with his parents for a follow-up visit after a recent hospitalization after a motor vehicle crash. He was wearing his seat belt when he crashed his car into a light pole while driving the speed limit. Initially, CD was vague about the details of the crash; however, he later disclosed he was attempting to return a text message at the time of the incident. He did not require cardiopulmonary resuscitation, intubation, or ventilator support, but was treated for mild traumatic brain injury and a broken arm. He was released from the hospital after overnight observation.

Unintentional injuries, suicide, and homicide were the leading causes of deaths among US individuals ages 10 to 24 years in 2017 (Table 5).55 Community violence is another major factor in injuries and deaths in adolescents and young adults.56 Driven by developmental processes and social determinants of health, the prevalence of these causes of death varies by age, sex, race, and ethnicity. Table 6 provides a list of injury prevention resources for adolescent patients, families, and physicians.

CausePercentage of Deaths
Unintentional Injuries40.6%
Motor vehicle crash61.7%
Poisoning16%
Drowning7.1%
Suicide19.2%
Suffocation43.2%
Firearm43.2%
Poisoning6%
Homicide14.4%
Firearm86.9%
Cut/pierce6.3%
Unspecified2.6%
TopicOrganization/DescriptionWebsite
Motor vehicle crashesCDC,
Transportation safety, Distracted drivinghttps://www.cdc.gov/motorvehiclesafety/distracted_driving/index.html#prevent
Parents are the key to safe teen drivershttps://www.cdc.gov/parentsarethekey/
Parent-teen driving agreementhttps://www.cdc.gov/parentsarethekey/agreement/index.html
American Automobile Association, Teen driver safetyhttps://exchange.aaa.com/safety/teen-driver-safety/
Trusted Choice, New smartphone apps to protect your teen driverhttps://www.trustedchoice.com/insurance-articles/wheels-wings-motors/new-smartphone-apps/
Farm Bureau Financial Services, 5 safe driving apps to minimize distracted drivinghttps://www.fbfs.com/learning-center/5-safe-driving-apps-to-minimize-distracted-driving
AAP, Teen drivershttps://www.aap.org/en-us/about-the-aap/aap-press-room/campaigns/teen-drivers/Pages/default.aspx
PoisoningNational Capital Poison Centerhttps://www.poison.org/
DrowningWater Safety USAhttps://www.watersafetyusa.org/
Community violenceAAP, Community violencehttps://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/resilience/Pages/Community-Violence.aspx
CDC, Preventing youth violencehttps://www.cdc.gov/violenceprevention/youthviolence/fastfact.html
National Child Traumatic Stress Network, Trauma-informed carehttps://www.nctsn.org/trauma-informed-care
Gun violenceAAP, Gun violencehttps://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/child_death_review/Pages/Gun-Violence.aspx
APA, Gun violence preventionhttps://www.apa.org/topics/violence/gun-violence-prevention
CDC, Firearm violence preventionhttps://www.cdc.gov/violenceprevention/firearms/index.html

Unintentional Injuries

Motor Vehicle Crashes

Epidemiology.

Motor vehicle crashes are the leading cause of death by unintentional injury among US adolescents.57 Although the number of these deaths has been decreasing, motor vehicle crashes account for more than 2,500 deaths and more than 300,000 nonfatal injuries in US adolescents annually.58,59 Based on 2010 data, these incidents cost $26 billion annually.60

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