Injury control

What are the common causes for injuries?

Unintentional injuries are common among children aged 14 years and under. Most of these injuries are caused by burns, scalds, drowning, suffocation, choking, poisoning, falls and electric shock. Young children under 4 years are at the greatest risk from unintentional injuries in the home because it is where they spend the majority of their time. As children grow older, they spend less time in the home and incidence of home injuries diminishes.

But injuries are preventable. All children try to learn by imitating, pulling, pushing, climbing and touching. This is the normal way of learning. A child while doing these things is liable to hurt himself. It is the duty of parents to encourage him in his process of learning and protect him against the obvious hazards. It is imperative for parents not only to make the household, but also the neighbourhood, safe for the child. If you have taken all necessary precautions inside the house but are not bothered about what goes on in the park where the child plays, you are still guilty.

All accidents do not result in death. Many of them leave the child crippled or disfigured or result in unnecessary pain. It is easier to prevent an accident than to treat a child after the damage has been done. Keep your eyes open and your mind alert for possible situations, which may result in injury to your child.

How can children be prevented from burns and scalds?

These are very common in India. Burns are commonly caused by hot water, which may be in a teapot or boiling in a pan, in a bucket in the bathroom or boiling water from taps. The child reaches up to the pan, not knowing what it contains. Out of curiosity he may put his hand into it or may spill it on himself thereby burning his hands, legs and abdomen.

Preventive Tips

1. Do not drink hot beverages when a child is sitting in your lap.
   
2. Coffee and teapots should not be left on the table. Table cloths should not hang down so that the child is able to pull it and overturn things on to himself.
   
3. The geyser temperature for hot water should not be set higher than 125 degree F. Do not leave your child alone in the bathroom with a bucket of hot water.
   
4. It is better not to use steam vapourizer for the child. Nebulizers are a better option when indicated.
   
5. Always check the temperature of hot water with the back of your hand before you wash the child.
   
6. Young children should not be allowed to play near hot ovens. Try not to have the child with you when you are cooking in the kitchen.
   
7. Place guards in front of heaters, and the iron should be unplugged when not in use.
   
8. Kerosene stoves are a common cause of burns. Fix the stove in such a way that it is stable and will not topple easily.
   
9. Chemicals like strong acids, alkalies, caustic soda and some dyes cause burns. All these chemicals should be kept locked.
   
10. Synthetic materials like nylon are liable to catch fire easily. Ensure that your child is not wearing clothes made of such material and keep him away from any source of fire.
    
11. Children are very fond of lighting matches and blowing out flame. Matches and lighters should not be accessible to children.

1. In case of scalds take off the clothes immediately.
   
2. Flood the burn area with tap water. Don’t use ice cold water.
   
3. For chemical burns, flood the burnt area with plenty of water.
   
4. Burned area should be cooled with running tap water. Cooling the burnt area for a few minutes is worth the effort because heat can damage the tissues of the body for quite sometime even after the source of heat has been removed.
   
5. Do not apply any ointment, toothpaste oil or cream to the burn.
   
6. The burn can be covered with a clean dry thin sheet.
   
7. If blisters have formed do not prick them because it will expose the burn area to unnecessary infection.
   
8. For small burns, you can apply antiseptic cream on your doctor’s advice. Paracetamol may be given to relieve the pain.
   
9. For large, extensive burns, the child should be taken to the nearest hospital.
   
10. Do not give milk or food to the child since he may require anaesthesia in hospital. Otherwise the child may vomit and aspirate.

How can injuries from electric shock be prevented?

Small children are very fond of putting their fingers into electrical sockets. Electric shocks can cause burns and even be fatal.

Prevention Tips

1. Children should be taught not to play with electrical fittings.
   
2. Do not amuse your child by repeatedly switching the light switch on and off.
   
3. Plug unused electrical outlets, alternatively one can place heavy furniture in front of them.
   
4. It is preferable to put safety circuits, which will automatically cut off the current in case any child comes in contact with a live point.

1. Switch off the electrical current immediately.
   
2. Push the child away from the current with a dry wooden stick.
   
3. Never attempt to push or pull the child directly yourself.
   
4. In case the child is not breathing, start CPR and rush your child to the hospital.
   
5. Electric shock can cause extensive burns for which the child may require hospitalisation.

What are airway obstruction injurries? How can they be prevented?

Airway obstruction injury (suffocation, choking and strangulation) is the leading cause of unintentional injury-related death among children. These injuries occur when children are unable to breath normally because food or objects block their airways (choking), material that blocks or covers their external airway (suffocation) or items that wrap around their neck and interfere with breathing, (strangulation). Children especially those under 3 years are particularly more vulnerable to airway obstruction due to the small size of their of their upper airway, their relative inexperience of chewing and their natural tendency to put objects in their mouths. Infants may suffocate when their face become wedged against or buried in a mattress, pillow, infant cushion or soft bedding. Children can suffocate when they become trapped in refrigerators, cupboards or drawers. A majority of childhood choking injuries are due to small food items like food, nuts, grapes, carrots, popcorn, coins, small balls or balloons. Strangulation occurs among children when items drawstrings of clothings, ribbons, necklaces, plastic or polythene carry bags become wrapped around their neck.

Prevention Tips

1. Place infants on their back on a firm, flat crib mattress. Remove pillows, comforters, toys and other products from the crib.
   
2. Always supervise your child while they are eating and playing. Do not allow children under age 6 to eat foods like peanuts. Children under age 6 should not eat grapes unless the skin is removed and they are chopped into small pieces.
   
3. Keep small items likes coins, safety pins, jewellery and balloons out of children’s reach.
   
4. Ensure that children play with age appropriate toys. Very small toys or toys with very small parts present as choking hazards to children.
   
5. Remove hood and neck drawstrings from all children’s outer wears, necklace, purses, tajeebs or clothing with drawstrings while they are playing.
   
6. Tie up all window blind and drapery cords. Never hang anything on or above a crib with a string or ribbon longer than seven inches.
   
7. Do not let empty carry bags lie around the house, for if a child puts it over his head, oxygen is cut off and he cannot breathe. Put these bags out of reach of children.
   
8. Dissuade your children from playing in cupboards. Cupboards should not have automatic locks and indeed as a precaution, you should keep them locked.
   
9. Always ensure that a window or door is open when burning a coke fire or using cooking gas.
   
   First Aid
   
   
   1. Choking should be suspected any time an infant begins to have trouble breathing (coughing, gagging or making a high pitched noise while taking a breath), or is unconscious and not breathing.
      
   2. If the infant can breathe, cough cry or speak, stand by but do not interfere and take the child to hospital.
      
   3. If the child is not able to cry or speak, is not breathing or becomes unconscious, call for help and start back blows and chest thrusts.

What first aid should be given to a child who has survived drowning?

Drowning usually occurs suddenly and silently. Childhood drowning and near drowning can happen in a matter of seconds and typically occurs when a child is left unattended or during a brief lapse in supervision. Two minutes following sub-mersion, a child will loose consciousness. Children are likely to drown in swimming pools as well as in open nallah, canals and sewers. During monsoon the city streets get flooded with water and open sewers are hazards to unsuspecting children playing in the rain. More than half of drowning among infants (under 1 year) occur in toilets and buckets.

Prevention Tips

1. Never leave a child unsupervised in or around water at home.
2. Empty all containers immediately after use.
   
3. Never leave a child unsupervised in or around swimming pool even for a moment.
   
4. Small children should not be allowed to go out in the rain and they should be always be accompanied by an adult while swimming.
   
5. Learn CPR (Cardiopulmonary resuscitation) if possible.
   
6. Never dive in water less than nine feet deep.

1. If drowning occurs lay the child on his back. Immediately clean the water from his mouth with finger or handkerchief.
   
2. Start mouth to mouth breathing (CPR) if the child is not breathing.
   
3. Do not waste any time in trying to drain water from the lungs.
   
4. Take the child to the nearest hospital even if the child looks fine.