Accidents, both inside and outside the home, are the main cause of death to children under five. The nought to five age group and the over 65s are the groups most at risk, as they are the ones who are least able to look after themselves. One in three accident patients in hospital is a child.
Young children are not aware of danger, and they do unexpected things. They do not know that if they eat certain things they will be poisoned, if they fall downstairs they may break bones, or if they touch a gas flame they will be burnt. It is therefore the responsibility of adults who look after children to try to foresee how accidents can happen and try to prevent them.
Safety in the home
No home can be totally accident proof, but most accidents in the home could be prevented with a little care and forethought. Children are more prone to non-fatal accidents than to fatal ones, but non-fatal accidents can leave
permanent scars and damage. During an average year 230 000 children in the under-five age group will have an accident at home. The main types of accidents are:
- choking and suffocation
- scalds and burns
Some of the causes of these accidents happening in the home are described below.
Choking and suffocation
- Playing with plastic bags;
- cat lying on sleeping baby;
- swallowing small objects such as buttons, small toys, tiny sweets;
- leaving a baby to feed himself from a propped-up bottle;
- plastic bib blown over the face of a sleeping child;
- allowing a baby to have a pillow;
- cord or ribbon fastening at the neck of a garment;
- a dummy on a long string round baby’s neck;
- food which is not suitably chopped or puréed for a small child, or has bones or gristle left in.
Scalds and burns
- Having small child on lap when drinking a hot drink;
- water too hot and not tested first;
- open fires left unguarded;
- using fabric for children’s clothing (especially nightwear) which is not flame-resistant;
- leaving matches or burning cigarettes lying about;
- leaving a teapot of tea on the edge of the table, or leads of electric kettles where toddlers can pull them, or saucepan handles overhanging the top of the cooker, or a washing machine ‘containing hot water without its lid or with its door open.
- Falling down stairs and steps;
- not using safety gates;
- poor lighting on the staircase;
- leaving things on the floor for children to fall over;
- leaving small children unstrapped in high chairs or prams;
- the drop-down side of a not being secure;
- babies rolling off surfaces such as beds, tables, or changing worktops;
- windows left open;
- cots placed under unbarred windows in the nursery;
- falls from the balconies of apartments.
- Swallowing pills the child thinks are sweets;
- drinking medicines for someone else or in the wrong quantities;
- drinking disinfectants and cleaning fluids; eating cosmetics, which he finds in unlocked drawers and cupboards.
- Babies will also chew newspapers, paper bags, magazines, etc., which can be harmful, and they will chew painted woodwork, which can cause lead poisoning if the paint is not lead-free.
- Petrol, lighter fuel, turpentine and rat poison have all been known to cause accidental poisoning to children.
- Broken glass;
- broken crockery;
- sharp edges to toys;
- sharp knives;
- razor blades; scissors.
- Children walking or running with a tumbler or mug in their hands can fall and break it;
- they can run into glass doors or they can ride or push their toys into them and break them.
- Small children will pick up sharp household instruments and tools, not knowing that they can cut themselves.
Being left alone in their bath, even when only for a few minutes. Children have also drowned in washing machines when left alone in the kitchen. A young child can drown in only a few centimetres of water.
- Unsafe wiring or electrical appliances;
- small children poking knitting needles down the holes of sockets, or chewing through the trailing flex of an appliance, or pulling the back off an appliance or poking their fingers into the live parts.
Most of the accidents described above can be prevented by parents not allowing these circumstances to arise.
Accidents can also be prevented by:
- making sure that all members of the family are safety conscious. This should
- include visitors to the house such as grandparents, relations and friends.
- never leaving a child alone unless he is completely secure, i.e. strapped in a pram or playing in a playpen; and even then frequent checks should be made to be sure he is safe.
- making sensible use of safety equipment such as a cat net on the pram, safety gates at the top and bottom of the stairs, a cooker guard, plastic plug-in socket covers, plastic film to cover glass doors and windows and hold glass in place if it is broken, window bars and safety catches, and cupboards with locks for keeping dangerous substances or articles.
- making sure that the home and garden are as safe as possible and carrying out regular checks on anything that may become dangerous. Repairs should be carried out immediately; damaged furniture, toys, worn carpets and damaged appliances have caused injury to many children.
- teaching a child how to cope with danger and how to be aware of it, without making him too timid. There should be a happy medium between recklessness and overprotection.
- setting a good example. Children will follow the example set by their parents.
A child will be very lucky indeed to avoid having any accidents at all, and parents should make as sure as possible that any accident is only a minor one, and that they have some idea of what to do in an emergency. All parents, especially the main person looking after the children, should have a basic knowledge of first aid, and there should be a well-stocked first aid kit easily accessible in every home. Either buy a special first aid box and contents, such as those supplied by major retailers and pharmacists, or use a clean biscuit tin with a well-fitting lid, clearly labelled. Check the contents regularly to clear out old items and replace used ones. The box should be kept in the kitchen or bathroom out of reach of children.
Contents should include:
- adhesive dressings in various sizes;
- assorted bandages, including crepe bandages for strains;
- a packet of gauze dressings:
- a tube of antiseptic cream;
- a roll of cotton-wool;
- paper handkerchiefs;
- a roll of adhesive tape;
- blunt-ended scissors;
- medicaments such as paracetamol, milk of magnesia, insect repellent, calamine lotion, TCP and Burneeze;
- and a first aid manual.
It is sensible to keep a special cupboard for storing medicines. It should be cleared out regularly to get rid of old medication.
Contents should include all medicines prescribed for anyone in the family; pain killers, such as aspirin (not for the under 12s); laxatives; kaolin mixture (for stomach upsets); antiseptic creams; eye and ear drops; nasal sprays; medicaments for cold relief; cough mixtures; medicine spoons; a medicine glass; and a clinical thermometer (or a heat strip).
General points on First Aid for Children
- Everyone in the house should know where the first aid box is.
- There should be a list of telephone numbers that may be needed, i.e., those of the doctor, ambulance, hospital, fire service and police.
- In an emergency try not to panic. Even if feeling panicky the parent should try to appear calm, and think clearly.
- Remove the child from the source of the accident, e.g., switch off the electricity, heat or gas, remove the child from the water, remove knife or tablets, etc.
- In the case of poisoning try to keep some of the poison (tablets, medicine, bleach, plant, etc) to show to the doctor.
- Stay with the child, or leave someone with the child and get help as quickly as possible.
- Do not administer any first aid unless you know what you are doing. Badly applied first aid can make matters much worse.
- Do not give the child anything to eat or drink. Keep the child warm, check that he is able to breathe, and get help.
- If the accident only appears to have minor effects, e.g., a fall, the child should be carefully observed for some time afterwards to check for delayed reaction. A check-up with the doctor or hospital is usually necessary.
- A little bit of blood goes a long way. What may appear to be a severe cut may only be a minor scratch when the blood is wiped away.
- The child will be frightened and will need calm reassurance and soothing, certainly not being shouted at or scolded.
Treatment for specific injuries changes from time to time as improvements are made. It is wise to keep up to date. First aid courses are often arranged by local hospitals, health centres, the St John’s Ambulance Association, the Red Cross Society or local education centres. Knowing what to do in an emergency will give confidence and help to reduce panic.
Treatments for specific injuries
Use only cold water to treat burns or scalds. Hold the burn in cold water for several minutes – under running water if it is a small hand burn. This will reduce the heat in the skin. Remove any tight clothing, and any fabric that is soaked in boiling water or a corrosive chemical such as bleach. Do not remove any burnt fabric. Do not apply ointment, cream or butter. Do not prick blisters. Medical treatment is usually needed.
Bleeding and cuts
For minor wounds the bleeding will soon stop of its own accord. The wound should be cleaned and a plaster put on.
For severe bleeding, press firmly on the wound with a pad of cotton-wool, pressing the edges of the cut together. Lay the child down and raise the affected limb; this helps to stop the bleeding. Apply a clean dressing and take the child to hospital for stitches. A wound that pierces the flesh, such as a dog bite, or one that happens in the garden, will make a tetanus injection necessary.
Do not move the child if you think a bone may be broken, unless he has to be moved from danger. If the leg is broken, tie the uninjured leg gently to the injured one, putting padding between. Put an injured arm in a supporting sling if possible, and get help as soon as you can.
Do not try to remove the object with your fingers – you may only push it further in.
Hold a baby or small child upside down by the legs and give sharp slap’s between the shoulder blades. A larger child should be held round the waist and tipped well forward over the parent’s arm, then slapped sharply on the back between the shoulder blades.
Remove child from water, lay him on his back and give mouth-to-mouth resuscitation immediately, even if the child appears dead.
- Clear the child’s mouth of any dirt, vomit, etc.
- Push the child’s head back and chin upwards to clear the airways.
- Put your mouth over the child’s nose and mouth and blow gently (20 breaths per minute) so that the child’s chest moves.
- Continue doing this until the child starts to breathe again.
- Place child in the recovery position, by turning him half over on to his stomach with one arm slightly behind him and the other arm bent in front. Bend the lower leg up to support the lower body and turn his head to one side.
If the child has swallowed pills or medicine get him straight to hospital, taking some of the substance with you. Do not try to make him sick. If he has swallowed household or garden chemicals including corrosive substances (such as bleach or weed killer), give him milk or water to dilute the poison, then get him to hospital.
Electric shock Switch off the current immediately, at the mains if it can be reached quickly. or if not by pulling out the plug. Do not touch the child until you have done so or you may also get a shock. If you cannot switch off the current, stand on a box or rubber mat and push the child away from the source of the electricity with a chair or broom handle. Make sure your hands are dry. If he has stopped breathing give mouth-to-mouth resuscitation (see ‘Drowning’ above).
If his heart has stopped, immediately begin CPR (cardiopulmonary resuscitation).
- Put the heel of one hand on the child’s breastbone, just above the notch where the ribs meet it, and place the other hand on top of that. Keep your fingers lifted off the child’s chest.
- Kneel beside the child with your shoulders directly over his breastbone.
- Push down with straight arms so that the child’s breastbone goes down about 2.5 – 3.0 cm (1-11/2 in.) then release it. Repeat this five times.
- Quickly lean towards the child’s head and push his chin up. Put your mouth over his nose and mouth, and blow gently once.
- Go on giving five compressions and one breath like this until the child’s heart starts. Then give mouth-to-mouth resuscitation (see ‘Drowning’ above) until the child starts breathing.
Remove the cause of suffocation, usually a plastic bag or a pillow, and give mouth-to-mouth resuscitation (see ‘Drowning’ above) if breathing has stopped.
Children fall down frequently and usually recover very quickly. If, however, a short time after the fall the child is sick, drowsy, bleeds from the ears or becomes unconscious, he may have damaged his skull and needs immediate medical attention.
Safety in the garden
Most of these points are obvious, but unfortunately many children have accidents in the garden because it is not regarded as needing the same security as the home.
- Cover any ponds, water butts or paddling areas with wire mesh or a lid.
- Fence the whole area, and keep the fence in good repair. Have child-proof catches on the gates and make sure people visiting or delivering post, milk, etc., do not leave them open.
- Keep all garden tools and substances in a locked shed.
- Fence off rubbish bins and garden refuse. Remove animal droppings as soon as they are spotted.
- Always use a fine mesh pram safety-net when leaving a baby outside in his pram.
- Keep garden toys in good repair and see they are of a safe design. The hard edges of swings should be padded with soft material such as old rubber tyres.
- Teach children how to climb trees, climbing frames, etc., safely and carefully, without reducing their sense of adventure.
- If any DIY jobs are being done, such as building or repairing walls or greenhouses, toddlers must be kept well away.
- Barbecue equipment or fuel and garden lights can be very attractive to small children.
- The flowers and other plants shown here are poisonous and should never be grown in a garden where children play.