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| Home > Healthy People > October 2002 |
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October - December, 2002 |
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Childhood dangers lurk around every corner
Being informed and prepared can make a vital difference in preventing injuries to children
It's every parent's worst nightmare, and it seems to be happening a lot: a child is abducted from their home, playground or the street, often in broad daylight.
But stranger abduction isn't on the rise, according to the National Center for Missing and Exploited Children - in fact, the majority of child abductions are a child's parent during a child-custody disagreement.
While it's important to teach children about "stranger danger," (the subject of St. John's pediatrician Don Sponenberg, M.D.'s pediatric Q&A on page 11) child abduction is not considered one of the top threats to children's health - child abuse and neglect, motor vehicle crashes, fire, drowning, accidental shooting, airway obstruction and poisoning are. St. John's urges parents to empower themselves - and their children - with information about how to stay safe in a not-so-safe world.
Motor vehicle crashes remain the No. 1 killer of children ages 14 and younger in the United States.
"Most of these deaths, as well as many injuries, occur because children are not properly restrained in the vehicle," says St. John's Trauma Prevention Education Coordinator Pam Holt, R.N. Children younger than 5 should always ride in a child safety seat, and the seat should be properly installed in the vehicle.
St. John's staff regularly conducts free child safety seat checks on the St. John's campus in Springfield. Child passenger safety technicians check the seats and show parents and other caregivers how to properly install car seats as well as how to properly restrain children in car seats. When a child turns 5, many families graduate the child from the car seat to the seat belt, with no other protection. But kids who weigh less than 80 pounds should sit in a booster seat, Holt says.
"Adult seat belts don't provide adequate protection for children who weigh less than 80 pounds, even if they are 4 or older," Holt says. "Booster seats, used in combination with seatbelts, protect older children from injury from crashes and inflating airbags, Holt says. She adds the safest place for a child is in the back seat of the vehicle. For more information about child safety seat checks, or booster seats, call Holt at 417-885-6672.
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CHILD ABUSE & NEGLECT
Child abuse and neglect is an epidemic that unfortunately makes routine headlines in the Ozarks. Most parents don't mean to harm their children - they often don't know how to control their anger or were victims of abuse themselves and are repeating the abuse cycle.
Shaken baby syndrome is the leading cause of death to children out of all child abuse cases. Most shaking incidents last just five to 10 seconds and usually occur as result of frustration because of a baby's incessant crying. Babies or toddlers who have been shaken and survive the incident are often brain-damaged, blind or have chronic seizures, paralysis, speech and learning disabilities and hearing loss.
Shaken baby syndrome is difficult to recognize, but perpetrators are typically young fathers or boyfriends of the child's mother. Female perpetrators are usually a babysitter or child-care provider and not the mother of the child. If you suspect your child has been shaken (major symptoms include seizures, bleeding in the eyes, vomiting, swelling of the head and bruises on the chest or broken ribs) seek help immediately. If you have the urge to shake your child, stop what you're doing, place the child in his crib or a safe place, leave the room and call a friend or listen to music to calm down. When you are calm, return to the child's room and try again to comfort him. Remember that babies cry as a way to communicate their needs to you.
Signs of Abuse and Neglect:
Signs of abuse and neglect in children include:
- Unexplained injuries such as cigarette burns, bruises, scratches, or cuts, especially on the fleshy parts of the body such as the stomach, thighs or buttocks;
- Poor hygiene, including dirty or torn clothing;
- Nightmares or trouble sleeping;
- Sadness, passivity, acting out violent behaviors with playmates or trouble getting along with playmates;
- Reluctance to go home from school, friends' homes or other family members' homes, or the tendency to stay away from their homes as much as possible;
- Destructiveness with toys or violence toward a pet;
- Fear of adults;
- Sexually acting out.
Parents who abuse their children often stay away from other mothers and fathers in the neighborhood, do not take part in school activities and may have a drinking or drug abuse problem. They also often don't want to talk about their child's injuries or seem nervous when they do.
If your partner abuses you but not your child, you still need to seek help - it could just be a matter of time before your child becomes a victim. Living in a violent or emotionally abusive household also has long-lasting psychological and sociological effects on children.
If you are an abusive parent, the Family Violence Center can help you.
Anger management classes, parenting classes and private counseling are also available from St. John's. Call 888-8888 or 1-800-909-TEAM for more information.
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DROWNING & WATER SAFETY
Drowning is the second leading cause of unintentional injury-related death among children older than 4, and the leading cause of unintentional injury-related death among children ages 1-4. It can happen in a matter of seconds and usually occurs in residential swimming pools and open water sites.
"Children can drown in as little as 1 inch of water," Holt warns, "and are therefore at risk of drowning in wading pools, bathtubs, buckets, diaper pails, toilets and hot tubs. The majority of children who survive near-drowning are discovered within two minutes following submersion; those who die are discovered 10 minutes following submersion. Nearly all who require cardiopulmonary resuscitation die or are left with severe brain injury."
Water Safety Tips:
Holt encourages parents to use these water safety tips to protect their children in the water:
- Never leave a child unsupervised in or around water in the home. Empty all containers immediately after use and store out of reach;
- Never leave a child unsupervised in or around a swimming pool or spa, even for a moment;
- Never rely on a personal flotation device or swimming lessons to protect a child. Learn CPR and keep rescue equipment, a telephone and emergency numbers poolside (or lakeside);
- Install four-sided isolation fencing, at least 5 feet high, and equipped with self-latching gates around home swimming pools. Fencing should completely surround swimming pools or spas and prevent direct access from a house or yard;
- Always wear a Coast Guard-approved personal flotation device when on a boat, near open bodies of water or when participating in water sports. Air-filled swimming aids such as water wings, are not considered safety devices and are not substitutes for PFDs;
- Never dive in water less than 9 feet deep;
- Children younger than 15 should never operate a personal watercraft.
FIRE & BURN SAFETY
Fires and burns are the fourth-leading cause of unintentional injury-related death among children 14 and younger and are among the most painful and devastating of all injuries. Flame burns are most common among older children while scald burns (caused by hot liquids or steam) are most common among young children. Young children have thinner skin than that of older children and adults, so their skin burns at lower temperatures and more deeply, Holt, who used to work in St. John's burn center, says. All children are also at risk for electrical, contact and chemical burns.
Tips for Burn Prevention:
St. John's Regional Health Center houses the only burn center in the region and has several tips for burn prevention:
- Never leave a child alone, especially in the bathroom, kitchen or near a grill;
- Keep matches, gasoline, lighters and all other flammable materials locked away and out of children's reach;
- Install smoke alarms in your home on every level and in every sleeping area. Test them once a month, replace the batteries at least once a year and replace the alarms every 10 years. Ten-year lithium alarms are also available and do not require an annual battery change;
- For the best protection against different types of fires, consider installing both ionization alarms, which are better at sensing flaming fires and photoelectric alarms, which are better are sensing slow, smoky fires;
- Plan and practice several fire escape routes from each room of the home and identify an outside meeting place. Practicing an escape plan may help children who become frightened and confused escape to safety in a fire.
- Set your water-heater thermostat to 120 degrees Fahrenheit or below. Consider installing water faucets and shower heads containing anti-scald technology;
- Use back burners and turn pot handles to the back of the stove when cooking. Keep appliance cords out of children's reach, especially if they contain hot foods or liquids. Cover unused electrical outlets with safety devices;
- Keep hot foods and liquids away from table and counter edges. Never carry or hold children and hot foods and/or liquids at the same time;
- Never allow children to handle fireworks.
Holt says homes or vehicles that contain methamphetamine labs put children at risk, especially for burns, because of the flammable nature of the chemicals used to make the illegal drug. She urges parents to get to know the parents of their child's friends well, and to always know where their child is playing.
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FIREARM SAFETY
An estimated 3.3 million children in the United States live in households with firearms that are always or sometimes left unlocked, according to the National Safe Kids Campaign. Unintentional shooting deaths among children most often occur when children are unsupervised and out of school - in the late afternoon, during the weekend, summer months or holiday season. Nearly two-thirds of parents with school-age children who keep a gun in the home believe that the firearm is safe from their children. However, one study found that when a gun was in the home, 75-80 percent of first and second-graders knew where the gun was kept. If you do keep a gun in the house, two safety devices - gun locks and load indicators - can prevent a tragedy.
Gun-Safety Tips:
- Always store firearms unloaded and locked up out of the reach of children. Ammunition should be locked in a separate location, also out of reach of children. Safety devices such as gun locks, lockboxes or safes should be used for every gun in the home.
- Parents should talk to children about the dangers of guns, teach children never to touch or play with guns and teach them to tell an adult if they find a gun.
- Parents should check with neighbors, friends or relatives, or adults in any home where children may visit to ensure they follow safe storage practices of firearms in their homes.
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AIRWAY OBSTRUCTION
Airway obstruction is the leading cause of unintentional injury-related death among infants younger than 1 year old. These injuries occur when children are unable to breathe normally because food or objects block their internal airways (choking), materials block or cover their external airways (suffocation) or items become wrapped around their necks and interfere with breathing (strangulation).
Children are at risk from choking on small round foods such as hot dogs, candies, nuts, grapes, carrots and popcorn. Hazardous nonfood items are coins, small balls and balloons.
"Most cases of infant suffocation occur when their faces become wedged against or buried in a mattress, pillow, cushion or soft bedding or when someone in the same bed rolls over on them. Plastic bags can also pose risks for infants if their mouth or nose is covered or pressed against them. Children can also suffocate if they become trapped in household appliances, such as refrigerators, dryers, trunks or toy chests," Holt says.
Strangulation occurs among children when consumer products become wrapped around their necks. Common items include clothing drawstrings, ribbons or other decorations, necklaces, pacifier strings and window blind and drapery cords. Children also often strangle in openings that permit the passage of their bodies yet are too small for and entrap their heads, such as spaces in bunk beds, cribs, playground equipment, baby strollers, carriages and high chairs.
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Airway Obstruction Prevention:
Tips to prevent airway obstruction among children are:
- Place infants on their backs on a firm, flat crib mattress in a crib that meets national safety standards. Remove pillows, comforters, toys and other soft products from the crib. Never hang anything on or above a crib with string or ribbon longer than 7 inches.
- Always supervise young children while they are eating and playing. Do not allow children under age 6 to eat round or hard foods like peanuts and other nuts, grapes, raw carrots, popcorn, seeds or hard candy. Keep small items such as coins, safety pins, jewelry and buttons out of children's reach. Learn first aid and CPR.
- Ensure that children play with age-appropriate toys according to safety labels. Inspect old and new toys regularly for damage. Make any necessary repairs or discard damaged toys. Consider purchasing a small parts tester to determine whether small toys and objects in your home may present a choking hazard to young children.
- Remove hood and neck drawstrings from all children's outerwear. To prevent strangulation, never allow children to wear necklaces, purses, scarves or clothing with drawstrings while on playgrounds.
- Never place a crib near a window. Tie up all window blind and drapery cords or cut the ends and retrofit with safety tassels. The inner cords of blinds should be fitted with cord stops.
- Do not allow children under age 6 to sleep on the top bunk of a bunk bed. Ensure that all spaces between the guardrail and bed frame, and all spaces in the head and foot boards, are less than 3.5 inches.
UNINTENTIONAL POISONING
The childhood unintentional poisoning death rate has declined over the past decade, largely due to child-resistant packaging, product reformulation, heightened parental awareness and appropriate interventions by poison control centers and health professionals. Children continue to be at significantly greater risk from unintentional poisoning death and exposure than adults because they are smaller, have faster metabolic rates and are less able physically to handle toxic chemicals. In addition, their natural curiosity and desire to put everything in their mouths increase their poisoning risk, according to the National Safe Kids Campaign.
Children are poisoned by household and personal care products, medicines, vitamins, plants, lead and carbon monoxide.
Poisoning Prevention Tips:
- Store all household products and medications locked out of sight and out of reach of children. Never leave potentially poisonous household products unattended while in use.
- List poison control center and emergency medical service numbers near every telephone. Keep ipecac syrup on hand to be used only on the advice of a poison control center or a physician. Check with your local poison control center to see if they recommend that you keep activated charcoal in the home as well.
- Always read labels, follow directions and give medicines to children based on their weights and ages. Only use the dispenser that comes packaged with children's medications.
- Test children for lead exposure, and test homes built before 1978 for lead-based paint. Cover lead paint with a sealant or hire a professional abatement company to remove the paint. Frequently wash children's hands and faces as well as toys and pacifiers to reduce the risk of ingesting lead-contaminated dust.
- Install carbon monoxide detectors in your home in every sleeping area, and on the ceiling at least 15 feet from fuel-burning appliances. Ensure that space heaters, furnaces, fireplaces and wood-burning stoves are vented properly and inspected annually.
If your spouse or partner is abusing your child and/or you, call 911 or the Family Violence Center at
417-864-7233 (TTY:417-863-1074). Counselors are available at the center 24 hours a day and can help you.
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