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"What To Do When Your Child Gets Sick": Injury Prevention - 10 August

"What To Do When Your Child Gets Sick" - Injury Prevention

The most common cause of death in all over 1 year old children is trauma, and the under 4's are most at risk. Thankfully, the vast majority of injuries in childhood will be minor. Here are the statistics for New Zealand:

Falls are the most common cause of injury in children of all ages. Most serious falls in small children occur when falling from one level to another (i.e. down stairs, off furniture, out of windows, or whilst being carried).

In NZ, drowning is the most common cause of death in the under 5s. A quarter of all drowning in this age group will occur within the home (e.g. in a bath or bucket); nearly half will occur in a swimming pool.

16 children will die in NZ each year, as passengers in motor vehicle accidents. 280 will also be hospitalised with injuries. Correctly fitted car seats will reduce the risk of death and injury by 50-70%.

366 children will be hospitalised each year as a result of accidental poisoning - the 2nd highest cause. Nearly all of these will be in the 0-4 year old age group. 2/3 of these are due to accidental ingestion of drugs or medicines.

5 children, aged under 10 years, die each year from fires - caused primarily by unattended heaters, or a child playing with matches, candles or lighters. 

Hot drinks are the number 1 cause of burns in under 5 year olds. Excessively hot water in baths, showers and sinks is the 2nd most common cause.

Over 100 children, aged 0 - 4 years, are admitted to hospital each year with cuts or puncture wounds. Over 50% are foot injuries after standing on something sharp.

Emergency first aid and life-saving intervention during the 1st couple of hours after serious trauma can save lives:
A (open an unconscious child's airway),
B (support their breathing),
C (put pressure on any obvious bleeding wounds - Circulation).

Most injuries are preventable, with proper preparation, planning and thinking ahead.

Who is most at risk:
Under 4s (usually at home)
Socially deprived backgrounds
Stress, bereavement or chronic illness in the family home.

Why do children have accidents:
Height - they may be unable to see above or over an obstacle due to their small stature; they are also very hard to see, especially for example by a reversing car.
Inquisitiveness - curiosity is essential to development, but may lead a child into danger they are not aware of.
Inexperience - they have a limited perception of their environment, and are unaware of potential danger in every day situations.
Inadequate supervision
Stage of development - young children are unable to appreciate danger, eg road sense does not develop until at least 8 years of age.
"Bravado" - children often injure themselves by pushing, shoving or wrestling each other (especially boys); they also push the boundaries of their abilities, especially when in a group.

How to prevent injuries in the first place:
Prevention is the most useful thing that parents or caregivers can do to keep their children safe. Thinking ahead about the potential risks in any situation (eg at home, walking to school, on the roads, at the beach) means that action can be taken to prevent the children putting themselves in danger in the first place.

Safety Checklist (adapted from The Child Safety Foundation of NZ):
Keep floors dry
Fix toddler-proof locks to low drawers and cupboards
Keep electrical cords away from the edge of the bench
Turn pot handles to the back of the stove
Keep sharp knives etc stored up high
Put safety plugs in all sockets
Use non-slip mats in the bath and shower
Supervise young children in the bath at all times
Keep all medicines, detergents, washing powders etc out of reach, in a locked cupboard.
Fit safety catches to low windows
Place hot liquids in the centre of the table
Fit a fire guard around all fireplaces and heaters
Keep the heater 1m away from curtains and furniture, and children 1m away from the heater
Don't keep chemicals in old drink bottles - it looks too tempting to children
Store buckets or other water containers in high places - babies can drown in tiny amounts of water
Fix stair gates to top and bottom of stairs
Check the hot water tap temperature - safer at 54oC (approx 10 seconds for serious burn) rather than 60oC (1 - 3 seconds for serious burn)

Minimum 1m railing around any deck, with vertical railings (to avoid climbing)
Paint edge of steps with white paint to help visibility
Trim hedges and trees around the driveway to ensure clear vision for drivers
Keep decks and paths clear of mildew, moss and excess water
Always check the driveway is clear of children and toys before moving your vehicle
Keep the pool fence locked at all times
Always supervise children in the pool
Teach your children to always wear a cycle helmet when riding a bike - reducing the risk of a head injury by 85%
Check that your child's car seat is compliant, correctly installed in the car, and always used - thereby reducing the risk of death by 70% for infants and 50% for toddlers.
Teach your preschooler your street address and phone number
Get a First Aid kit, familiarise yourself with it, and know what to do in different emergencies.

For more information, and advice on Basic Life Support:

Call Health Line - 0800 611 116. 24/7 toll-free number, staffed by registered nurses for triaged health advice.

Child Safety Foundation: (09) 638 7603

Poisons Information Line: 0800 764 766.

Read the chapters on injury and first aid in "What To Do When Your Child Is Sick" - an emergency manual for parents and carers; by Associate Professor Paul Middleton, Dr Andrew Ratchford, Dr John Mackenzie, Dr Jason Smith; available from book stores. In 2011, the authors will also be running courses for parents in New Zealand - see the website

First Aid Courses in NZ include the Red Cross and St John (information available on-line).

Your family doctor, practice nurse or well-child/Plunket nurse will give you information in a non-urgent situation.

 In an emergency, dial 111 or go to your nearest emergency department.