- Knowledgebase: Child Safety, Injury Prevention and Treatment
- Questions about child safety and injury prevention, as well as treatment for minor injuries.
- 49. AAP: CHILDHOOD INJURY: IT'S NO ACCIDENT - Top
- I'm here to talk to you about ways to keep your children safe from injury at home, at play, and while riding in the car. You're here because you care about your child's well-being. I thank you for inviting me, and your children thank you for taking extra steps to ensure their safety.
Too often we feel powerless to stop our children from getting hurt. Each year, injuries claim more than 20-thousand lives among those under age 19. Nearly four-thousand children under age four lose their lives to unintentional injuries each year.
But don't worry... your child doesn't have to join those statistics.
The first thing you should know is that the medical community no longer uses the word "accident." That word implies that an event cannot be prevented. We now know that most childhood injuries CAN be prevented... and I'm here to give you the power to do just that.
The tips I'll tell you about come from the American Academy of Pediatrics. The Academy and Allstate Insurance Company developed this presentation through an alliance called the ALL KIDS SAFE campaign. That campaign is supported by a grant from the Allstate Foundation.
The American Academy of Pediatrics is an organization of 53-thousand pediatricians dedicated to the health, safety, and well-being of infants, children, adolescents, and young adults. The Academy has been a voice for children for more than 60 years.
Allstate has been an active advocate for safer homes, safer cars and safer lives for nearly 50 years... supporting things like better training for young drivers, the development of safer cars, and states setting safe speed limits.
The information you're about to hear is from experts, and based on research. That research is based on the experiences of parents just like you. Their experience teaches us one thing above all else. There is no substitute for adult supervision. An informed and alert parent or adult care provider can prevent a world of hurt for a child.
You should also be aware that safety tips can change depending on your child's age and development. You'll need to adapt some safety procedures to your infant, toddler, older child, or child with special needs. We call those procedures "child-proofing." And I'll provide you with a checklist you can take home with you, to "child-proof" each room in your house... and to keep your child safe during play and in the car.
II. Home
Let's begin our general overview of how to keep your children safe from injury with a look around our own homes. The potential for harm here can be greater than you think, but not difficult to prevent if you use the following advice.
Fire
To keep your children safe from fire, check your smoke detectors and make sure the batteries are working. Most fatal house fires happen at night, so smoke detectors are crucial "wake up" and warning systems to get your family out alive. Test your smoke detectors once a month to make sure they're working, and make it a habit to change smoke detector batteries every spring and fall when you change your clocks.
Do you have an escape plan ready in case of fire? If not, develop and practice an escape plan for yourself and your children. Ideally, you should have two escape routes from each room in case one is blocked by fire. Make sure your kids know and understand this saying... "Don't hide, go outside," in case of fire.
Have you heard the expression "fall and crawl?" That means get down on all-fours, beneath the smoke. Teach that to your children. Also tell them to feel doors before opening them. If a door is too hot, that means flames are raging right on the other side.
And remember that old stand-by... stop, drop and roll. That's what you and your kids should do if clothing catches fire. Children should cover their faces with their hands when they roll, and keep rolling until the flames are out. Practice it with your children.
Make sure younger children understand that firefighters are their friends and helpers, and not to hide from them.
Choose a safe place where you all can meet up once you're out of the house.
Buy a fire extinguisher for your home and make sure the adults in the home know how to use it properly.
Teach your children about the dangers of playing with matches or lighters.
And post emergency numbers where the whole family can get to them in a hurry.
All common sense ways to protect your child from fire... But what about protecting your child from getting burned where there is no flame?
Scalding
I'm talking about scalding... a very common type of burn for children. Do you know what the tap water temperature is in your home? If your water is at 140-degrees, your child can get a third-degree burn in just six seconds. So make sure and set your water heater no higher than 120-degrees. You can check your hot water temperature by holding a meat thermometer under the tap and letting the water run to its hottest.
Some hardware stores sell water temperature control devices for bathtubs and sinks. That's another step you can take to make sure your children don't get scalded.
Also, do you have cords dangling from appliances? What if your child tugged on a cord and pulled something hot down on top of him? The same goes for tablecloths. A tug from a child can end in scalding or other injury.
Always make sure you turn the handles of your pots and pans inward from the edge of the stove, so little hands can't reach them. Better yet, keep children out of the kitchen while you're cooking if you can.
And make sure and check the temperature of foods you cook and microwave, before letting your little one dig in. Food or drink that's too hot can easily scald an infant or child's mouth.
Poisoning
The kitchen is not only a place where we keep our food, it's a place where we keep cleaning products, and other items that can poison a curious child. Where do you keep your sprays and cleansers? Make sure to put them in high, out of reach, cabinets. Your child can get hurt playing in cabinets even after you've moved your poisonous products. So put cabinet locks on lower cabinet doors in kitchens and bathrooms. And never put poisonous or toxic products in containers that were once used for food.
Medicines that may be safe for you and me can be deadly for a child. Make sure you keep prescription and over-the-counter medications out of sight, and out of reach. Buy medicines that have child-resistant caps.
Did you know that some drugs become poisonous after their expiration date? Check expiration dates on your medicine. Throw away old medicine by flushing it down the toilet.
As I'm sure you know, children will put just about anything in their mouths... even peeling paint. Check your walls, blinds and window sills. Breathing in dust from chipped or peeling paint, or swallowing the paint chips, can put lead in your child's system.
If your child does ingest something poisonous, you want to be ready to take action. Ask your pediatrician about syrup of ipecac. The syrup can get rid of the poison by inducing vomiting. But you should never use it unless a pediatrician or the Poison Control Center advises you to first. Also, keep the phone numbers for your pediatrician and the local Poison Control Center on hand.
Cribs
Okay, you've made it through a long day of parenting, and your child is lying safely in his crib. But is that crib as safe as it can be?
Maybe you've got an old crib handed down from family-member to family member. Or maybe you've got your eye on a charming antique crib. Well hold on a minute before you put your baby down for a nap.
Does your crib meet current safety standards? Cribs should have slats that are no more than 2 3/8 inches apart. Any wider, and a baby's head could get trapped between the slats.
Be sure to read and follow all the instructions that come with a new crib.
Also, remove mobiles as soon as your child is able to push up on her hands and knees. She might get a hold of the mobile, and its parts could choke or strangle her.
Remove bumper pads as soon as your child can stand. (Refer to Slide) The parents of the little one in this slide should take those bumper pads out right away. Otherwise he might use the pads as steps, and push himself up and out of the crib.
And place your child's crib away from windows. Cords from window blinds and draperies can strangle your child. Make sure those cords are tied up high away from the crib. You want your child to be able to stand in her crib without putting her in reach of danger.
Walkers
From standing, to walking. Products like the one on the slide have replaced traditional walkers. Why? Walkers can lead to serious injury, and some evidence shows they may also hinder your child's progress learning to walk.
As far as injuries go, walkers can easily tip over when the child bumps into an obstacle, even one as small as a toy or a throw rug. Children in walkers are also more likely to fall down stairs and get into dangerous places that otherwise would be beyond their reach.
These new products let your child stand, but stay in one place at the same time. These are a better alternative to walkers.
Unintentional firearm injury
It sounds like common sense to keep firearms out of children's reach. But more than 5-thousand children and teens die each year from gunshot wounds. These injuries are almost always inflicted by the victim, a sibling, or a friend.
The safest course of action is to remove all guns from places where children live and play. But if you feel you must have a gun in your home, store it UNLOADED in a locked place, and keep the ammunition in a separate locked place.
You have control over how safe your child is in your home. But what about when your child goes over to a friend's house to play?
Make sure there's always a responsible adult present, and ask safety questions. You need to know if your child is at risk of injury in someone else's home.
III. Play
We've taken a broad look at safety in the home. Now let's head outside for a look at safety during play.
Drowning
Most children love the water. But each year in this country, more than 14-hundred children and teens drown.
Make sure your child learns how to swim as soon as he or she is old enough. Usually age 5 is a good time to learn.
The American Academy of Pediatrics does NOT recommend that children under four years of age take part in classes that claim to teach youngsters how to swim or be "water safe." A child under age three CANNOT be made "water safe." Kids this age just don't have the strength or judgment.
Even if you have children age three and older, never let them swim unsupervised.
But swimming isn't the only drowning danger a child faces. Don't leave your child alone in the bathtub, even for a minute. Toilets can also pose a drowning threat to small children, so it's best to keep the bathroom door shut when that room is not in use.
Most of us have buckets or pails around the house. But did you know that's a drowning danger for a child? Watch out for buckets and pails with even an inch or two of standing water in them. A curious baby or toddler can topple over inside a bucket and drown before you even know what happened.
Just in case a tragedy like this does occur, parents should know CPR, to breathe life back into their child. Contact your local hospital or American Red Cross chapter to find out about CPR classes.
Now, if you have a swimming pool, the first thing you should do is build a fence around that pool. Not just any fence... a fence at least four feet tall, with no opening in the fence greater than four inches wide. Make sure the fence goes all the way around the pool, and separates the pool from the house.
Make sure the gate is self-closing and self-latching, and that it opens away from the pool. A fence that meets these guidelines can keep wandering children away from the water.
Although a fence is the most important safety measure your family can take, you can do other things to make your pool safer.
Install an approved safety cover on your pool. Make sure and keep a long pole and Coast Guard approved flotation device at poolside. Keep a phone nearby as well, in case you have to call for emergency services.
If your child has a friend with a pool, make sure the proper safety steps have been taken before you let your little one swim there.
Bicycle Safety
You may remember the feeling of independence you had the first time you got on your bicycle. Even with training wheels, you felt a kind of freedom of movement you'd never known before. But that invigoration can lead a child into harm's way. That's where you... the practical parent... come in.
Many states already have laws mandating children and adults to wear bicycle safety helmets. (Refer to status in your own state.) You can set a good example by wearing a safety helmet yourself.
Children under nine years old should not be allowed to ride their bikes in the street. Have them stick to bike paths and sidewalks. And never let your child ride after dark.
By the way, no child under 12-months of age should ride on a bicycle with you. Children one-year to four-years old may ride in a rear-mounted seat as long as they wear a helmet. But don't try carrying your infant in a front-pack or back-pack. It's just not safe.
Pedestrian Safety
You can take steps to keep your child safe on foot as well as on wheels.
Did you know that more than half of motor vehicle-related deaths in school-age children are caused by pedestrian injuries? Children ages seven and younger always need supervision when crossing the street. They simply don't have the mental maturity to safely accomplish this task alone.
By the time your child turns seven, you should teach him safe street-crossing skills, and practice them with him.
Do you worry about your child darting out into the street? To prevent her from getting hurt, teach her to:
· Always stop at the curb, edge of the road, or at the outside edge of a parked car.
· Look left-right-left before entering the street.
· If a car is coming, wait until it passes, then look left-right-and left again.
· Cross the street only when the road is completely clear.
Make sure your child tells an adult exactly where he's going, that he's going with a friend, and that he has chosen the safest possible route... avoiding things like railroad tracks, construction sites, and remote areas.
And remember, children as old as 12 still need help crossing big streets with lots of traffic.
Toys
Of course, when we're talking about playtime, we can't forget toys. You may think it's up to the toy-maker to ensure the product's safety. That's partially true. But it's up to you to make sure the toy is right for your particular child… and that your younger children do not get their hands on your older children's toys.
The U.S. Consumer Product Safety Commission says that in 1996, there were about 140-thousand toy-related injuries in this country. There were also 13 toy-related deaths.
Here's a list of what to avoid:
You should never give an infant or toddler a toy with:
Parts that could pull off and/or fit into a child's mouth, nose, or ear
* Long ribbons or strings that could choke or strangle
* Exposed wires and parts that get hot
* Lead paint
* Toxic materials
* Breakable parts
* Sharp points or edges
* Glass or brittle parts
* Balloons
* Springs, gears, or hinged parts that could pinch or entrap tiny fingers
Make sure you read toy labels. Most will tell you at what age a child can safely play with the toy.
IV. Ride
Taking a child on a trip in the car can be fun and exciting for you and your little one. But as you know, a motor vehicle can be a dangerous place.
More children are killed and disabled in car crashes than from any other cause of injury.
Here are some suggestions for getting from point A to point B safely.
On every trip, no matter how short, make sure that you and your children buckle up. If you have an infant or toddler, make sure to use a properly installed car seat.
Car seats are the law in all 50 states. But 35-percent of children still don't ride in car seats. In many more cases, parents unknowingly use car seats incorrectly, putting their children at great risk.
Keep in mind that your child needs a special car seat depending on his weight.
For instance, a child weighing twenty-pounds or less needs an infant car seat, or a convertible seat that will adjust as the baby grows.
Remember to use rear-facing car seats until your child weighs at least twenty pounds and is at least one-year old. Some large infants reach twenty pounds before one year of age. Again, convertible, rear-facing seats are best for these children.
In fact, a convertible seat will suit your child from seven pounds to forty pounds.
For a child weighing more than 40 pounds, you should buy a booster seat.
If you have a child with special needs, you may need to buy a car seat designed to meet those needs.
Before you buy a car seat, practice using the seat in your car with your child. Make sure you're able to adjust all the harnesses and buckles correctly. The best car seat is one that fits your child and fits your car. The best seat is also one that you are comfortable with… and can use correctly every time your child is in the car.
Air Bags
If your car has airbags, you can feel confident that those airbags, together with properly used seat belts, could save your life in case of an accident.
But airbags and children don't always mix. If your car has a passenger air bag, a crash could cause that bag to inflate with enough force to cause serious injury, even death, to an infant or child... especially if that child is not properly restrained, using a seat belt or car seat.
So, never put a rear-facing child seat in the front seat of a car with an air bag.
Make sure all children are buckled up, no matter where they sit.
And remember... the back seat is the safest place for a child of any age to ride… especially children ages 12 and younger.
And of course, make sure you always use your seat belt as well.
You may be wondering if an air bag on-off switch is an option for you. The American Academy of Pediatrics believes that deactivating an air bag should be the exception, not the rule. By planning your transportation and your trips carefully, you should be able to avoid situations that would require turning off a passenger air bag.
There are certain, specific situations in which you could benefit from an on-off switch… such as:
· You must transport a child in a truck with no back seat.
· You must transport more children than can safely fit in the back seat.
· You must transport a child with a specific medical need that requires constant observation… and no one is available to sit with that child in the back seat.
Otherwise, the AAP recommends leaving the air bags intact and placing all children in the back seat.
Airline travel
Some of you may be wondering how to best protect your children during airline travel. Well those child safety seats can come in handy there too.
The Federal Aviation Administration recommends using a safety seat on airplanes. The F-A-A says car seats on planes provide extra protection for a child during turbulence.
But the F-A-A has banned the use of child booster seats and harness and vest type child restraint systems.
Tests show those particular seats don't adequately protect children on airplanes.
The F-A-A recommends children under forty pounds use approved safety seats just as they would in a car. And children over forty pounds should use the standard airline belt.
F-A-A rules dictate that children over age two sit in their own passenger seat.
Drinking and Driving
Back down on the ground, let's return to car safety for a moment. There's one more issue that we have to talk about. I'm sure you can guess what it is. That's right… drinking and driving. Vehicle crashes are the leading cause of death for teenagers and young adults.
On average, teens drink alcohol more than five days each month, according to a 1998 survey from the American Academy of Pediatrics. The survey also found that the more days per month teens drink, the higher the average number of drinks they consume each time.
And, the survey found that the more frequently teenagers drink, the more likely they are to have ridden in a car with someone who also has been drinking. Teens who drink six or more days during a month… are three times more likely to ride in a vehicle driven by someone who has been drinking.
If you have teenage children, here are some tips you can use to encourage your kids to drive, and ride, safely.
First off, once again you can set a good example by NEVER drinking and driving.
Then, establish "Good Driving Rules" for your teen, such as:
· Your child must maintain good grades in school in order to get a driver's license.
· A teen is four times more likely to killed while driving at night than during the day, so limit nighttime driving for first-year drivers.
· Until your teen has driven safely for a year, let him take only a few passengers at a time.
· Make sure your teen and whoever rides in the car with him use safety belts.
· Discourage any speeding or reckless driving.
· And let your teen know that you won't tolerate driving while drinking or using other drugs. Make sure your teen knows to choose a designated driver, and never to take a ride from someone who has been drinking.
If you suspect your teen has a drinking or substance abuse problem, urge him or her to talk with a pediatrician or school counselor. Trusted adults like these can refer your child for other help, if needed.
(Speaker - skip this section if your state already has graduated licensing, or replace it with a description of your state's graduated licensing law)
Another thing you should consider is graduated licensing. Most teens get their driver's licenses in two stages: a learner's permit… followed a few months later by a regular driver's license. The U.S. Department of Transportation recommends graduated licensing… so that learning to drive is spread over three stages. Each stage lasts at least six months, and if the teen meets certain requirements in that time, he gains more driving privileges.
Until our state passes a graduated licensing law, (Even though our state has graduated licensing) we, as parents, can create our own such rules at home. For example, if your child gets a learner's permit and goes through a six month period demonstrating safe and responsible driving, you could then allow him to drive at night… but still accompanied by a licensed driver. So you see… he is gradually learning to be a good driver and earning your trust, and you are gradually rewarding him with more privileges.
V. Conclusion
The rewards of parenting are many... as are the responsibilities. We are entrusted with the care and safety of our children. It's a daunting task, but you've probably realized, much of injury prevention is down-to-earth common sense. That, and being aware. So much of being a good parent is realizing that you have the power to prevent... to prevent harm, to prevent pain.
While you're thinking in a pro-active way about all the steps you'll take to keep your child safe, let me suggest another action you can take.
Monitor your state's laws. Make sure they protect children as well as adults. Seat belt laws, car seat laws, speed limit laws, drinking and driving laws... these laws have proven to save lives.
But less than twenty states have bicycle safety helmet laws. So you see we still have some work to do. (Refer to your state)
And not just at the state house. Consider the local emergency room for a minute. Did you know many emergency rooms don't have pediatricians on duty? Many don't even have the specific tools needed to treat children.
Children are not miniature adults. They have special physical needs and emotional requirements. If your child were sick or hurt, wouldn't you want expert emergency care on hand?
Find out what your local E-R has to offer, and where the nearest pediatric emergency room is. Make sure you know how to reach a poison control center in your area. Any preventive steps you can take now could save your child's life later.
I want to thank you again for the opportunity to give you a brief overview of injury prevention. I hope it will start you on your way to thinking about injuries differently, and realizing we can stop most of them before they happen.
They say that knowledge is a powerful thing. Now you've got the power to keep your kids safe. You're armed with the information I've given you, and the understanding that adult supervision is the best way to prevent injury.
Please keep in mind that you need to make sure your child-proofing efforts match the age of your child. Precautions you take for an infant will have to change as that child grows.
In the end, none of us is able to protect our children from every eventuality. But you came here to listen and learn, and you'll leave here with a safety checklist and hopefully a new mindset about injury prevention. Now you're better equipped to keep your children safe, at home, at play, and on their way. - Updated: March 5, 2001
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