overview...>16 usa & canada 16 strollers and prams 17 common and new hazards pediatr surg int...

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Child safety issues that GPs should know about.

Non-government, independent, not-for-profit community organisation with registered offices in each state of Australia.

Purpose - prevention of unintentional childhood injuries Established nationally 1979

Core program areas Home Safety Car & Road Safety Playground Safety School Safety Research & Injury Surveillance Training

WWW.KIDSAFEQLD.COM.AU 3

Children under 6 years are more commonly injured in their own home.

What are the hazards?

Are childhood accidents preventable?

What is regulated and what is safe?

What every new parent needs to know when taking baby home:

Child car seats and baby capsules – how to choose and use them, safe and unsafe practices;

slings/pouches – wearing your baby;

sleeping surfaces – cots, bassinettes, co-sleepers, mattresses, infant swings and travel systems.

Overview


Overview of common and new hazards in and around the home:

button batteries

toys vs products aimed at children

poisoning

scalds

garages and driveways


Every year in Australia

more children die of injury

than die of cancer, asthma

and infectious diseases

combined


Children up to 6 years of age are at most risk of injury around the home.

Consumer products causing the most injuries in this age group include prams, strollers, cots, high chairs, baby change tables, bunk beds, trampolines, button batteries and magnets.

Other injuries around the home include immersions, driveway runovers, scalds and burns, poisoning, and falls from playground equipment.

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Risk vs HazardRisk (Challenge) is something obvious to the child where he/she can determine own ability and decide whether to take that risk.

A hazard is something unseen or not obvious to the child that often results in injury.


Australian StandardsBaby carriersBaby exercise jumpers Baby toys - regulatedBaby walkers – regulatedBassinnettesBath aides for babies – regulatedBisphenal A (BPA) in consumer productsBuilding blocks – regulatedCar seats for children – regulatedChange tablesCots (folding) – regulatedCots (household) – regulatedCradles (rocking)Dolls – regulatedDummies (baby) – regulatedFlotation and aquatic toys – regulated


High chairsInflatable toys, novelties and furniture – regulatedMagnet toys and novelties – regulatedNightwear for children – regulatedPaper patterns (children’s nightwear) – regulatedPlastic children’s items with more than 1% DHEP – regulatedPlaypensPrams and strollers – regulatedPush/pull along toys – regulatedRocker chairsSafety gatesStuffed toys – regulatedSwimming and flotation aides for children – regulatedToy boxesToys containing lead and other elements – regulatedToys for children under 3 - regulated

Australian Standards


Taking baby home

In hospital baby is swaddled.Skin to skin contact is encouraged.

In the child car restraint baby must NOT be swaddled. Arms and legs must be through the harness to be effective.

No beanies or hats. Do not tuck the swaddle or blanket over the baby.

Skin to skin does not mean showering with the newborn.

WWW.KIDSAFEQLD.COM.AU 11 WWW.KIDSAFEQLD.COM.AU 12

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Safe sleeping, cotsCots must comply with AS/NZS 2172• The mattress must fit snugly to within 20mm of the sides and ends• When the mattress base is set in the lower position, the cot sides or end need to be at least 500mm higher than the mattress• The spacing between the bars or panels in the ends and sides needs to be between 50mm and 95mm• There should not be small spaces between 30mm and 50mm that could trap the baby’s arms or legs.• There should not be small holes between 5mm and 12mm that could trap small fingers.• Check there are no fitting (bolts, knobs etc that might catch clothing and cause distress or strangulation•Castor wheels must have brakes.


Slings and hammocks

3 deaths in Qld1 SA>16 USA & Canada


Strollers and prams


Common and new hazards

Pediatr Surg Int (2013) 29:741–744 DOI 10.1007/s00383-013-3275-y

Small strong earth magnets

2-year 8-month-old girl with a 2-day history of vomiting after meals, abdominal pain and lethargy. No history of foreign body ingestion. She looked unwell and was irritable. Xray revealed a radiopaqueforeign body. At laparotomy she was found to have bowel perforations with entero-enteric fistulae caused by four magnets.

Chain of magnetic balls withdrawn from The bowel of 7-year-old boy was admitted to the General Surgical Unit with a 3-week history of generalized crampy abdominal pain, non-bilious vomiting and anorexia.

ANZ J Surg 83 (2013) 489–490


Between 15% and 18% of all burns in kids are from hot liquids

Area of body most affected from hot beverages:Face, neck and chest

Area of body most affected from bathroom scalds: Legs and feet

Almost a quarter require skin grafts

Common hazards - burns

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Store medicines and chemicals up high in a locked cupboard, out of reach and out of sight of children.

Poisoning is a leading cause of injury to children under five years, and children are often poisoned by common household chemicals, cleaners and medicines.

Common hazards - poisoning

Hand sanitiserLaundry podsE-cigarette

containers may contain nicotine

Lye water


On average 8 children die each year in Australia from low-speed vehicle runovers

1 child each week is runover in their own driveway!


Injuries due to disc batteriesWell described in medical literature from late 1970’s

Severe injury associated with battery becoming lodged in one position

Any battery with more than 1.2V of charge

3V 2cm batteries associated with highest risk: size and charge

Production of NaOH ions at the anode (negative pole)

Caustic injury with local erosion through tissue

Damage continues even after battery removal

Pattern of injury due to:

◦ Charge

◦ direction battery facing

◦ location (oesophageal)

◦ Duration (> 1 hour)


How do children present?Battery missing

Seen to have been playing with one

Parents heard a gulp, cough or choking episode

Self-reported by child (older)

Occult cases: Very non-specific and presentation/ diagnosis often delayed◦ Partial food refusal: (can still vomit, take soft food/ fluids)

◦ Drooling

◦ Mimic croup

◦ Chest pain

◦ Upper GI bleeding (venous: melaena/ arterial: haematemesis)

◦ Mimic epistaxis

◦ Ear/ nasal dischargeWWW.KIDSAFEQLD.COM.AU 24

Antero-posterior and lateral x-rays

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How do kids access disc batteries?◦ Loose:

◦ Purchased loose

◦ After removed from product by adult (table, benchtop)

◦ Discarded (floor, bin, storage container)

◦ Battery packaging: not required to be child resistant

◦ Product:

◦ Accessible battery compartment

◦ Broken product/ battery compartment

◦ Compartment not resecured

◦ Ingested whole product: torches, hearing aids

◦ 3V batteries still have sufficient charge (1.5V) when spent to cause damage

Toys vs products aimed at kids



Current issuesExposure, particularly to 2cm batteries increasing

Batteries accessed pre, in and post product

Range of different products

Only toys are regulated

Proportion of occult/ severe cases increasing

Medical delays can contribute to disability

◦ Diagnostic

◦ Radiologic

◦ Transport/ management

Death can occur weeks after battery removal



Strategies: preventionAwareness: social media

Voluntary guidelines for industry◦ Secure battery compartments

◦ Guideline for promotional products

◦ Child resistant packaging

◦ Labelling

Horizontal battery standard:

◦ any product that contains a disc battery should be robustly constructed and have a secure compartment

Battery recycling initiative

Novel ideas to prevent kids from swallowing them/ damage

Kidsafe SA Inc.Level 1, Gilbert Building Women's & Children's HospitalPhone: 8161 [email protected]

mailto:[email protected]

overview...>16 usa & canada 16 strollers and prams 17 common and new hazards pediatr surg int...

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