faiqa qureshi md - appna · unintentional childhood injury mortality ... clean dry dressing and...
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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