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Keeping Your Child Safe From Accidents

HCA image for child injuries Every year, there are always children who require medical treatment, days home from school, and/or rest due to accidents. Some children suffer some form of permanent damage due to accidents, such as brain damage from a head injury, long-term breathing problems from smoke inhalation, disfigurement from burns, or liver or kidney damage from poisoning.
Main causes include:
  • Motor vehicle accidents (with the injured child as a passenger, pedestrian, or bicycle rider)
  • Drowning
  • Burns
  • Choking, suffocation
  • Firearms
  • Falls
  • Poisoning

Motor Vehicle Accidents

Motor vehicle accidents injure children either when they are riding in a vehicle as a passenger or are hit by a vehicle when they are a pedestrian or a bicycle rider. Children who are not properly secured in car seats or booster seats are at particularly high risk.
Follow these tips to help keep your kids safe:
  • Use a properly secured car seat that is appropriate for your child's age, height, and weight. Carefully read the manufacturer's information to make sure that the seat is right for your child.
  • Make sure you know how to adjust and secure the seat. You can go to your local police or fire station or attend a car seat clinic to make sure you are using the seat properly.
  • Become familiar with the guidelines for safely traveling with your child. In general:
    • A baby should be in a rear-facing seat until they reaches the age of two or until they meet the highest height and weight limits for the rear-facing seat.
    • A child over two or a child who has outgrown a rear-facing seat should be in a front-facing seat that has a harness. When the child exceeds the height/weight limits for the seat, a booster seat should be used.
    • Continue to place your child in the booster seat until they are large enough to fit correctly into an adult seat belt. This is usually when a child is about 4 feet 9 inches (1.45 meters) tall and is 8-12 years old.
    • All children younger than 13 years should ride in the rear seat of the vehicle.
      • The backseat is the safest place for all children to ride. Never use a rear-facing car seat in a front passenger seat with an airbag.
      • Children under 13 should never sit in a passenger seat equipped with an air bag. If it cannot be avoided and your child has to ride in the front seat, turn off the airbag if possible.
  • Always use your own seat belt in order to keep yourself safe and provide a good model for children.
  • Teach your children how to carefully cross a street.
  • Your child should always wear a bike helmet when bicycling, riding a scooter or skateboard, or rollerskating/blading.

Drowning

Babies and toddlers often drown when unsupervised in the bath. Toddlers are also at risk for drowning in small quantities of water, including the amount in a cleaning bucket, a toilet, or a child’s wading pool. Preschoolers are at great risk when unsupervised around swimming pools or ponds. Older children are at risk when they do not know how to swim, are not familiar with water currents or water safety rules, or dive into shallow water.
What can you do to keep your kids safe?
  • Never leave children alone with any body of water.
  • Do not allow anyone of any age to swim alone. As the supervising adult, you should be within arm's length of children who are swimming. You should know how to swim, be able to rescue someone, and do CPR.
  • Have your child take swimming lessons. Remember that even a child who knows how to swim is still at risk for drowning and will need constant supervision.
  • A fence or barrier should completely enclose your pool or spa. All gates or doors leading from the house to the pool area should have a self-closing, self-latching mechanism that is above the reach of toddlers and young children. You may want to get a pool alarm or rigid pool cover in addition to the fence and gates.
  • If you use a lightweight, floating pool cover, be extra alert to the potential for drowning accidents. These covers do not keep people from falling in, and no one should ever crawl or walk on them.
  • Remove any obstacles to allow a full view of the pool or spa from the house.
  • Body parts and hair can be trapped in the pool drains. Be sure that the pool has drain covers or a filter system to release the suction.
  • Empty wading pools and buckets when you are done using them. Also, keep the lid on your toilet down and your bathroom door closed.
  • When swimming in open water, choose an area where there is a lifeguard and be aware of currents and undertow.
  • When the depth of the water is unknown, teach your children to go into the water feet first. Jumping or diving can result in injury.
  • Have your child wear a US Coast Guard-approved life jacket when you are at the beach or boating. Inflatable toys or arm bands are not lifesaving devices.

Burns

Younger children have a particularly high rate of scalding from exposure to hot water. Burn injuries also frequently occur when a child’s clothing catches fire.
To help keep you kids safe, follow these measures:
  • Make sure that your children sleep in fire-retardant sleepwear.
  • Keep your hot water temperature no higher than 120°F (49ºC).
  • Always carefully check the bathwater to make sure it is not too hot before you put your baby or child in.
  • Your house should have approved smoke alarms on every level in a main hall and in every bedroom; check the batteries every month.
  • Contact your local fire department to attend a fire safety course.
  • Plan an escape route for your family; consult with your local fire department regarding safety apparatus for your home.
  • Teach your kids to “stop, drop, and roll” if their clothing should ever catch fire.
  • Teach your children to never play with matches, candles, or other sources of flame.
  • Before your children start using playground equipment in the summer, make sure that it has not grown so hot in the sun that it could cause a burn.
  • Keep hot foods and liquids away from the edge of counters or tables where small children could reach them.
  • Gate off your cooking area so children cannot approach the stove.
  • Be sure that your electrical outlets have child-proof plugs. Make sure that toddlers do not chew on electrical cords.

Choking and Suffocation

Foods such as hot dogs, hard candy, grapes, seeds, popcorn, and nuts—especially peanuts—are common culprits in choking deaths. Small toys (tiny rubber balls), too-small pacifiers, and bits of balloons are also common choking hazards. Children also are at-risk for becoming entangled in the ties on hoods, the strings that control window blinds, toys strung across cribs, and cords used to attach pacifiers to clothing.
What can you do to keep your kids safe?
  • Do not feed toddlers grapes, hot dogs, hard candy, popcorn, nuts, or raw vegetables.
  • Make sure your children stay seated while eating.
  • Always supervise your child while he or she is eating.
  • Learn the Heimlich maneuver and CPR techniques appropriate for your children’s ages.
  • Purchase a "choke tube" which is used to test the size of small toys, objects, or pieces of food before you let your baby or toddler use them. Objects that are small enough to go through the choke tube can also pass into a child’s airway and obstruct breathing. Choke tubes can be found in many children’s stores and on the internet.
  • Never let your child chew on or mouth a balloon or medical gloves. Never leave your child unsupervised with a balloon.
  • Encourage your older children to use toys with small parts in a room that your younger children cannot access.
  • Do not dress your children in clothing with drawstrings at the neck, or hoods that tie.
  • Use a cord safety kit on all window blinds and curtains to prevent strangulation.

Accidents Involving Firearms

Firearms can cause death, severe injury, and devastation. Accidents occur due to accidental discharge of a firearm, as well as due to their use during the commitment of homicide or suicide.
To keep your kids safe:
  • Do not store firearms in your home.
  • Teach your children to call you immediately if they are playing at a friend’s home and there are firearms.
  • Teach your children never to touch or play with a gun, and to immediately report to an adult if they see any other child touching or playing with a gun.
  • If you must keep firearms in your home, store them unloaded in a locked location, with the ammunition stored in a separate, locked location; use gunlocks.
  • Take a gun safety course.

Falls

Falls are a frequent cause of injury in children. Babies are at risk of falling from furniture, down stairs, or due to the use of baby walkers. Both toddlers and preschoolers are at risk for falling from windows and shopping carts. Older children tend to receive injuries falling from playground equipment, bikes or scooters.
What can you do to keep your kids safe?
  • Do not use a baby walker.
  • Keep your child seated in the grocery cart’s safety seat and stroller, and always buckle the waist straps.
  • Do not allow children to play unattended or to stand on furniture close to windows.
  • Before your child begins to play on a playground, inspect it for safety and make sure that there is reasonably thickly padded surface (9 inches [23 centimeters] deep of loose fill or a specially-made rubber resilient surface) to cushion falls under all of the play structures.
  • Supervise your children closely at the playground.
  • Encourage your child to use developmentally appropriate playground equipment; your toddler may be able to climb the higher slide, but may not have the judgment to avoid an accident.
  • Your child should always wear a bike helmet when bicycling, riding a scooter or skateboard, or rollerskating/blading.

Poisoning

Poisoning in childhood is frequently due to household cleaning products, medications, vitamin supplements, plants, and cosmetics. Toddlers and preschoolers may be attracted to medications and vitamins because they resemble candy; cleaning products may look like sweet beverages; cosmetics may smell like fruit or candy. Because young children explore the world by putting things in their mouths, poisoning is a serious risk.
To keep your kids safe :
  • Keep the poison prevention center’s number next to your telephone.
  • Keep all medications, cleaning supplies, and cosmetics in a high, locked cabinet. Some common substances that children aged five and under swallow:
    • Medications (prescription and over-the-counter) and supplements
    • Cleaning products
    • Topical medications and ointments
    • Personal care products
  • Only buy medications and cleaning supplies with child-resistant caps.
  • Before you bring a plant into your home, check to see if it is poisonous if eaten; some common, popular plants are quite toxic, including holly, poinsettia, foxglove, and many others.
  • Kerosene, gasoline, and oil-containing furniture polishes are among the most dangerous household substances for children. If at all possible, do not keep these in your home.

Supervise, Supervise, Supervise

These safety tips are by no means exhaustive; those listed are only the most basic of safety rules. You will also notice that the most consistent rule across every category is close supervision: No safety efforts can substitute for careful, consistent adult supervision. The children who are most at risk for accidental injury or death are those children who are not well-supervised by adults.

RESOURCES

American Red Cross Health and Safety Services http://www.redcross.org

Safe Kids Worldwide http://www.safekids.org

CANADIAN RESOURCES

About Kids Health http://www.aboutkidshealth.ca

Canadian Red Cross http://www.redcross.ca

References

Dowd M, Keenan D, Bratton H. Epidemiology and prevention of childhood injuries. Critical Care Med. 2002;30:385-392.

Near-drowning. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php. Updated March 8, 2013. Accessed February 7, 2014.

Protect the ones you love: Child injuries are preventable. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/safechild/NAP/background.html. Updated April 19, 2012. Accessed February 7, 2014.

Safety for your child: birth to 6 months. HealthyChildren.org website. Available at: http://www.healthychildren.org/english/tips-tools/Pages/Safety-for-Your-Child-Birth-to-6-Months.aspx. Updated May 11, 2013. Accessed February 7, 2014.

1/13/2009 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Franklin RL, Rodger GB. Unintentional child poisonings treated in United States hospital emergency departments: national estimates of incident cases, population-based poisoning rates, and product involvement. Pediatrics. 2008;122:1244-1251.

4/2/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Saki N, Nikakhlagh S, Rahim F, Abshirini H. Foreign body aspirations in infancy: a 20-year experience. Int J Med Sci. 2009;6(6):322-328.

5/28/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Committee on Injury, Violence, and Poison Prevention. Policy statement—prevention of drowning. Pediatrics. 2010 May 24. [Epub ahead of print]

2/7/2014 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Car safety seats: information for families 2013. American Academy of Pediatrics website. Available at: http://www.healthychildren.org/English/safety-prevention/on-the-go/Pages/Car-Safety-Seats-Information-for-Families.aspx . Updated June 3, 2013. Accessed February 7, 2014.

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