Home SafetyManual

forPublic Health Nurses

NEW YORK STATE DEPARTMENT OF HEALTHALBANY, N. Y.

EDWARD S. GODFREY, JR., M.D., COMMISSIONER1943

CONTENTSPage

Foreword 1Accidents vs. Disease 2Home Accidents in New York State 1942 3Teaching Home Safety 4

Methods of Approach

Faulty Design of the House 5Disrepair or Neglect of Maintenance 6Dangers in Wiring and Electrical Appliances 7-8Lack of Skills 9Poor Housekeeping and Disorder 10Poor Habits and Attitudes 11Protection for Children 12-15Protection of the Aged 16-17Personal Factors Which Predispose to Home Accidents 18

Teaching DevicesSuggestions for Use 19Common Home Hazards—Check List 20Family Safety Council 21Cartoons 18, 19, 22-23

Organization and Group TeachingCommunity Safety Program 24Organization of Home Safety Conference 25Training Available in Home and Farm Accident Prevention 26Educational Material for Use in Home and Farm Safety Programs 27References 28-^29Suggested Outline for Home Safety Discussion 30Suggested Home Safety Pledges 31Organization Chart of National, and New York State Home and

Farm Safety Work 32

FOREWORDHome accidents in New York State exceed, by more than one third,

motor vehicle accidents which are five times as frequent as are occupa-tional accidents.

An accident is an unforeseen, unpremeditated event, but not un-preventable.

Industry has foreseen many of its accident hazards and has usedmechanical safeguards together with the education of employees to com-bat accidents in the plant. Extensive education combined with effectivelegislation had helped to reduce motor vehicle accidents even beforedriving was curtailed.

Accidents in the home and in connection with farming, however, havehad very little attention. The mounting fatalities finally have arousedthe Nation. Concurrent with the organization of the national program,New York State set up a program under the leadership of the Divisionof Public Health Education of the State Department of Health. (Seechart of national and state organization on page 32.)

The main objectives of the state program are:1) To call attention of the public to the seriousness of the home

and farm accident situation2) To mobilize strong forces to combat home and farm accidents

through widespread education3) To provide materials, program aids, and a field service for the

promotion of education in home and farm safety.The war has emphasized the seriousness of accidents since they reduce

manpower which is needed for the production of materials and food.More than twice as many workers are killed in their homes as in theiroccupations. Accidents in the home as well as accidents in the plantsabotage the war effort.

Within the next year, in New York State, at the present rate, an acci-dent will occur in every seventh home and among the many who areinjured more than 3,000 will surrender their lives needlessly.

As a guide to the educational approach we find that home accidentsmay be classified under six major headings: (1) Faulty design of thehouse; (2) Disrepair or neglect of maintenance; (3) Poor housekeep-ing and disorder; (4) Lack of skills—not knowing how to do things;(5) Poor habits and attitudes; (6) Failure to protect children, the aged,and the handicapped.

Public health nurses accustomed to control disease by means of immu-nization, will realize that the only immunization against accidents iseducation. Widespread instruction and discussion are needed in schools,among organizations and with housewives in the homes. Although manyindividuals and agencies are at work in the field of home safety thedirect approach to the home can best be undertaken by the public healthnurses. It is hoped that this manual will be of assistance in outlining theapproach both to the home and to the community.

Burt R. Rickards, DirectorDivision of Public Health Education

2

Accidents vs. Disease(NEW YORK STATE, 1941)

ONLY 3 DISEASES KILL MORE THAN ACCIDENTSAGES 2 TO 24—Accidents kill more than any diseaseAGES 2 TO 34—Accidents kill more males than any disease

AGES 1 TO 4Accidents most Important cause ofdeath. Pneumonia was second—onlythree fifths as many deaths as acci-dents.

AGES 5 TO 9Accidents most important cause ofdeath—four and one-half times asmany deaths as heart disease, ,thesecond cause.

AGES 10 TO 14Almost twice as many deaths fromaccidents as from the second cause—heart disease.

AGES 15 TO 19Accident deaths most numerous.Tuberculosis was second—only threefifths as many deaths as accidents.

BOTH SEXES - ALL AGES

RATE

HEART DISEASE

CANCER

CEREBRAL HEMORRHAGE

ACCIDENTS

I NEPHRITIS

TUBERCULOSIS

PNEUMONIASOURCE NEW YORK STATE DEPARTMENT OF HEALTH. DEATH RATES PER 100,000 POP

3

1942 DEATHS FROM ACCIDENTSNEW YORK STATE

TOTAL .7994

NUMBER

HOME ACCIDENTS'

MOTOR VEHICLE

OTHER' PUBLIC

OCCUPATIONAL

TYPE NOT STATED

INCREASE OF 146 OVER 1941

Home Accidents in New York State—194265 Years

andOver

2,0661,745

134122

2.45

54

AllAges

Total 3,471Falls 2,258Conflagrations, burns,

explosions 425Poisonous gas 313Mechanical suffoca-

tion 118Poisoning 63Firearms 31Unclassified 263

Under 5Years307

40

694

10811

75

5-14Years

101

13

406

159

27

15-24Years

62

13

1218

114

13

25-44Years323

104

8155

4259

45

45-64Years612

343

89108

2174

49

4

TEACHING HOME SAFETYAn Opportunity of Importance for Public Health NursesThe prevention of home accidents is a public health problem and as

much a responsibility of the public health nurse as the prevention ofdisease. The homes of New York State produce more deaths fromaccidents than from all other sources, and the greatest toll is taken fromamong our young children and our old folks, the two groups we Ameri-cans take pride in protecting. The continuous story of death and oftemporary or of permanent disability from accidents with all the by-prod-ucts of physical pain, misery, and economic loss is doubly shockingwhen it is known that the tragedy in the story need never have been.

Concerted action is being made to attack the entire problem with abroad community program. Each of us will be able to help in promotingsuch a program and to assist in many ways. Our public health nursingcontribution per se, however, lies in the homes which come within thescope of our influence. It is our part to know that each family hasreceived information and motivation concerning home safety which willaccomplish three things: (1) Arouse a consciousness of the problem;(2) Bring about the correction of existing hazards; and (3) Create thedesire to develop new habits which will prevent injury to themselves andothers. Just as using the brake of an automobile becomes a habit aftersufficient practice, so one may become practiced in observing, correcting,and best of all preventing conditions which may be sources of danger.

The starting point might well be with the nurse herself. She mustknow facts about accidents, their causes and prevention, and she mustkeep her interest alive with pertinent, current information which canbe obtained in abundance through newspapers, magazines, safety litera-ture, or personal experience. She must train herself to become sensitiveto conditions so that she never will fail to observe potential hazardsquickly and accurately. She must herself develop safe work habits—useof the right tool, never to climb on anything unsafe, to make small rugsnonskid, and in brief to learn to do what she would have others do. Asher knowledge of skills develops she will be gathering a wealth of eco-nomical and practical ideas and possibly some intriguing gadgets to aidher in her teaching of others. Who does not like to know of new waysof doing things, where otherwise they might not be receptive to criticismof housekeeping methods?

The results of self-learning and of teaching should be capable ofmeasurement. No preventable accident should be sustained by the nurseherself, and at least a reduction of such accidents should be demonstratedin homes where she has given instruction.

Knowledge of her subject, powers of observation, the ingenuity tooffer economical and practical solutions to existing problems and theability to help others to help themselves are the well-known tools of thepublic health nurse. They have aided her in doing her part in savinglife from diphtheria and from enteritis in infants. There is every reasonto believe that these same tools will be effective if applied to the prob-lem of preventing accidents in the homes of our State.

Marion W. Sheahan, DirectorDivision of Public Health Nursing

5

METHODS OF APPROACH

FAULTY DESIGN OF THE HOUSE

Type and HazardStairs

Faulty con-struction

Steps

Not observed

StairwaysInsufficient over-head clearance

Stair RailsFaulty con-struction

LightingInsufficient light

Accident

Fell and fractured clav-icle because stairs wereuneven in height

Fell, fractured ankle boneon step to lower levelroom

Struck head, severelybruised on overhangingbeam

Badly bruised in plung-ing down stairs when lostgrasp on handrail

Fractured hip in fall overdark step

Prevention

Stairs should be uniform,straight, not winding. Hand-rails provided.

Plan all rooms on same level.Provide railing. Have stepslighted. Paint last step white.

Have a light installed. Sus-pend cardboard or otherobject to warn. Paint beamwhite.

Have stair rail right heightand size. Provide lower railfor children.

Have switch at top andbottom of stairs.

Storage Space LimitedDisorder

KitchenFaulty planning ofspace

ExitsToo few

DoorwaysToo near steps orstairways

Too close together

Broke nose in fall overroller skates

Curtains caught fire fromstove placed too close towindow

Cut off from escape whengas stove exploded

Instantlykilled when mis-judged distance betweenexit of room and top ofstairs

Fell down basement stairswhen mistook entrancefor thatofadjoining room

Install closets, boxes, shelves,cupboards.

Change arrangement if pos-sible. Keep window closed.Dispense with curtains or tieback securely.

Provide two exits fromkitchenand all other rooms.

Have ample landing betweenhead of stairs and doorway.

Identify stairway, doorway.

6

DISREPAIR OR NEGLECT OF MAINTENANCEType and Hazard

StairsDefective covering

Steps and SidewalksIce

Floor CoveringsLinoleum slippery,cracked, worn

ScreensFastening insecure

Cuproard DoorSharp corner

Loose PlasterFa lling on occupantof room

Rroken Chair RungsCollapse of chair

PorchRailing broken

Accident

Fractured nose from fallwhen heel caught inloosened metal edging

Arm injured — amputa-tion later was necessaryfrom fall on ice coveredsteps

Severe wound whenstruckhead against stove in fall

Child badly bruised fromfall out of second storywindow when screen gaveway

Injury causing loss of eyewhen bumped againstcorner of open door

Injury to head — brokeneyeglasses

Rruises and spine injury

Hip injury — railing gaveway when leaned against

Prevention

Repair or remove defectiveedgings or coverings.

Prevent eavespouts drainingon steps and sidewalks. Re-move ice immediately. Usesalt, ashes or a board cover-ing.

Recoat surface with nonslipwax. Tack down or patchleaving no uneven edgings.

Keep in good repair. Securelyfasten with nails or hooks toostiff for little fingers to loosen.

Ease stubborn doors so thatthey close and open freely.Change location or removedoor if a hazard.

Tape plaster up as soon ascrack appears while awaitingreplastering.

Discontinue use untilrepaired.

Put up warning until railingscan be renewed or repaired.

7

DANGERS IN WIRING AND ELECTRICALMAINTENANCE

Type and Hazard

Any Appliance

Using appliances indamp location orwhere user is incontact with plumb-ing

Overloaded circuit

Adjusting when inoperation

FusesUsing fuses of toogreat capacity

ConnsFrayed, leavingwire exposed

Accident

Person received shockfrom handling connect-ing cord with wet hands

Individual electrocutedinbathtub when attempt-ing to adjust electricheater

A fire resulted from anoverloaded circuit whenfuse failed to blow

Fire caused by over-heated wires

Shock to child playingaround lamp, caused bymetal lamp frame made“alive ” by worn cord

Prevention

Avoid use of portable heaters,curling irons, radios, etc., inbathroom because water,plumbing, damp surfaces theremake shock hazard extremelygreat. In any location avoidhandling appliances whenperson is also in contact withany plumbing fixtures.

Appliances should be connected only to appliance out-lets and not to light sockets,If a number of appliances areused, connect them to outletsthat are on different circuits.

Do not attempt to adjust, oil,or clean any electrical appli-ance while it is connected tothe electricity supply. Eventhough the appliance has aswitch to control its opera-tion, pull the plug.

Use only Underwriters’ Labor-atories approved fuses of thecorrect rating for each circuit.Find trouble caused by blow-ing of fuses, before replacing.Do not use any object assubstitute for fuses.

Discard badly worn cords.If outer surface of cord isfrayed, several layers of elec-trician’s tape around the cordusually will make a saferepair. Use only cords bear-ing approval of Underwriters’Laboratories. Never pull on acord. Disconnect by graspingplug. Avoid use of long cordsunder rugs or furniture.

8

DANGERS IN WIRING AND ELECTRICALAPPLIANCES

Type and HazardWashing Machines

Inattention

Improper installa-tion

Electric IronOverheating

HeaterOverturning

Electric FanWhirling blades

Heating PadOverheating

Accident

Arm drawn into wringerby loose sleeve.

Child’s arm caught inwringer

Shock while operating

Fire caused by connectediron left on ironing boardwhile answering tele-phone call

Fire caused by heater tooclose to wall

Cut hand in blades

Burned when asleep withpad on “high”

Prevention

Do not wear loose, flowingclothing that may be caughtin the wringer rolls.

Keep children away.

Keep in good repair. Anyindication of shock whileoperating requires immediateattention. Washing machinesand ironers can be made saferfor use in damp surroundingsby electrically grounding“their frames.” Have anelectrician do this.

Disconnect and put on standwhen called away.

Put in safe place, away fromwalls, and curtains. Discon-nect when leaving room.Keep children away.

Place in safe position. Shutoff fan to move it. Selectfan with adequate guard forblades or one with rubberblades.

Remove and disconnectbeforefalling asleep. Don’t applyheating pad to a helplessperson (an infant, an invalid,a sleeping or unconsciousperson) unless carefully at-tended and under medicalsupervision. Don’t use pinsor other metallic means tofasten a pad injplace. Keeppad always dry even if themoistureresistant covering isin place. Renew such moistureresistant covering if it showsany sign of deterioration.

9

LACK OF SKILLSType and Hazard

Waxing

Floor left slipperyMopping

Hot water

CleaningBathtubLeft slippery

Hanging CurtainUsed a substitutefor ladder

KnivesMisuse

CookingSteam

Starting FiresBums, fires

CanningBursting jars

Food PreservationBotulism

Food storage

Heavy Lifting

Improper position

Dry CleaningExplosion

Gas AppliancesLeaking gas

Accident

Broken arm from fall

Child scalded by fallinginto pail of boiling water

Fell, cut foot on glassfixture

Broken hip resulted infall from rocking chair

Badly cut when knifeslipped

Burns resulted whencover was removed fromboiling liquid

Child severely burnedwhen starting fire withkerosene as she had seenher mother do

Narrowly escaped injuryfrom broken glass whenhot jars were set on topof hot oven

Deaths from eating home-canned spinach

Severe intestinal upsetfrom eating infected foodBack strained when mov-ing sack of flour to flourbin

Instantly killed in explo-sion which occurred whendry cleaning curtains in-doors

Asphyxiated because ofescaping gas

Prevention

Wax lightly. Rub in well.

Never leave a pail of hotwater on floor — unguarded.

Cleanse properly to removesoap.

Use a well-built ladder, ingood repair. Wear low, firmheels. Have no loose hems inskirt or slacks. Movecautiously.

Hold knife blade away frombody when cutting.

Stand back at arms lengthbefore removing lids.

Do not use kerosene to startor quicken a fire. Do notuse too much paper for fearof a chimney fire.

Set hot jars on several thick-nesses of cloth on kitchentable.

Use pressure cooker for non-acid vegetable canning. Ifany other method is used,boil for fifteen minutes beforeserving, or even tasting.Use care in quickly coolingall perishable foods.

Bend knees — keep backstraight.

Send articles to dry cleanersor use noninflammable clean-ing fluids. Never do drycleaning indoors.

Adjust flame properly. Havegas leaks repaired imme-diately. Repair or replaceloose burner cocks.

10

POOR HOUSEKEEPING AND DISORDER

Type and HazardTin Cans

Sharp edges

Broken GlassSharp edges

Cooking UtensilsPan handles

KnivesOut of place

CigarettesFailure to extin-guish

Oily RagsStored carelessly

NewspapersStored on dampfloor

FirearmsLeft loaded andeasily accessible

BottlesBreakage

Poisons (Medicinal)Accidental use

Poisons (Insectand Rodent)

Accidental hand-ling or swallowing

Poisons (Gleaning)Accidental use

Poisons (Food)Lack of cleanliness

Accident

Palm of hand injuredwhen using makeshift canopener

Hand cut when emptyingbasket containing glass

Severely scalded fromboiling water when pro-jecting handle caught inapron strings

Cut when reaching incrowded drawer for knife

House burned down fromfirefrom cigarette thrownin waste basket

House burned — spon-taneous combustion,caused by oily rags

Bottom papers of largeheap in damp garage,found charred, ready forspontaneous combustion

Hand shot away whenloaded gun was dropped

Hand cut when bottle,into which boiling waterwas poured, broke

Child poisoned by swal-lowing sleeping pills forcandy

Child died after swallow-ing ant poison

Child swallowed lye

Severe intestinal upsetfrom eating infected food

Prevention

Use efficient can opener.Dispose of cans safely.

Wipe up floor with flannelcloth or absorbent paper.Wrap in heavy paper — tiesecurely. Label—broken glass.

Always turn pot handles in.

Keep knives in rack or wide-mouthed glass jar where theycan be seen.

Extinguish thoroughly. Neverthrow in a waste basket.

Store oily rags in coveredmetal containers.

Do not accumulate. Make arack to keep off damp floor.

Unload before bringing intohouse. Store in locked cup-board.

Put a silver knife or spoon inbottle before filling with boil-ing water.

Keep all medicines in separatelocked cabinet —out of reachof children. Dispose of left-over medicines.

Keep out of reach of children.Use traps and nontoxic prod-ucts rather than poisons.

Keep on high shelf or in cupboard. Mark plainly.

Always wash hands before{»reparing food. Avoid hand-ing food if you have anyinfection.

11

POOR HABITS AND ATTITUDESType and Hazard

ClothingInappropriate

"At Ease”Tilting chair

SmokingFalling asleep

Razor BladesSharp edges

Living Conditionsa) Disorder

b) Lack of neatness

Mental Statesa) Inattention

b) Poor judgment

c) Tension

Accident

Burned to death in light-ing oven when fluffynegligee caught fire

Concussion sufferedwhentilted chair slipped andoccupant fell off porch

Infant suffocated fromsmoke and fumes whenmother fell asleep withlighted cigarette whilenursing infant

Bad cut. Blade wrappedin a soap paper in hotelwas picked up by maid,crushed in hand

Concussion from fall overcarpet sweeper left outof place

Bad fall at night overcard table in middle offloor after party

Broken wrist, slipped ongrease

Baby choked from swal-lowing a pin

Overcome with escapinggas whenmilk boiled overand extinguished gasflame

Infant choked on peaswhen given full pods toplay with while motherwas shelling

Child burned from over-turned coffee whenmother hurried him

Prevention

Wear short sleeved housedress without puffed pockets,or loose strings, or bow.

Never tilt back on two legs ofa chair.

Extinguish cigarette beforelying down. Do not smoke inbed while nursing infant.

Wrap in paper blade came in.Place in box in which bladescame in or provide box withslot in top. When full, sealslot, mark "caution.”

Always put back in properplace at once all equipment,tools, knives, cleaning ma-terials, etc.

Replace furniture after using— arrange furniture for clearpassageway.

Immediately wipe up spilledgrease.

Pick up all pins after sewing

Train yourself to keep yourmind on your work. Realizeaccidents occur when mindis off guard. Be alert.

Use foresight in the selectionof objects to amuse an infant.

Control through makingpatient aware — suggest ahealth examination. Statesof nervous tension and gangercause accidents. Control bygood hygiene and relaxation.

Prevention

12

PROTECTION

Children Are Victims o£ a Large Per Cent of FatalHome Accidents

AccidentSuffocation

Choking

Burns

Falls

Some CausesMother falling asleep while nursing baby

Baby sleeping with others

Heavy, clumsy, insecurely fastened and too confin-ing covers

Swallowing beans, buttons, marbles, safety pins,parts of toys and rattles

Bathing child in hot water or too near hot waterfaucets or stove

Projecting handles of utensils on stove

Spilling hot food, hot liquids, or overturninglighted oil lamps

Pails of hot water on floorMatches

Unsafe, unprotected electrical appliances, stoves,irons, heaters, outlets, oil stoves, overheated woodand coal stoves

Over exposure to sun rays

Unguarded in crib, high chair or carriage

Unguarded top of tableUnprotected windows

Stairways, porches, and steps

Ladders and high places

13

FOR CHILDREN

The Majority of Home Accidents of Children Can RightlyBe Charged to Adults

PreventionKeep awake while nursing infantHave baby sleep alone always

Provide firm mattress or folded blanketunder baby—no pillow. Fasten coverssecurely or use safe sleeping bag

Keep small objects away from children

Check temperature of water. Protectfrom hot water faucets and hot stoves

Turn pot handles in

Have table covers only to edge of table.Keep hot foods, etc. out of reach ofchildren.Guard pails of hot water

Keep matches in metal container in safeplaceRepair defective equipment. Guardagainst hot stoves. Keep children out ofkitchen during meal preparation

Caution regarding leaving children insun for long period

Keep sides of crib up. Select crib withnarrow spacing of rods. Fasten child se-curely in high chair or carriageProtect child if bathing on tableScreen or bar open windowsPlace gates at top and bottom of stairsand porch openingsTrain child how to climb

Emergency Care Until Doctor Arrives*Remove constricting clothing immedi-atelyKeep child quiet in well ventilated room

If object is visible try to remove imme-diately with care to avoid injuring child.Child may be inverted—lifted up by hisfeetCover slight burns with sterile gauze orclean cloths soaked with bicarbonate ofsodaIn severe burns cut away clothing unlessskin is adherent. Do not apply anygreasy substances. Avoid chilling

If bruised, apply cold compressesIf cut apply sterile or clean dressingStop bleeding

* In severe accidents have doctor called at once. In any accident have doctor see child.

14

PROTECTION

AccidentInjuries and Wounds

Poisoning (Not Gas)

Injuries to Nasal Passage,Ears and Eyes

Shooting

Accidents in the Yardmotor vehicle

injuries

DROWNING

Animal Bites

Some CausesRunning with sharp object in mouthPutting small objects in nose and ears

Stepping on broken glass, opened tin cans, razorblades, tacks, pins, needlesCareless use of scissors, knives, etc.

Dangerous medicines, germicides, insecticides, lye,etc.

Lead paint on cribs and toys

Putting small objects as listed above in nose andears. Falling on or sticking sharp object in eye

Playing with firearms and explosives

Inattention in driving car

Playing in street

Stepping on nails in boards, broken wires, andglassClimbing trees, ladders, poles, etc.Overturning bird bath

Falling into garden pool and striking head againststones

Falling into cisterns or wells

Teasing or playing with dogs, cats, etc.

15

FOR CHILDREN

PreventionKeep pencils, sticks, other sharp andsmall objects away from children. Trainnot to put sharp pointed objects inmouth or near eyes

Place all dangerous articles out of reachof children. Dispose safely of glass, etc.

Destroy unused dangerous medicines.Label all poisonous substances plainly.Keep all poisonous substances in lockedcabinet out of reach of children

Purchase crib and toys with safe paintor use lead free paint for redecoratingIf child persistently sucks crib, tapebars with adhesiveKeep floor, crib, play pen clear of allsmall objects and sharp articles

Always unload and store firearms withammunition in safe place. Store explo-sives carefully

Make sure children are not in drivewaywhen driving car in or out of garage

Train children not to run into street forball or in playing

Keep yard free of sharp objects

Teach children dangers of climbingAnchor bird bath top firmly to preventoverturning

Provide adequate play yard. Keep chil-dren away from pools, swamps unlessaccompanied by adultCover wells and cisterns securely

Keep children away from strange dogsand cats. Teach children dangers ofteasing animals

Emergency Care Until Doctor Arrives*Remove if possible. Keep child as quietas possible

Stop bleeding by pressure or elevationof wounded extremity—apply dry sterileor clean dressing

Give antidote immediately

Stop bleeding. Apply sterile or clean,dry dressing. Keep child as quiet aspossible

If severe injury do not move child un-necessarily. Keep warm

Dress injurySee doctor immediately because minorinjuries of this type may cause lockjaw

Keep warm and quiet

Wash wound under running water—-apply clean gauze

* In severe accidents have doctor called at once. In any accident have doctor see child.

16

PROTECTION

The Largest Number of Fatal Home Accidents Occuramong the Aged

AccidentsFalls

Poisoning

Poisoning (Gas)

Burns, Scalds, Explosions

Some CausesSlippery walksSlippery floors, toys and objects on floor, insecurerugs, cluttered stairsStairs without handrail

Slippery bathtubPoorly lighted stairways, halls, and rooms

High bedsDefective ladders and scaffoldsDefective eyesight, hard of hearing

Exposure to extreme heat

Contaminated foods

Dangerous medicines, germicides and other poi-sonous substances

Improper care of fires

Inadequate Ventilation

Running motor in closed garage

Grasping hot objects

Ignition of clothing

Lighting of fires

Spilling boiling liquidsInflammable liquids

17

OF THE AGED

Predisposing Factors: Senility, Lessened Agility,Impaired Vision, Brittle Bones, Low Vitality

PreventionKeep sidewalks free of iceOrderly housekeeping

Handrail on stairwaysGrab bar in bathroomSufficient light at all times, small nightlight or convenient switch

Low beds or safe footstoolLadders in repair, discourage climbingEncourage the aged to recognize theirlimitationsAvoid overexertion in hot weather

Care in selection, preparation and stor-age of foodKeep medicines and poisonous sub-stances in locked cabinet or out of reach—mark plainly

chimneys cleanAdjust dampers in coal stoves so gaswill escape through chimneyKeep gas range in safe place and goodrepair to avoid extinguishing

Keep rooms, heated by oil or gas heat-ers, well ventilatedCaution to always leave door open

Use- holders for hot handles, etc.

Caution regarding danger of lightingfires with keroseneKeep away from flames

Care in carrying pails of hot liquidsKeep away from inflammable liquids

Emergency Care Until Doctor Arrives*Place patient in comfortable positionDo not move more than is absolutelynecessaryKeep warm. Watch for shock. Applycold compresses to bruisesDress injury with sterile or clean clothStop bleeding by pressure

Give antidote for specific poison

Remove to fresh air immediately

Watch for shock

Get patient into fresh airApply gauze soaked in soda bicarbonatesolution. Cut away clothing from burnedarea. Do not disturb if skin adheres toclothing

* Call doctor immediately for severe accident. In any accident have doctor see patient.

18

PERSONAL FACTORS WHICH PREDISPOSETO HOME ACCIDENTS

The public health nurse can make her most important contributionto the home and farm safety program by seeing an accident before ithappens and preventing it. She, as well as the physician, can assist inpreventing accidents to the handicapped, by helping them and theirfamilies to foresee hazards and correct them.

Conditions in a home which are conducive to accident occurrenceeither in the physical structure of the house, type of equipment, mainte-nance of equipment, or housekeeping are doubly hazardous where thereare sick or aged persons.

In the case of certain illnesses such home hazards are extremely seri-ous. People with diseases of the heart and blood vessels must realizetheir limitation and avoid hazards. In certain diseases of the centralnervous system such as epilepsy, and also in psychoses, care and fore-sight must be used in protecting these patients from injury by falls andother accidents. The diabetic person and his family need to know thedangers of skin infections and gangrene from minor injuries.

Defective eyesight and hearing may predispose to home accidents andattention must be given to individuals with these conditions.

Cripples, as well as persons with chronic illnesses need protection andguidance, in adjusting to conditions in the home.

The periodic physical examination with subsequent correction ofdefects and treatment may well be considered an important phase ofaccident prevention.

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19

TEACHING DEVICESSuggestions for Use

One of the most familiar and effective devices for arousing interestin home safety is the check list for common hazards in the home. Severalforms have been compiled by different organizations. The contents ofthe American National Red Cross check list is shown on page 20. Asupply of these forms may be obtained from the local Chapter.

The methods of making a survey of home hazards may vary. In somehomes a suggestion may be made to the family to secure a form fromthe Red Cross Chapter, Home Bureau or other organization interestedin the project. In other homes, the housewife may request assistance ofthe public health nurse in making the inspection. The latter approachwill give the nurse an opportunity to discuss the hazards found and helpwith the elimination of dangers.

The family safety council is another project which has been used suc-cessfully in some communities. The diagram on page 21 will be helpfulin planning with families who show interest in working it out together.It can be simplified to meet the needs of the family and should arousethe interest and participation of all members of the household.

The home safety cartoons pictured on pages 18, 19, 22, and 23 will beuseful in connection with family teaching. A booklet containing addi-tional drawings is available on request.

Some of the pamphlets listed under educational materials on page 27may be secured for distribution in the homes.

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20

COMMON HOME HAZARDS*Check List of HAZARDS in and about the HOME Issued by

THE AMERICAN NATIONAL RED CROSS

Yes NoT. Falls and Broken

Bones—• — Are stairs clear of toys

and other householdarticles?

— — Are stairways welllighted ?

— — Are small rugs securedagainst slipping?

— — Is ice cleared from stepsand walks?

—■ — Are porch railings andfloors sound?

— — Are bicycles, play appa-ratus, etc., in goodrepair?

2. Burns and Scalds—

— Are hot containers onstoves beyond reachof small children?

— —■ Are small children pro-tected from tubs ofhot water?

— — Are matches kept fromlittle children?

— — Is screen used at fire-place ?

— — Are chimneys cleanedregularly ?

— — Is woodwork protectedfrom stove pipes?

— — Is trash disposed ofpromptly?

— — Are attic and basementclear of rubbish?

— — Are plans made in caseof fire?

3. Electric Shock— — Are electrical appliances

in good condition?— — Are worn and broken

cords promptly dis-carded?

— — Are installations and re-pairs made by compe-tent persons?

Yes No4. Asphyxiation &

Suffocation— — Are gas burners adjusted

for proper combus-tion?

—— Are all gas connections

substantial?—

— Are garage doors alwaysopen when startingautomobile engine?

— — Is bedding securedagainst possiblesmothering of baby?

5. Cuts and infection— — Are toys with sharp

points and edges dis-carded ?

— — Are sharp - edged toolskept away from smallchildren ?

— — Is skillful use of knivesand other toolslearned?

6. Poisonings— — Are all poisons separately

stored?

— — Are poison containersclearly identified?

— — Are medicines separatelystored ?

— — Are unused medicinespromptly discarded?

7. Gunshot Wounds— — Are firearms about prem-

ises unloaded?— — Are all firearms out of

reach of young chil-dren?

—— Are they always handled

as if loaded?* You may want to check answers with pencil and change as corrections are made.

21

COLLECTSPENALTIES

ASSISTSWITHAWARDS

TREASURER

SUGGESTEDTOPICSOFMEETINGS

1

STORYFROM

SAFETYMAGAZINE

2CHECK

LISTDISCUSSION:REPORT

OF

HAZARDSDISCOVERED

ANDCORRECTED

3DISCUSSIONOF

ACCIDENTSIN

FAMILYAND

HOWTHEYMIGHTHAVE

BEENAVOIDED

4PENALTIESDECIDED

UPONFOR

CARELESSNESS5

AWARDSAGREEDUPON

FORACCOMPLISHMENT;

6

EMERGENCYTRAINING

A

FIRSTAID

B

FIREPREVENTION

C

FIREFIGHTING

FAMILYSAFETYCOUNCIL

KEEPSMINUTESAND

RECORDS

CONDUCTSCORRESPONDENCEAND

RESEARCH PLANSPROGRAMSSECRETARYOFFICERS

CHAIRMANCALLS

PERIODICMEETINGS

PRESIDESTOHEAR

REPORTS

LEADSDISCUSSION IMPOSES

PENALTIESANDMAKES

AWARDS

ihu, I

%. ttclmTMUC/ut,

NATIONAL SAFETY COUNCIL

BURNS

NATIONAL SAFETY COUNCIL

BURNS

Tnaki 7wafaicf' 'p&uwuL*/

national safety council

POISONING tP-dhm OiuLctimMiC<faAmothA.ik4<u.

NATIONAL SAFETY COUNCIL

SUFFOCATION

23

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NATIONAL SAFETY COUNCIL

SHOCK

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NATIONAL SAFETY COUNCU

INJURIES

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CUTS

24

ORGANIZATION AND GROUP TEACHINGCommunity Safety Program

Home safety should be the concern of everyone. The public healthnurse by virtue of her place in the community has an excellent opportu-nity to promote understanding of the need for community participationin a home safety program.

The responsibility for initiating and organizing community actionmay be assumed by the health officer or any other interested individualor group. He may call together representatives of local government,civic and service organizations, social agencies, schools, and churches.This group would serve as an advisory planning committee and selectmembers for the program, publicity, and arrangements, committees toorganize a local home safety conference. The purposes of such aconference are:

(1) To focus attention on the seriousness of the local home and farmaccident situation

(2) To provide an opportunity for open discussion of the problem(3) To provide an opportunity for the organizations concerned with

home and farm safety to help plan and participate in community pro-grams of safety work

(4) To provide a permanent arrangement whereby groups of organ-izations can adequately plan their respective programs of safety inrelation to the community situation in its entirety.

Some of the community projects which can be expected from organ-ized effort are: safety programs in organizations and community groups;publicity campaigns in safety education; community surveys; and RedCross Home and Farm Accident Prevention Classes. (See page 26.)

These above suggested steps in organization of a home safety confer-ence are outlined in the diagram on the opposite page.

In addition to stimulating community action the public health nursecan offer suggestions for radio programs, motion picture showings, lec-tures, and exhibits. The home safety program in New York State isgoing forward largely through organizations.

The Grange, Home Bureau, Parent Teacher Associations, the youthgroups, 4-H Clubs, Boy Scouts, Girl Scouts, and Juvenile Grange arecarrying on programs to inform their memberships about home andfarm safety. All organizations, service clubs, and community groupsmay well make the subject of home safety a part of their program.

The public health nurse can do her part in community educationby urging every organization in the area which she serves to appointa home safety committee and to work for the education of thememberships.

25

REDCROSSACCIDENT

PREVENTIONCLASSES

TIME,PLACE RESOLUTIONSREPRESENTATION ORGANIZATIONS AGENCIES SCHOOLS CHURCHES

ORGANIZATIONOFHOMESAFETY

CONFERENCE COMMUNITYSURVEY

LOCALHOMESAFETYCONFERENCE

ADVISORYPLANNING

COMMITTEE SPEAKERSPUBLICITY

COMMITTEEPOSSIBLE

OUTCOMEEXHIBITS

EDUCATIONPUBLICITY

CALLEDBYHEALTHOFFICER

ORANY

INTERESTEDINDIVIDUAL

ORGROUP PROGRAM

COMMITTEE REGISTRATION ORGANIZATIONSSTIM-

ULATEDTOHAVE

SAFETYPROGRAMS

FORTHEIR MEMBERSHIPS

26

THIS TRAINING IS AVAILABLE IN HOME AND FARMACCIDENT PREVENTION IN EVERY COMMUNITY

AMERICAN NATIONAL RED CROSSWASHINGTON, D. C.

HAROLD F ENLOWS, DIRECTORFIRST AID WATER SAFETY AND ACCIDENT PREVENTION

NORTH ATLANTIC AREA OFFICE AMERICAN RED CROSS315 FOURTH AVENUE, NEW YORK CITY

JAMES J. TATTERSALL, DIRECTORFIRST AID WATER SAFETY AND ACCIDENT PREVENTION

LOCAL CITY AND COUNTY CHAPTERSWILL PROVIDE

FIELD INSTRUCTORS TO TRAIN LOCAL INSTRUCTORS*15 HOUR COURSE

INSTRUCTOR'S CERTIFICATE

HOME AND FARM ACCIDENT PREVENTIONFOR GENERAL PUBLIC

12 HOURS FOR CERTIFICATE

HOME ACCIDENT PREVENTION9 HOURS FOR CERTIFICATE

•NOTE HANDBOOKS FOR INSTRUCTORS'- PAMPHLETS FOR CLUB LEADERS AND HOME AND FARMACCIDENT CHECK LISTS WILL BE PROVIDED

27

EDUCATIONAL MATERIALFOR USE IN

HOME AND FARM SAFETY PROGRAMSSecure through Division of Public Health Education,

of the New York State Department of Health

ExhibitsTwenty poster panels (shipped in lots of three)

Useful in conferences and for window exhibitsHome Safety—convention exhibit (requires truck to transport)

Motion PicturesSafety in the Home 1 reel sound 16mm.Sentinels of Safety 1 reel sound 16ram.Electrical Safety 2 reels silent 16mm.Four Point Safety Home l£ reels sound 16mm.

Talking Slide Films (15 minutes each)Hand HelpersSeven Million HandsTreasure ChestLet’s Be Friendly (farm animals)Strictly Personal

Illustrated LecturesLantern Slide Talk

by W. Graham Cole, Metropolitan Life Insurance Com-pany

New York CityHome Groan (easel chart lecture)

Travelers Insurance CompanyHartford, Connecticut

Home Groan (45 Kodaslides with lecture transcribed)

Electrical Transcriptions of “Health Hunters” Radio PlaysTwenty-five subjects related to home and farm safety

PamphletsPrevent That Accident (home safety)Doctors Fight Accidents (for physicians)Home Safety—a manual for Public Health NursesHome Safety—a manual for Architects and BuildersArchitects Check List on Home Safety (mimeographed)How Safe is Your Home (a home accident survey form)Stop Farm AccidentsPortfolios containing home safety literature prepared by other

organizations are available for loan to public health nurses

28

REFERENCESThe Public Health Nurse and

Home Safety

The Visiting Nurse and theHome Safety Campaign

Spring Cleaning for Safety

Home Safety

The Home Accident Problem

Accident Hazards — (Excerptfrom Rehabilitation Review)

The Nurse in Accident Preven-tion

The Role of the Health De-partment in the Preventionof Accidents

Women’s Part in IndustrialSafety

Education in Safety or Safetyin Education—(Editorial)

The Public Health Nurse inHome Accident Prevention

The Nurse Can Reduce HomeAccidents

Rosebelle Jacobus, Public HealthNurse, November, 1928, p. 561Martha P. Langley, R.N., PublicHealth Nurse, February, 1929,p. 83Public Health Nursing, March,1931,p. 151Rosamond Losh, executive secre-tary, Children’s Bureau, KansasCity, Missouri, Public Health Nurs-ing, June, 1931, p. 290Gertrude Zurrer, R.N., PublicHealth Nursing, July, 1932, p. 400Dr. Hart E. Fisher, American Jour-nal of Nursing, November, 1936,p. 1118W. Graham Cole, director ofsafety, Metropolitan Life Insur-ance Company, Public HealthNursing, February, 1937, p. 78Dr, Edward S. Godfrey, Jr., com-missioner, New York State De-partment of Health, AmericanJournal of Public Health, Febru-ary, 1937Julia A. Wider, R.N., PublicHealth Nursing, July, 1937, p. 418Stephen G. Rice, The Journal ofEducational Sociology, September,1937, p. 4John Melpolder, consultant on ac-cident prevention, American Na-tional Red Cross, Public HealthNursing, February and March,1938Alma C. Haupt, R.N., Safety Maga-zine, February, 1940, p. 38

29

REFERENCESThey “Didn’t Think”

Accident Prevention and FirstAid — (Free and inexpensivepamphlets and charts)

Accidents in the Home

Safety in the Home—(Practicalsuggestions to public healthnurses)

The Nurse and First Aid

Study of Home Accidents:Their Public Health Signifi-cance

First Aid Is Too Late—(Radioskit and round table)

Home Defense Against Acci-dents

Killed in Action

Safety on the Home Front

The Danger of Botulism

Hurt at Home—(Cook Countyhospital survey)

Anxiety and Its ControlFatigue and Its ControlMorale and Its Control

D. Bacon, Public Health Nursing,June, 1940, p. 353American Journal of Nursing,April, 1941,p. 458

Alma C. Haupt, R.N. and W. Gra-ham Cole, Metropolitan Life In-surance Company, American Jour-nal of Nursing, April, 1941, p.391Report of subcommittee on HomeSafety of APHA Committee onHygiene of Housing, Public HealthNursing, August, 1941Ralph C. Pendleton, M.D., Ameri-can Journal of Nursing, August,1941, p. 916, and September, 1941,p. 1047Donald B. Armstrong, M.D., Sc.D.,and W. Graham Cole, AmericanJournal of Public Health, Novem-ber, 1941Public Health Nursing, January,1942, p. 17

R. L, Lee, Hygeia, February, 1942,p. 106Mildred D. Shelley, Hygeia, April,1943

L. Marguerite Scudder, R.N., NewYork State Nurse, April, 1943,p. 37Ivan C. Hall, American Journal ofPublic Health, July, 1943, p. 818National Safety Council, 20 N.Wacker Drive, Chicago, 111.Three booklets, available free ofcharge, from the New York StateDepartment of Mental Hygiene,Albany, New York

30

SUGGESTED OUTLINE FOR HOME SAFETYDISCUSSION

1. Statement of home accident problem in the nation, state, and com-munity in relation to:

a) Loss of life and disabling accidentsb) Importance of individual and community participation in

home safety2. Give illustration of one or more recent accidents in the home. Stress

the high rate of home accidents which exceed all other types ofaccidents in New York State.

3. Principal types of home accidents in order of frequency of occurrenceFalls causing fractures, concussions, and injuries exceed all

others—highest cause in ages sixty-five and overBurns, highest cause in children up to fourteen yearsPoisonous gasMechanical suffocation, highest cause in children under fivePoisoning and firearms

4. Factors influencing home accidentsAge groups—highest rate in children and the agedDangerous monthsFaulty repairsDisorderly housekeepingDefective tools, appliances and machinery

5. How to maintain home safetyDesign of houseKeep up repairs of house, electrical appliances, toolsBecome safety consciousAcquire skills—know how to do thingsBe orderly—good housekeepingProtect children and aged persons

6. Devices for home safety programCheck list—inspect tjie home each season and make repairsFamily safety council—interest the family in setting up a council

7. Community organizationStudy groups—(ARC home safety classes)Lectures, motion pictures, exhibitsSecure cooperation of professional groups, teachers, doctors,

nurses, utility groups (water, gas, electricity), communityorganizations, Home Bureau, Grange, service clubs, etc.

Development of Home Safety Conference for community organi-zation

Home Safety is the most fruitful field for increasing the well beinaof the individual, the community.

31

HOUSEHOLDERS’ PLEDGEIn recognition of the 30,000 deaths which annually occur from acci-

dents within the home of which the chief are falls, burns, and poisons,I pledge to my State and Nation that I will work to prevent accidentsin my home.

1) I will make a seasonal inspection of accident hazards, using a check list;2) I will remove each hazard found or put up a warning;3) I will use care in all household supervision especially to avoid burns and

poisonings to children and to protect older persons from falls.

Signed

How to Use Above Pledge

Have organizations print or mimeograph pledges for the membershipof the organization. Let each signer keep his pledge and display it, asa reminder.

GRANGE SAFETY PLEDGEWe, the undersigned members of Grange

of County, agree to assume, during thewar emergency, a special responsibility to keep on the production line.

We pledge ourselves to think of the safe ways to manage about allfarm and home operations, to instruct in safety, our young children,our newly employed help, and others who come to the farm or hometo work with us.

We resolve to have fewer accidents in order to conserve the timeof physicians, nurses, and hospitals, and to keep, at the highest point,our own production of foodstuffs to win the war.

Signatures of members:

How UsedThe above pledge is posted on a Bulletin Board in the Grange meeting

place with signatures of members added until all have signed it. Thepledge then is kept on display as a reminder.

32

PERSONALHEALTHANDSAFETY

SAFETYIN

HOUSINGEDUCATIONAL MATERIALS FARMSAFETYFINANCE

ORGANIZATIONOFNATIONALANDNEWYORKSTATEHOMEAND

FARMSAFETYWORK EDUCATIONAL MATERIALS

SAFETYTOCHILDRENIN

FARMWORK

NEWYORKSTATEHOMEAND

FARMSAFETYADVISORYCOMMITTEE

DIVISIONPUBLIC

HEALTHEDUCATION

NEWYORKSTATE

DEPARTMENTOF

HEALTH

B.R.

RICKARDS,GENERAL

CHAIRMANNATIONALSAFETYCOUNCIL

20N.WACKER

DRIVE,CHICAGO

NEDH.

DEARBORN.EXECUTIVE

VICE-PRESIDENTDIVISION

HOMEAND

FARMSAFETY

STANLEYH.

KERSHAW DIRECTOR SAFETYINSTRUCTION

A.ADULT

GROUPSB

SCHOOLAND

YOUTHGROUPS

PUBLICINFORMATIONAND

INTERPRETATIONSUBCOMMITTEESSAFETYIN

LANDSCAPINGAND

GROUNDSif)»-

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RESEARCHANDSTATISTICS

FIELDSERVICE

HOUSEHOLDSAFETY

FIELDSERVICE LEGISLATION

This manual is presented to the public health nurses of New YorkState to offer suggestions which will help them to assist in the programof home safety.

The material, for the most part, was written and compiled by Mrs.Ethel Hendriksen of the Division of Public Health Education, and MissMary McCormick of the Division of Public Health Nursing.

We are indebted to Mr. Howard J, Blanchfield and Mr. Nicolas Apgarof the Division of Public Health Education for the format and thediagrams included in the booklet.

Acknowledgment is given also for the assistance of the followingorganizations in reviewing the material: National Organization forPublic Health Nursing, Metropolitan Life Insurance Company, Ameri-can National Red Cross, Good Housekeeping Institute, and the RussellSage Foundation.