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

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

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)

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

““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).

‘Accidents’ waiting to happen

‘Accidents’ waiting to happen

‘Accidents’ waiting to happen

“...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)

“...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.

Mapping injury rate shows link to deprivation in Bristol

Relative rates of unintentional injury

The Avon Longitudinal Study of Parents and Children (ALSPAC) and accidental injuries

0-6 months• Rolling at 3 months

• Crawling at 6 months

• Grabbing

• Hand to mouth

• Random ‘lashing’ about

0-6 months injury risks

• Rolling + Crawling

• Grabbing + Hand to mouth

• Random ‘lashing’ about

Falls

Suffocation

Choking

Hot drink scalds

Hot drink scalds

Toddlers

• ‘Head-heavy’ toddling

• Exploring, climbing, reaching

• Hand to mouth

Toddlers injury risks

• ‘Heavy headed’ toddling

• Exploring, climbing, reaching

• Hand to mouth

Falls

Falls

Drowning

Hot drink scalds

Strangulation

Choking

Poisoning

Getting older

• Copying (Wanna be like you..)

• Playing, exploring, learning

• Climbing

• No sense of danger..

Risks

• Copying

• Playing, exploring

learning what’s nice

• Climbing

Poisoning

Bathwater scalds

Kitchen hazards

Falls

Poisoning

Falls

Prevention = The 5 E’s

Engineering

Enforcement

Education

Engagement

Empowerment

“Common sense inn’it?”

Risk

Rob

Average

Deprived

Prevention = The 5 E’sPrevention = The 5 E’s

EngineeringEngineering

EnforcementEnforcement

EducationEducation

EngagementEngagement

EmpowermentEmpowerment

BURNS and SCALDS under 2 BURNS and SCALDS under 2 years years

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

Place burn occured

0

5

10

15

20

25

30

35

40

45

50

%6 months %

15 months%

24 months%

6 months

15 months

Drinks/cooking waterFood/utensilKitchen applianceHeating applianceBathSunCigaretteOtherNo response

24 months

Cause of burn

Kitchen

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

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

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.

Preventing Poisoning

Safe storage, straight away

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”).

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

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