Faiqa Qureshi MD

Unintentional Childhood Injuries - What’s the big deal?

Unintentional Childhood Injury Mortality

Unintentional accidents are the leading killer of children <14 years age and are responsible for more deaths than all other childhood diseases combined.

Each year more than 4.5 million children are treated in hospital emergency departments

2/3 of these injuries occur in one environment

The Child’s own Home

Choking/Strangulation Each year approximately 873 children ages 14 and

under die from airway obstruction.

More than 19,000 children get treated in hospital emergency rooms for choking-related episodes

Majority of choking injuries are associated with food items: hot dogs, candies, nuts, grapes, carrots, and popcorn.

Choking/Strangulation Non-food items tend to be round in nature such as

coins, small balls, and/or objects that conform like balloons.

Half of all toy choking deaths involve balloons.

As a good rule of thumb: if it fits through a toilet paper tube - the toy is too small to be played with by a child less than 3.

Choking-what to do First make sure child is actually choking

If object seen remove it

If child less than 2 - alternate 5 back blows with 5 chest thrusts until object comes out or help arrives.

If >2 - abdominal thrusts

If becomes unresponsive start CPR, call 911.

Button Batteries Cause local corrosive injury resulting in perforations,

fistulas, strictures, VC paralysis

Larger lithium batters are more harmful

Severe burns can occur in 2-2.5 hours if lodged in esophagus or airway

Magnets Sold as bucky ball, neocube, etc…packaged in 100+

numbers

Adolescents – fake tongue piercing

Ingested magnets can stick together and trap and compress portions of bowel wall between them leading to ischemia, perforations, sepsis, bowel obstruction

Strangulation Window Blinds/Cords

No looped cords

Keep cribs away from windows

Bumper Pads

Strangulation by loose ties

Suffocation against soft pads

Entrapment between pads and crib

Older kids use them as ladders to

climb up and out of crib

Newer mesh products safer

Burns Each year over 100,00 children are treated for burn

injuries

Scald burns, especially those caused by hot foods, liquids, and steam in the kitchen among the most common burns in young children.

Noodle soup reported to cause a significantly longer hospital stay than other types of soup

Burns Turn down hot water heaters

Cover electrical cords

Supervise children in the kitchen

Burns-What to Do

Remove child from heat source

Immediately cool skin with lots of cool water

Do not put Vaseline or butter or any other home remedy on the burn

If blister or charred skin is present, cover burn with a clean dry dressing and seek medical care.

Fire Smoke and Carbon Monoxide Detectors

Ladders for 2nd floor

Fire extinguishers

Escape Plan

Drowning Drowning is the second leading cause of injury related

death among children age 1-4. Home swimming pools are the most common site for a

drowning between the ages 1-5. Children can drown in as little as one inch of water---

REALLY!!!! A caregiver claimed to be supervising the child in nearly 9

of 10 drowning related deaths

Drowning Prevention Secure pools with 4-5 foot unclimbable locking

fencing with latch. 4 sided isolation fencing around home pools could prevent 50-90 %

of childhood drownings and near-drownings.

Secure all bathrooms with toilets/ tubs

Never ever leave child’s side in tub

Move pet water bowl’s out of reach

Drowning-what to do Remove child from the water

Perform CPR

Call 911

Call your child’s doctor even if your child seems to recover completely.

Falls Falls are the leading cause of

accidental injury in children

Gates at the top of stairs must be hardware mounted

Falls - Windows Screens are designed to keep bugs out, not kids in.

Only open windows on upper floors if they have window guards or window stops that prevent opening greater than 3.5 inches

Falls-Balconies and Decks Space between bannister posts should be no more than

3 ½ inches apart (about same width of average size adult’s clenched fist.)

Falls-Kitchen Kids love to help in the kitchen.

Falls –What to Do Call 911 and try not to move your child if they are

unconscious but breathing.

If child acting unusual call your child’s doctor and seek medical attention.

Apply direct pressure to bleeding areas and seek medical attention.

Tip Overs

Toddler Killed When Dresser Falls On Him

“You can always fix a hole in the wall, but you can't fix a hole in your

heart”

-Brett Horn, father of 2 year old Charlie Horn

Tip Overs/ Televisions

Tip Overs/ Stoves

Poisoning More than one million children are unintentionally

poisoned each year by household and personal care products such as medicines, pesticides, vitamins, lead, plants, and carbon monoxide.

For every 10 poison exposures in children, approximately 9 occur in the home.

Many Things Look Alike Candy and medications

Juice and cleaners

Poison Tend to think of poisons as things that would look and

taste bad BUT…..

Many are pretty

Many taste good Some mouse poisons taste/smell like peanut butter.

Poisonings/ Medicines Approximately half of poisoning to children under 5

years old involve medicines.

Poisoning/Medication Very Dangerous (few doses fatal to 22 lb toddler)

Most Dangerous (One dose fatal to 22 lb toddler)

Blood Pressure medications

Clonidine (ADHD medicine)

Oral Diabetic Medicines

Lomotil (anti-diarrheal

Nose sprays/eye drops (Visine/Afrin)

Camphor

Tricyclic antidepressants (Imipramine/Desipramine)

Phenothiazines (Thorazine, Chlorpromazine)

Quinine

Chloroquine

Methyl salicylate

Theophylline

Poisoning/ Prevention Never ever transfer potentially harmful substances into

familiar containers!!!!

Keep cleaning supplies up high

Lock cabinets

Medications in childproof containers

Poisoning-What to Do Remove toxin/ medicine from child.

If exposure to eyes or skin immediately flush with copious amounts of water.

Call poison control.

Do not induce vomiting or give anything to drink unless advised by a professional.

If seeking medical attention, bring the poison’s container, even if empty.

Child Items to Please Take Back Baby Walkers

Each year there are over 21,000 ER treated injuries associated with baby walkers for children under 15 months of age.

Baby Bath Seats Gives you a sense that your baby is secure in the tub

Suction cups may pop up causing tip over

Plug in Outlet Covers Choking hazards

Sleep positioners

Child Items to Please Take Back Seat Belt Positioners

Interfere with proper fit

If too short for a regular

seatbelt then need to be

in booster seat with built in

belt positioner

No safety standards for

these add on items

Trampolines/ Hover boards

Conclusions Unintentional childhood injuries are the leading cause

of childhood morbidity and mortality

Child proofing the home and playground will prevent a vast majority of these injuries

Every parent/grandparent should know simple first aid maneuvers to treat any injuries until help arrives