Prevention

Accidents are the number one cause of death in children between the ages of 1 and 16 years. Most accidents and many of the serious consequences are preventable. Start child-proofing your home at 6 months of age.

Remember prevention is easier and better than treatment.

Do's & Dont's for Prevention of Accidents

• Keep crib sides securely fastened.
• Use restraints in high chair, carriage, stroller, car seats, etc.
• Never prop baby bottles
• Do not hang or tie toys to the crib because your baby may become entangled in the string.
• Avoid use of pillows until 18 months of age
• High chairs should have a broad base to prevent tipping, a safety strap, and a latch on the tray.
• Teach your child the meaning of the word “HOT” between 9-12 months of age.
• Use gates on stairways to prevent falls.
• Windows should open from the top or have guards attached. Prevent falls from upper story windows!
• In the kitchen area- be alert for spattering grease, keep pot handles turned inward, and keep hot containers in the middle of the table at mealtime. Use back burners whenever possible.
• Be sure broken glass and razor blades are safely disposed of.
• Always check bath water temperature- never run hot water first as your child may fall in.
• Be alert for small objects- peas, buttons, hard candy, popcorn, beads, nuts, raisins. Avoid nuts, gum, raisins, and popcorn until your child is 3 years old.
• Use safety plugs in unused wall sockets; be sure electric cords are not frayed and secure electrical cords so lamps cannot be pulled down.
• Be careful when using plastic bags- especially dry-cleaner bags.
• Make sure that your child cannot get into the Drano or similar products, oven cleaner, furniture polish, antifreeze, insecticide, medication, alcohol, or any other toxic substance. Keep them locked up. Remind grandparents and sitters to do the same. If you are using one of these items, put it away in a secure place before answering the phone or door bell. Do not store poisons in innocent looking (old milk cartons) or unlabeled containers. Have the Poison Control Center number handy. The Poison Control phone number is 962-2323 or 1-800-222-1222.
• Always use a car seat or seat belts, even when taking your child in someone else’s car.
• Turn the water heater temperature down so that the hottest faucet water won’t burn (temperature lower than 120ºF).
• Don’t use a lawn mower when children are playing nearby and never allow children to ride on a riding mower.
• No peanuts or popcorn for your child until 3 years old.
• Don’t turn your back on baby when he is on the bed, table, or bassinet. Never leave baby or toddler alone in the bath, even for a few seconds, even for the phone or doorbell.
• Keep your baby away from loose cords, i.e. Venetian blind cords. Make sure no cord hangs in or near your baby’s crib.
• Never tie a pacifier around your baby’s neck.
• Consider putting a smoke alarm near the children’s sleeping area. Develop and practice escape routes with children in case of a fire.
• Discourage your child from running with food or other objects in his mouth.
• Teach road safety, i.e., never run into the street, look both ways before crossing.
• Teach bicycle safety, i.e., use bicycle helmets on each ride. Get a bike helmet for your child when he gets his first bicycle. Example is the best teacher, wear a helmet yourself!
• Don’t put the baby down on a water bed- he may suffocate.
• Teach safety in water- never consider young child “water-safe”. Keep toilet lids down and bathroom doors closed. Do not leave pails of water where children may fall into them and be unable to get out.
• Never leave your baby alone in a room with pets, no matter how gentle.
• Put plants up and out of reach.
• Use safety latches for cabinets.
• Avoid jewelry; necklaces and bracelets may snag and earrings may be swallowed.

Car Seats

Automobile accidents are the leading cause of accidental death in children. For this reason, utilization of a car seat each time your baby rides in the car is an absolute requirement. Unrestrained babies and children become flying missiles during a collision. The thing that usually stops them is not their parent, but the dashboard or car window.

Use of the car seat should start on your baby’s first ride home from the hospital. Most children accept car seats very well. Consistency is important not only for your child’s safety but also to help him accept the fact that when he rides in the car he must be in his car seat. The safest position for the car seat is in the middle of the back seat. Take the car seat with you and use it when riding in someone else’s car. Your baby depends on the health and safety of his mother and father, so don’t forget seatbelts for yourself and other family members!

The requirements of a car seat are as follows:

• Must be approved by the National Highway Traffic Safety Administration.
• Must be used as directed.
• Must not be used with passenger side airbags.
• It is recommended to keep your child rear facing until 20lbs and 1 year old.
• A forward facing car seat should be used from 20lbs and 1 year of age to at least 4 years old or 40lbs.
• A booster seat should be used from 40-80 lbs. or until your child is 8 years old.

Sun Protection

The fastest growing cause of cancer deaths worldwide is skin cancer or malignant melanoma. More than 8,000 deaths per year in the United States are reported, and the figure is growing rapidly. A child or adolescent who experiences a simple blistering sunburn is twice as likely to develop skin cancer later in life. The more sun-induced skin injury (sunburns) a child sustains, the greater risk for skin cancer. Therefore, it is the parent’s responsibility to help each child decrease this risk by developing good sun protective habits. Teach your child the following guidelines:

• Avoid prolonged sun exposure (i.e. school recess is OK) if possible between 10 AM and 2 PM.
• Wear sunscreen daily. It should have UVA and UVB protection. It should have SPF of 15 or greater, and it should also be waterproof. Apply sunscreen 30 minutes prior to going out into the sun. Reapply sunscreen more often if your child is in the water. Children under 6 months of ages should be kept in the shade if at all possible.
• Fair-skinned or especially sensitive children should wear photo-protective clothing, especially hats that shield the face.
• Avoid tanning parlors. No tanning beds are healthy.
• If on medications, inquire about possible sun reactions.
• If sunburn develops, follow the instructions for treatment of standard burns.

Bicycle Safety

Nearly 900,000 children under the age of 14 are treated each year for bicycle-related injuries. Nearly 100,000 children suffer head injuries. Approximately 600 children die yearly from bicycle-related injuries. Bicycle helmets reduce the risk of serious head injury by 85 percent; however, in most communities only 2 percent of children actually wear bicycle helmets.

Children should first begin wearing a helmet when they are passengers on an adult bike. Children who are old enough to sit well unsupported and whose necks are strong enough to support a light weight helmet (9-12 months) may be carried in a rear-mounted seat. As with seat belts, parents must serve as role models and should wear helmets too.

Establish the helmet habit early. It’s important to be consistent. The minute a child’s bike leaves the garage, a bicycle helmet must be worn. Most bicycle injuries occur very near the home. You should buy a helmet that meets the safety standards of the American National Standards Institute.

Children should be taught to ride with the traffic, not against it. Teach your child proper hand signals. The right size bike is also important. A child should be able to put both feet nearly flat on the ground at the same time while sitting on the seat.

Poisoning

Poisoning is one of the most common medical emergencies. Each year, about 500 children in the United States die of poisoning. Most, if not all poisoning, is preventable. Children are naturally inquisitive and curious and will open drawers and doors to find toxic materials. Make sure that anything potentially dangerous is locked up and away from your young children.

The most common ingestants are medicines, gasoline and other petroleum products, furniture polish, household washing products, and Drano-like products. All are potentially lethal and should be safely stored high and away from children. Don’t store dangerous material in friendly containers, i.e., gasoline in a Pepsi bottle. A common source of ingestion is a purse with medicines inside left unsupervised. Make sure your purse is empty or not available.

If an ingestion of a non-food material occurs, follow the steps outlined:

• Identify the drug or chemical that was ingested.
• Have the bottle next to you when you call and estimate the amount taken.
• Call Poison Control at 962-2323 or 1-800-222-1222. Put this number on an emergency list by your phone.
• The Poison Control Center will tell you if you should go to the emergency room.

Plants

The following plants are poisonous to ingest and/or to skin contact. While your child is little, remove them from your home and be aware of their presence in your yard.

• Ivy
• Black Locust
• Gypsum Weed
• Poke Weed
• Butter Cups
• Dieffenbacia
• Rhubarb
• Common Noonseed (Dumb Cane)
• Swedish Ivy
• DUtchman's Breeches
• Deadly Nightshade
• Philodnetron
• Jerusalem CHerry
• Deandre
• English Ivy
• Pyracantha
• Autumn Crocus
• Mistletoe
• Lantana Camara
• Holly Azalea
• Water Hemlock
• Castor Bear
• Yew Mushroom
• Iris
• Tulips
• Mayapple
• Larkspur
• Wandering Jew
• Cherry Trees
• Foxglove
• Wisteria
• Foliage
• Hemlock

Minor Injury Management

The active and curious youngster will inevitably suffer from minor bumps, cuts, bruises, and scratches. Here are a few suggestions for minor injuries. For major accidents or injuries, consult us.

Minor Cuts & Abrasions

Wash the injured area with antibacterial soap and water. Blot dry and apply band aid. If the wound is open and appears infected, wash as above and apply a topical antibiotic ointment and cover with a band aid. If redness or drainage occurs, call our office.

Larger Cuts & Lacerations

Wash the injured area with antibacterial soap and water. Blot dry and apply a sterile dressing. Apply pressure to control the bleeding and call us or go to the emergency room if you think stitches may be necessary. If a tetanus booster has been given within 5 years, no extra immunization is required.

Puncture Wounds

Wash with antibacterial soap and water. Start soaking in warm salt water (2 tsp. to 1 qt. water) or antibacterial soap twice daily for 15 minutes. Sterile dressings are applied between soakings. If signs of infection or drainage develop, call the office. It is important that a tetanus booster has been given within the past 5 years for protection.

Animal Bites

The most important thing is to locate and detain the offending animal after treating the wound as above. The bite of an animal should be reported to your local police or Board of Health. If the animal is not detained, call the office. Cat bites may require antibiotics. Call the office during office hours.

Nose Bleeds

Don’t panic. Most nose bleeds can be controlled by direct pressure. Keep the child sitting upright with head forward, and apply direct, firm, and constant pressure to the side of the nose - against the middle of the nose - until bleeding stops, or for at least 10 minutes. If this does not work, call the office.

Burns

For small burns of any cause, the following procedure is recommended:

• If from a caustic or acidic substance, flood with large amounts of water.
• Apply cold running water for 5 to 10 minutes
• Do not apply any ointment such as petroleum jelly
• Keep clean with antibacterial soap and water.
• Pain control with ibuprofen or acetaminophen can also be used.
• If blistering does develop, do not break the blister purposely. Should they accidentally break, keep clean with soap and water, and cover with loose gauze to keep clean.

If you have any questions about the above treatments, please call us.

Head Injury

Minor falls are a normal part of childhood. Most head bumps are not dangerous or life threatening. Kids with head bumps will have a swollen area that resembles a goose egg. This area can be bruised, red, and tender.

Symptoms of a more serious head injury include vomiting, loss of consciousness, blurred vision, confusion, inability to wake, unequal pupil (the black center in the eye) size, and difficulty with balance.

Treatment of a minor head injury includes applying ice or a cold compress to the swollen are, Tylenol or Ibuprofen for headache or discomfort, and careful observation for 48 hours. For the first 8-12 hours, you should check your child every 2-4 hours to make sure they are acting and sleeping normally. Call the office if symptoms of severe head injury are seen.

Prevention includes no baby walkers, the use of helmets for biking, scooters, and roller blading, car seats or seat belts, and blocked stairways.

The Chocking Infant (under one year of age)

Airway obstruction should be suspected in an infant who suddenly begins to cough, gag, or have high-pitched or noisy breathing.

Airway obstruction may be partial or complete. In partial airway obstruction, the infant may be able to cough, although there may be wheezing between coughs. If a child is coughing, the airway is only partially obstructed - leave him or her alone! As long as air exchange continues, do not interfere.

Poor air exchange is characterized by an ineffective cough, high-pitched noises while inhaling, increasing difficulty breathing, and blueness of the lips, nails, and skin. When this occurs, treat the infant as though he or she has complete airway obstruction.

If the infant has a complete airway obstruction, no air can be expelled, so he or she will be unable to make a sound.

What to Do

If the choking infant is unable to breath or make a sound, turn the infant’s head and face down over your knees and forcefully give 5 back blows with your open hand. This is done in an effort to propel the object from the infant’s windpipe. If this fails, turn the infant face up and deliver five chest thrusts. Repeat these procedures as necessary if there is no response. Finger probing of the mouth should be attempted only if you see a small object in the infant’s mouth. If you are unsuccessful clearing the airway, call 911 immediately.

The Chocking Child (one year or older)

Airway obstruction should be suspected in a child who suddenly begins to cough, gag, or have high-pitched noisy breathing. The older child may also use the “Universal Distress Signal” of choking, clutching the neck between the thumb and index finger.

Airway obstruction may be partial or complete. In partial airway obstruction, the child may be able to cough, although there may be wheezing between coughs. If a child is coughing, the airway is only partially obstructed - leave him or her alone! As long as air exchange continues, do not interfere.

Poor air exchange is characterized by an ineffective cough, high-pitched noises while inhaling, increasing difficulty breathing, and blueness of the lips, nails, and skin. When this occurs, treat the infant as though he or she has complete airway obstruction.

If the child has a complete airway obstruction, no air can be expelled, so he or she will be unable to make a sound.

What to Do

If the child’s cough is absent or ineffective, you will want to perform the Heimlich maneuver (Subdiaphragmatic Abdominal Thrusts). This is done by standing behind the child and wrapping your arms around the child’s waist. Grasp one fist with your other hand and place thumb side of your fist in the child’s midline slightly above the navel. Press fist into child’s abdomen with quick inward and upward thrusts. Each abdominal thrust should be delivered decisively, with the intent of relieving the obstruction. Several thrusts may be necessary to expel the object. BE PERSISTENT!