Window falls and children: Lauren’s story

With a New Year’s Eve party a few hours away, Ruth Chi sent her 5-year-old daughter, Lauren, upstairs for a quick nap to ensure she’d have the energy needed later to ring in 2018.

Ruth had just turned her attention back to party prep in the kitchen when she heard yelling upstairs. Suddenly, her eldest son ran past her and into the adjacent backyard.

Lauren had fallen from her second-story window and landed on the concrete patio below. Her brother cradled her in his arms.

“I ran outside the screen door and saw my son hugging Lauren, who was on the ground,” Ruth says.

Crying only slightly, Lauren seemed miraculously unharmed. Ruth carried her daughter inside and examined her body from head to toe. She didn’t see any blood or notice any obviously broken bones. Lauren could understand her mother’s instructions, was responsive and could speak.

The only thing amiss that Ruth noticed were faint red marks on the side of Lauren’s body and a small bump on the right side of her head. Not wanting to take a chance, Ruth brought her daughter to closest emergency room despite Lauren’s protests that she might miss the party.

After a few tests and just 20 minutes or so, the team at the hospital prepared the family to be brought by ambulance to CHOC Hospital’s level II pediatric trauma center. Critically injured children from across the region are transported and transferred to CHOC for the pediatric expertise only a children’s hospital can provide. CHOC’s trained trauma team cares for children and their unique physiological, anatomical and emotional needs with protocols and equipment designed for pediatric patients.

At CHOC, Lauren and Ruth were met by a team of experts who performed more tests and scans. Lauren was the 22nd patient to be treated at CHOC that year for having fallen from a window. The following year, CHOC would go on to see 15 such patients, and in 2019, an additional 24 patients. And in the first 10 months of 2020, CHOC has treated 18 patients who tumbled from a window, says Amy Waunch, CHOC’s trauma program manager.

The no. 1 reason why children fall from windows is furniture placed below, Amy says – and that is exactly what happened with Lauren.

With warm weather a near constant in Southern California, Lauren opened her locked bedroom window. The curious 5-year-old climbed atop her bed and pushed her head against the window screen to survey a nearby park.

The window had a safety mechanism in place to prevent it from being opened too wide, but children can slip through gaps any wider than 4 inches, Amy says.

All those factors, combined with Lauren’s size and strength, allowed her to push through the screen and plummet out the window and onto the ground.

The most common injuries resulting from a window fall treated at CHOC are head injuries like skull fractures and intracranial bleeding, followed by extremity fractures, Amy says.

Lauren, however, seemed just fine. She and her mother passed the time waiting for test results by talking and playing games.

But the family received sobering news at about 9 p.m. that night, when Lauren was diagnosed with an epidural hematoma, a type of traumatic brain injury when blood builds up between the outer membrane of the brain and the skull. This can create pressure on the brain’s tissue and can be deadly.

Lauren would need surgery right away, CHOC experts told the family, who quickly agreed. Lauren was taken to the operating room.

After about an hour, Ruth and her husband were reunited with Lauren in the post-anesthesia care unit.

“She responded well when we talked to her,” Ruth recalls.

After a three-day stay at CHOC’s main hospital campus, Lauren and her family headed home.

After several neurosurgery follow-up appointments, Lauren began treatment with pediatric neurologist Dr. Sharief Taraman. Additionally, Lauren underwent neuropsychologic assessment to determine whether the injury affected her cognitive function.

Today, three years later, Lauren is a happy and healthy 8-year-old with no signs that she survived a near fatal accident. In fact, Ruth even needs to remind her fearless daughter to be careful sometimes.

And she’s not stopping with reminders. The furniture has been rearranged in Lauren’s room, and Ruth continues to caution her friends about the dangers of children and window falls.

“Never say never, I tell people,” Ruth says. “I never would have thought this would happen to me or my family or my daughter. It’s almost impossible. Well, it happens.”

Learn more about CHOC's pediatric trauma services

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5 ways to protect children from window falls at home

The combination of warming weather and children spending more time at home due to the COVID-19 pandemic prompts an important reminder for parents to protect kids from window falls.

In March and April 2020, the CHOC Trauma Center treated eight patients injured after falling from windows. By comparison, clinicians there treated three patients for window falls during the same time period in 2019.

“Forty-three percent of all trauma cases here at CHOC are related to unintentional falls, and of those, 35 percent were window falls,” says Amy Waunch, CHOC’s trauma program coordinator.

Window screens are no match for even a young child’s weight, and small kids can squeeze through openings as narrow as 4 inches. Any window higher than 6 feet from the ground poses a risk for serious, even fatal injury.

“Boys younger than 5 are at the biggest risk, and the peak age is 24 months,” says Amy Frias, a CHOC community educator and the Orange County coordinator for Safe Kids Worldwide.

With Trauma Injury Awareness Month underway, here are five tips from CHOC experts to help keep kids safe from window falls:

  1. Lock them down— Install removable window locks or guards to limit a window’s opening to no more than 4 inches. Be sure the device can be removed quickly by adults in case of an emergency. Keep windows locked when not in use.
  2. Open windows strategically – If your home has double-hung windows, which open from both the top and bottom, open just the top to prevent falls.
  3. Practice vigilance – If you open windows to let in fresh air, be mindful of closing and locking windows before you leave the room.
  4. Position furniture carefully – Keep beds, bookcases, chairs, play chests and other furniture away from windows so your child isn’t tempted to climb.
  5. Supervise, supervise, supervise – As with all injury prevention efforts, keeping an eye on kids is critical. As children grow, their abilities, strength, dexterity and curiosity grow too – and they may be able to outsmart your best-laid safety plans.

If your child does fall out of a window, call 911 and avoid moving your child. A traumatic injury to the head, neck or spine may not be immediately obvious.

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