1-Accidents in and around the home: Part 1: poisonings

 There are so many different ways a child can be injured and harmed in and around the house.  Working in a paediatric emergency department, medical and surgical wards, I have seen the outcomes of a few of these potentially

preventable accidents.  Nothing replaces the role of supervision by a responsible adult- but there are other things we can do to make the home a safer place for our children.  Not all accidents can be completely avoided, but common sense and foresight goes a long way in prevention.  More than 2000 children die every day across the world as a result of an unintentional or accidental injury and 10s of millions of children are taken to hospital with injuries that often result in lifelong disabilities (UNICEF, WHO, cited in CP, 2009, p.24)..  Don’t let it happen to you and your child!

 

It is important to teach our children about danger and how to stay safe.  We must teach this from an early age, but do not depend on the fact that because you have taught your child not to do something that might harm them, that they will stay safe.  Young children have tunnel vision, cannot comprehend the big picture of a situation, and even though they may understand the word “no” or “stop”, may not obey or fully comprehend the entire concept of why.  Even when you teach a child about a particular danger, they may not understand the concept that it may hurt or kill them.  Don’t rely on your child to keep him/herself safe: continue to supervise and remove potential dangers as well.

Poisonings/ingestions-

Over 45 000 children die each year from an unintentional poisoning (CP, 2009, p.24)- it happens so easily.  Kidsafe poisoning factsheet.

 Medication- This is the obvious one.  Many a child has come through the emergency dept for ingestion of medication, some even need to be admitted for treatment and observation.  Some medications, although very safe in therapeutic levels, can be fatal to children in overdose or cause long term health problems.  Paracetamol is a commonly overdosed drug, and without treatment, can cause major liver damage.  Some medications can be fatal to small children in very small doses (ie. If just one tablet is taken it may result in death).  These included some antidepressants, heart medications, anti-malaria medications, stronger pain killers and some diabetic medications (McGregor et.al, 2009, p.399).  Medications need to be stored correctly:  I already have some advice on this HERE.

 Cleaning chemicals- can be very dangerous.  You need to allocate a storage area out of reach (even with a chair) for all cleaning chemicals.  One child I used to regularly care for inhaled and ingested some caustic soda.  It melted her airways and oesophagus.  As a result she now lives with a tracheostomy, cannot talk, and gets fed through gastrostomy tube in her stomach- although she still has a meal and pretends to eat so she can feel normal.

 Shed/garden/garage poisons- again, up high and lock them away.  Do not store poisons in containers that look like drinking containers and make sure these things are supervised when in use, and put away immediately after use.  Label everything.  Some shed poisons are used in suicide attempts.

 Cigarettes, illicit drugs and alcohol- I have nursed children in the emergency dept, both on the ward and in intensive care, after having ingested these substances and they can make a child very sick.  Again- storage and supervision, or even better- remove these substances from the home altogether.

 Plants- some household plant are poisonous is chewed on by littlies.  Don’t laugh, it does happen.  Approximately 5% of all poisonings involve plants.  Check the pot plants you may have around the inside and outside of your house, remove poisonous plants and teach children not to touch when age appropriate.  A list of dangerous plants can be found HERE: Kidsafe poisonous plants factsheet.

 Creams, deoderant and makeup- should all be treated like chemicals.  Be mindful of what you leave on your change table- baby oils, nappy creams and powders not only make a mess when played with by a baby or toddler, but can also be very dangerous.

ACTION: POISONS HOTLINE (Australia): 13 11 26.  If a poisoning does occur- read the label for advice on ingestion- some substances will cause greater damage if vomited (ie- acidic or highly alkaline chemicals) The use of “syrup of Ipecap” is no longer recommended in the treatments of poisonings (McGregor et.al, 2009, p.402).  Call an ambulance if there is decreased consciousness, seizures, vomiting with aspiration, difficulty breathing or life threatening concern.  Commence CPR  if necessary.  Be sure to take the packet or bottle of the ingested substance with you- for the hospital staff to calculate what dosage was taken, and the ingredients.

 

WHAT YOU CAN DO:

**LEARN FIRST AID and CPR.  St John’s offers a “Care for Kids” first aid course.

**Take this home safety questionnaire NOW:

**Kid-safe fact sheets can be found in the foyer of the Women’s and Children’s Hospital, SA. , possibly also at other major children’s hospitals. Also online.

**Assess your home from a child’s perspective- what can you see, what can you reach, what looks interesting, what would encourage your curiosity, what is potentially UNSAFE?

**keep important phone numbers (like poisons hotline) on speed dial or written near your phone.

**keep a stocked first aid kit in your home and car.

**read more about safety and first aid- most of this information you need to know before an accident happens.  See these links:

Kidsafe

http://www.indiaparenting.com/raisingchild/data/raisingchild027.shtml

http://www.hkfsd.gov.hk/home/eng/source/safety/Children_home_accident.html

child and youth health:

Child and Youth Health home safety:

Child and Youth heath toddler safety:

CPR current recommendations:

Conclusion:  Adequate prevention strategies and supervision could potentially prevent over half of childhood accidents.  Look around your house from a child’s perspective, room by room, and predict any potential dangers.  Do this regularly- children grow fast and their development progresses rapidly- one day you are considering when the first roll will be, before you know it, your child is dragging chairs to reach things in high places.  You need to constantly assess your home and be one step ahead of your child- don’t wait until your child can access a danger before you do something about it!!

references

CP (author not stated)- 2009, ‘Study: Over Two Thousand Kids Die of injuries Each Day’, Contemporary Pediatrics, vol 26, no1, p.24

 McGregor, T; Parkar, M; Rao, S; 2009, ‘Evaluation and management of Common Childhood Poisonings’, American Family Physician, vol. 75, no.5, pp.397-403.

 Kidsafe website

 CYH website.