Preventing childhood accidents

14 November 2018

First published December 2012

What is the best way to keep children safe from serious hazards and injury?

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Intended learning outcomes


This learning module focuses on what community practitioners can do to reduce the risks of serious accidental injury to young children. After studying this module and completing the self-assessment, you should:

  • Understand the links between the stages of child development and different safety hazards
  • Be aware of the hazards that pose the greatest risk of serious accidental injury
  • Know the simple steps that parents can take to keep their child safe from serious injuries
  • Gain confidence in raising safety issues with parents and carers at key developmental checks
  • Know where you and the families you work with can find resources, advice and guidance on accident prevention.

Minor injuries are common in childhood - they are a normal part of children growing up, testing out new abilities and exploring the world. However, every hour, four children under the age of five are admitted to hospital with more serious accidental injuries. 1 In 2010, 83 under-fives died following accidents.2

The real safety risks

Child accident prevention is not about wrapping children up in cotton wool; it's about protecting them from serious accidents - those which can hospitalise, disable or even kill. Some common accidents can have a lifelong impact on the child and their family, with falls from heights, burns and scalds, and road accidents all having the potential to cause disability and disfigurement.


Number of under-fives admitted to hospital every week following accidents

  • Falls – 308
  • Poisoning – 80
  • Burns and scalds – 42


Inequalities

There is a strong link between accidental injury and inequality: children from the most disadvantaged families are three times more likely to be admitted to hospital with serious accidental injuries and 13 times more likely to die in an accident.3,4

 

Stages of development

Parents are often taken by surprise when their baby or toddler learns a new skill, such as grabbing, rolling over or crawling. Practitioners who work with parents of young children can help to raise awareness of the biggest injury risks at different stages of a child’s development and provide clear, practical and accurate safety advice at each step.

 

 

1-6weeks

6 weeks -
6 months 

6 months - 1 year
& 1-3 years

Burns and scalds

Hot drinks can scald in seconds – put yours down before picking up your baby.                                                                   

Keep hot drinks, kettles and pans well away from curious hands

Put hair straighteners in a safe place to cool

Put cold water in the bath first

Choking

Babies can choke if they're propped up to feed - always hold them while feeding

Cut food into small pieces and keep small objects like coins out of reach

Drowning

Use just 5 cm of water at bathtime and never leave your baby alone in the bath

Supervise children near garden ponds and paddling pools

Falls

Take extra care when carrying your baby on stairs

Your baby could roll or wriggle off a raised surface - change nappies on the floor

Protect your child from falls by:

  • Using safety gates on stairs
  • Strapping them into their highchair every time
  • Using window locks/catches

House fires

Test your smoke alarms regularly. Plan and practice a fire escape route

Poisoning

 

 

Make sure tablets are kept out of reach

Keep cleaning products locked away

Road accidents

Use a car seat on every journey

Rear-facing child seats are safest - use one for as long as possible

Use a car seat that's appropriate for your child's weight, age and height

Encourage hand-holding or use walking reins/wrist straps when walking near traffic

Suffocation and strangulation

Babies can suffocate on duvets and pillows - save these until they're over
1 year old

Tie up blind cords so they can't cause strangulation

Keep nappy sacks in a safe place out of your baby's reach

 

Staying safe in the home
 

Nine out of ten parents of under-fives feel that their home is a very safe place for their child. However, many parents have low awareness of potentially serious risks to their children's safety and how those risks change as their child grows.5

Burns and scalds

Babies and young children are especially vulnerable to scalds because they have thin skin. Hot bath water is the leading cause of serious scalds. Injuries typically happen in the few seconds that a parent is distracted - a child might play withthe hot tap or fall in trying to reach a toy.

A mug of hot drink with milk, left standing for 10 minutes, can still scald a young child in less than 1.5 seconds. Many accidents happen when babies and toddlers grab at a mug left on a coffee table and spill the contents onto themselves.

Young children lack the reflex to pull away from a heat source, so to avoid contact burns they need to be kept away from hot cooker hobs, irons and hair straighteners. Hair straighteners can still burn eight minutes after being switched off.

Choking

Propping a baby up  to drink a bottle of milk is dangerous because if they choke, they can't push the bottle away.

Supervising young children while they're eating can prevent many food-related choking accidents, but it also helps to cut food into small pieces. And as young children tend to put  everything in their mouths, it's important to keep small objects like coins, buttons and cell batteries out of reach.

Drowning

A baby can drown in as little as 5 cm of water and it can happen completely silently. Young children should never be left without adult supervision when they're in or near water, whether it's a bath, garden pond or paddling pool.

Falls

Babies can suffer serious injuries from falls from relatively low levels; for example, by wriggling or rolling off a bed when left unattended for a moment. Accidents tend to happen very quickly and take parents by complete surprise.

Babies are natural explorers, so once they start crawling they need safety gates to protect them from falls on stairs. Babies who have learned to be cautious around stairs while crawling do not apply that caution when they start to walk - so safety gates are important later on too.

Young children have no concept of risk and can easily topple out of a highchair if they're not strapped in using a five-point harness. These falls commonly happen when the child pushes themselves up or reaches out for something.

Falling out of a window can cause severe injuries and even  death. Once a child has the dexterity to open a window, window locks or catches will help to keep them safe.

House fires

Children die quickly in house fires because they are easily overcome by the thick, black, toxic smoke that can spread within minutes. The most effective way to prevent death and injury from house fires is to have a working smoke alarm on every level of the home.

Poisoning

Babies and young children like to explore the world with their  mouths, so potentially  harmful  substances need to be kept out of sight and out of reach. Common causes of accidental poisoning are everyday painkillers, household cleaning products and 'liquitab' detergents. Child-resistant safety caps don't provide 100% security, so cupboard locks are a practical way to keep hazardous substances away from young children.

Suffocation and strangulation

As toddlers start to climb and explore their surroundings, they can get tangled up and strangled by blind cords. Tying up cords with a cleat means there is no hanging loop for the child to get caught in.

Nappy sacks pose a serious threat of suffocation if left close to a young baby - once the baby has developed the grasping reflex, they might be able to get hold of a nappy sack and pull it to their face, but not be able to let go or pull it away from their nose and mouth. Duvets and pillows shouldn't be used for babies under one for the same reason.


Home safety equipment checklist

  • Smoke alarms
  • Blind cord cleats
  • Cupboard locks/safety catches
  • Window locks/catches
  • Highchair with five-point harness
  • Anti-slip bath mat
  • Safety gates
  • Fire guard

Staying safe when out and about

Car seats for under-fives checklist

  • Use a car seat on every journey
  • Use a car seat that is right for the child's weight and size
  • Seats with ISOFIX attachments are easiest to install - check to see if you can fit one in your car
  • Use a professional fitting service if you can - they are offered by many reputable stores (Mothercare offer a free car seat fitting service in all stores across the UK)
  • Keep babies in rear-facing seats for as long as possible - ideally up to 13kg (15 months)
  • Avoid second-hand car seats, as damage from an accident may not be obvious

Being outdoors can be very exciting for young children but they can easily get into dangerous situations. Each week, six children under five are killed or seriously injured on Britain's roads, with most of these accidents happening to pedestrians.6

In-car safety

With so many options when it comes to child seats, in-car safety can be a confusing area for parents. Using a poorly-fitting child seat or one that's wrong for the child's weight and size will put them at greater risk of serious injury in the event of a crash.

Walking

Young children lack the understanding to deal with traffic, so always need to be supervised by adults when near roads. It is a good idea for parents to encourage hand-holding when out and about. Some parents find that walking reins or wrist­ straps are helpful too.

Young children copy how their parents and carers behave, so it's important for adults to set a good example by using crossings whenever possible. Parents should talk to young children about road safety, but not expect them to really understand or remember until they're older.

Engaging with parents and carers

Tips for effective engagement

  • Present information as a reminder, eg: 'Of course, at this stage, lots of babies do this... ' to show that you're not criticising or judging
  • Give simple, practical advice that people can build into everyday routines, eg: 'It's good to strap your child into their highchair every time, so they don't learn to push themselves out the moment your back is turned'
  • 'Drip feed' safety advice by offering it in context when an opportunity arises, eg, if you're having a cup of tea with a parent, mention why you're putting it down away from the edge of the table
  • Use surprising facts that grab attention, eg: 'Did you know that a hot drink, left standing for 10 minutes, can still scald a young child in less than two seconds?'
  • For parents with poor literacy, make use of picture-based resources

Parents and carers are highly motivated to keep their children safe from serious injury, but there area number of factors which can hold people back from taking the steps that will improve safety in the home and when out and about.

Understanding the barriers The barriers that parents face when it comes to preventing childhood accidents include:

  • Thinking that it will take time that they just don 't have
  • Not understanding what the biggest injury risks are
  • Feeling that accidents are inevitable
  • Not realising how quickly serious accidents can happen
  • Being taken by surprise by breakthroughs in their child's development.

Disadvantaged parents may face additional obstacles, such as not being able to afford safety equipment or living in overcrowded conditions where it's harder to keep  children safe. If they have poor literacy, they may find written information about child safety difficult to follow.

Three simple messages

You might find it useful to keep these three messages in mind when talking to parents and carers about child safety.

  1. You can build small, simple steps into your everyday routine to help protect your children from serious accidents - they'll quickly become second nature.
  2. Many of these steps cost little or no money and can easily fit into busy lives.
  3. Babies and toddlers often make sudden breakthroughs in their physical development - so stay one step ahead when thinking about safety in the home.

Using resources

You can use posters, displays, leaflets, booklets and DVDs to reinforce safety messages. Offering safety advice to parents in their own home is particularly effective - research shows that for families with an increased risk of home accidents, home visiting can reduce the risk of accidental injuries by more than a quarter.7

Accessing services

You may be able to refer low-income families to the fire and rescue service for a free home fire safety check, includingsmoke alarm fitting. If there's a home safety equipment scheme in your area, you may be able to refer them to that too. Reputable retailers can advise on child car seats.

Learn more about NMC revalidation here.

Reflection

This learning module should have equipped you with the knowledge you need to provide clear, practical and accurate advice to parents and carers about how to keep young children safe from serious accidental injuries.

Remember:

  • Child accident prevention is not about wrapping children up in cotton wool - it's about protecting them from serious accidents which can hospitalise, disable or even kill
  • Under-fives are at greatest risk of being seriously injured in an accident at home
  • There is a strong link between accidental injury in childhood and poverty and deprivation
  • The biggest injury risks are closely linked to a child's stage of development
  • Parents and carers need to stay one.step ahead of their child's development when it comes to preventing accidents
  • Parents and carers can protect children from serious accidents by building si;nall steps to safety into their everyday routines.

Did you achieve the intended learning outcomes?

Were any issues raised that contradict what you have previously been taught?

How will you apply what you have learned to your work in the community?

Are there any issues that you need to explore further?

 

Useful resources and further reading

The following resources will support you to continue developing your professional understanding of how to prevent serious accidental injuries in young children www.capt.org.uk

Safety advice for parents, plus accident prevention resources for practitioners who work with children and families. You can join the mailing list to receive a monthly email update about child safety issues www.capt.org.uk/shop/accidents-and-child-development Essential reading about the accidents that children have at different stages of their development and how to keep them safe without restricting their freedom and growth, plus more tips on how to engage with parents www.childsafetyweek.org.uk

Annual community education campaign, with free resources to help people run child safety activities and events www.makingthelink.net

Case studies and other resources for practitioners and policymakers involved in child accident prevention www.mothercare.com

For copies of free leaflets on car and home safety please email: health.visitors@mothercare.co. uk

REFERENCES

  1. HOSPITAL EPISODE STATISTICS. Emergency hospital admissions among children aged 0-4 years in England due to accidental causes. 2008-09.
  2. OFFICE FOR NATIONAL STATISTICS. Deaths registered in England and Wales in 2010. October 2011. Available at www. ons.gov.uk.
  3. HIPPISLEY-COX J, GROOM L, KENDRICK D, COUPLAND C, WEBBER E and SAVELYICH B. Cross sectional survey of socioeconomic variations in severity and mechanism of childhood injuries in Trent 1992-7. BMJ 2002;324: 1132.
  4. EDWARDS P, ROBERTS I, GREEN J and LUTCHMUN S. Deaths from injury in children and employment status in family: analysis of trends in class specific death rates. BMJ 2006;333:119.
  5. CHILD ACCIDENT PREVENTION TRUST. Survey for Child Safety Week 2012. Available at www. childsafetyweek. org. uk.
  6. DEPARTMENT FOR TRANSPORT. Reported road casualties Great Britain: Annual report 2011. September 2012. Available at www. dft. gov. uk.
  7. NATIONAL CHILDREN'S BUREAU. Home visiting and childhood injury. Highlight no.213. November 2004: Available at www. whatworksforchildren.org. uk.

Learn more about NMC revalidation here.

 

Image credit | iStock

 

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