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Safe at HomeSafe at Home
Child injury prevention update Child injury prevention update for Bristol’s childmindersfor Bristol’s childminders
Rob Benington
Injury Prevention Manger
NHS Bristol
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This presentation:This presentation:
Injuries in BristolInjuries in Bristol
Injuries and child developmentInjuries and child development0-6 months0-6 monthsToddlersToddlersGrowing olderGrowing olderParentsParents
Preventing injuries Preventing injuries
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Our Our (annual) (annual) UK child UK child injury injury burdenburden
Deaths
(231)
Emergency admissions
(124,000)
Attendances at emergency
departments(2,000,000)
Minor injuries treated at Health Centres and GP surgeries or at home
ReferencesInjury pyramid:BMA (2001) Injury Prevention Very minor (often untreated) injuries
Low numbers
High numbers
High severity
Lower severity
((Figures are approximate annual totals for different age groups : deaths 0-18; admissions 0-14, attendances, 0-16)
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Bristol’s 0-16 Bristol’s 0-16 annual annual
injury burdeninjury burden Deaths: one or two
1,000+ emergency admissions
13,000+ emergency attendances
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““Injuries do not occur by chance. Injuries do not occur by chance. They are largely preventable, non-They are largely preventable, non-random events, and not “accidents”. random events, and not “accidents”. Certain groups of people with certain Certain groups of people with certain characteristics are more likely to be characteristics are more likely to be injured. By studying how injuries injured. By studying how injuries vary within a population, we can vary within a population, we can begin to gain an understanding of begin to gain an understanding of the factors that lead to injury, and the factors that lead to injury, and how the risk of injury may be how the risk of injury may be reduced”. reduced”.
Injury Prevention, Injury Prevention, British Medical Association, (2001).British Medical Association, (2001).
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‘Accidents’ waiting to happen
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‘Accidents’ waiting to happen
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‘Accidents’ waiting to happen
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“...certain groups of people are more likely to be injured....”
Children of poor families have more injuries
0
20
40
60
80
100
1 2 3n 3m 4 5
1979-1983
1989-1992
Injury death rates in children 0-15 by social class.
(BMA, 2001.)
Social Class 1 (Richer)........Social Class 5 (Poorer)
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“...certain groups of people...”
Children... • of single parents
• of alcohol and drug users
• living in rented accommodation
• of unemployed parents
.....are at higher risk of injury.
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Mapping injury rate shows link to deprivation in Bristol
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Relative rates of unintentional injury
The Avon Longitudinal Study of Parents and Children (ALSPAC) and accidental injuries
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0-6 months• Rolling at 3 months
• Crawling at 6 months
• Grabbing
• Hand to mouth
• Random ‘lashing’ about
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0-6 months injury risks
• Rolling + Crawling
• Grabbing + Hand to mouth
• Random ‘lashing’ about
Falls
Suffocation
Choking
Hot drink scalds
Hot drink scalds
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Toddlers
• ‘Head-heavy’ toddling
• Exploring, climbing, reaching
• Hand to mouth
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Toddlers injury risks
• ‘Heavy headed’ toddling
• Exploring, climbing, reaching
• Hand to mouth
Falls
Falls
Drowning
Hot drink scalds
Strangulation
Choking
Poisoning
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Getting older
• Copying (Wanna be like you..)
• Playing, exploring, learning
• Climbing
• No sense of danger..
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Risks
• Copying
• Playing, exploring
learning what’s nice
• Climbing
Poisoning
Bathwater scalds
Kitchen hazards
Falls
Poisoning
Falls
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Prevention = The 5 E’s
Engineering
Enforcement
Education
Engagement
Empowerment
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“Common sense inn’it?”
Risk
Rob
Average
Deprived
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Prevention = The 5 E’sPrevention = The 5 E’s
EngineeringEngineering
EnforcementEnforcement
EducationEducation
EngagementEngagement
EmpowermentEmpowerment
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BURNS and SCALDS under 2 BURNS and SCALDS under 2 years years
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Burns and scalds – CausesBurns and scalds – Causes
1.1. Hot drinks Hot drinks
2.2. Hot foodHot food
3.3. BathwaterBathwater
4.4. Hair straighteners / ironsHair straighteners / irons
Hot water burns like fire
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Place burn occured
0
5
10
15
20
25
30
35
40
45
50
%6 months %
15 months%
24 months%
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6 months
15 months
Drinks/cooking waterFood/utensilKitchen applianceHeating applianceBathSunCigaretteOtherNo response
24 months
Cause of burn
Kitchen
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Falls in under 5’s - Causes
• Stairs and steps• Falling from furniture (sofas, bunk beds, high
chairs)• Falling from beds when having nappies changed• Baby walkers• Climbing routes
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Falls in under 5’s - Prevention
• Childproofing
Use stair gates and window locks, break climbing routes by moving furniture.
• Rules
No (stair) climbing without a parent.
No play on bunk beds.
Strap into high chairs
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Causes of poisoning
1. Common painkillers and cold remedies are the single biggest cause of serious childhood poisoning.
2. Things not put away in their safe place.
3. Batteries, coins, small toys, pins, keys and other small objects are left where small children can reach them.
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Preventing Poisoning
Safe storage, straight away
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Preventing Poisoning
• Tidy up.
• Lock away above head height. (Treat all pills, medicines, liquid painkillers and cold remedies like prescription medicines).
• Straight away. Health visitors in Nottingham found poisoning happens when things are left out because they are still in use, or “will be put away later”).
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Things to do Things to do (please)(please)
Check blind cordsCheck blind cords Scrutinise the hot drink policy in Scrutinise the hot drink policy in
your settingyour setting Check where your poisons are Check where your poisons are
keptkept Ask for free stuff from health Ask for free stuff from health
promotionpromotion Tell parents what you’re doing and Tell parents what you’re doing and
whywhy
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Avonsafe Avonsafe www.tinyurl.com\www.tinyurl.com\avonsafe avonsafe
RoSPARoSPAwww.rospa.comwww.rospa.com
Child Accident Child Accident Prevention TrustPrevention Trustwww.capt.org.ukwww.capt.org.uk
Further informationFurther information