CRJ-200 FLT CREW BEGINS TAXI BEFORE GND CREW SALUTE; STRIKE TOW BAR AND INJURE CABIN ATTENDANT.

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THE AIRPLANE WAS BEING PUSHED BACK. WE HAD JUST COME TO A STOP AFTER THE INITIAL PUSH. THE TOP OF THE STARTING ENG CHKLIST WAS COMPLETE -- ONLY ITEMS MISSING WERE 'PARKING BRAKE' AND 'ENG STARTED.' FOR NO PARTICULAR REASON THAT I CAN REMEMBER; I GOT DISTR AND THEN CALLED RAMP FOR TAXI; WHICH I DON'T NORMALLY DO UNTIL LATER IN THE CHKLIST. RAMP CLRED US TO TAXI. I THINK THIS RADIO EXCHANGE INADVERTENTLY TRIGGERED THE CAPT TO GO OUT OF SEQUENCE AS WELL. NOBODY PROMINENTLY VISIBLE IN FRONT OF US. THE RAMPERS WERE PROBABLY HUDDLED AROUND THE NOSE GEAR. THE CAPT STARTED TO ADVANCE THE THROTTLE AND BEFORE ANYBODY COULD DO ANYTHING; A NOISE WAS HEARD AND A BUMP FELT. WE STEPPED ON THE BRAKES; BUT IT WAS TOO LATE. THE AIRPLANE HAD MOVED A COUPLE OF FT FORWARD AND THE NOSEWHEEL HAD MOVED ON TOP OF THE TOW BAR. THE FLT ATTENDANT LAMENTED GETTING HURT IN THE BUMP. SHE CALLED THE PARAMEDICS AND AFTER TAKING CARE OF THE PAX WALLED HERSELF DOWN THE STAIRS AND TO THE AMBULANCE ABOUT 15 MINS AFTER THE ACCIDENT AND WAS TAKEN AWAY FOR CHKS. NOBODY ELSE SUFFERED ANY INJURY TO MY KNOWLEDGE. THE TRIGGERING EVENT WAS MY GETTING DISTR AND DOING SOMETHING THAT NORMALLY HAPPENS A FEW MOMENTS LATER. A CONTRIBUTING FACTOR WAS THE CAPT'S FAILURE TO MAINTAIN SITUATIONAL AWARENESS. I CANNOT RECALL ANYTHING THAT I MIGHT HAVE SEEN OR HEARD THAT CAUSED MY MOMENTARY LAPSE OF ATTN. THE WX WAS GOOD; WE WERE ON TIME; AND THE CREW GOT ALONG FINE. ELIMINATING THE OBVIOUS; THE ONLY OTHER POSSIBLE CONTRIBUTING FACTORS COULD HAVE BEEN MAYBE FATIGUE (EARLY WAKE-UP ON THE 4TH DAY OF THE TRIP) OR MAYBE STRESS DUE TO FAMILY RELATED EVENTS (A FUNERAL IN THE FAMILY) THAT POSSIBLY AFFECTED ME MORE THAN I THOUGHT. LESSONS LEARNED: 1) KEEP FOCUSED ALWAYS. 2) USE THE CHKLIST RELIGIOUSLY AND REPEAT IT IF NEEDED. 3) THROTTLES ARE OFF LIMITS UNTIL YOU SEE THE TUG; TOW BAR; AND THE SALUTE. 4) FATIGUE AND STRESS CAN BE SUBTLE ENEMIES -- BE SURE YOU ARE FIT TO FLY. 5) KEEP A MARSHAL IN FRONT OF THE PLANE WITH THE STOP SIGN UNTIL THE VERY END OF THE PUSH SEQUENCE.