PUBLIC HEALTH ADVISORY CONCERNING FENTANYL AND FENTANYL-LACED SUBSTANCES

Healthy Homes - Injury Prevention

Who is at risk for childhood injuriespicture of child touching cleaning products under a sink
What are the leading causes of childhood injury?
What can be done to protect children from falls?
What should you do to prevent burns from fires?
How do you prevent scalding burns?
What to do about drowning?
How do you protect against poisonings?
What can you do to prevent furniture tip-overs?
What can be done to protect against road traffic injuries?
What should you do to prevent sports injuries?
What to do about firearms in the home?
Additional resources

Who is at risk for childhood injuries?

All children ages 0-19 every day are at risk for childhood injuries. Across the United States, injuries are the leading cause of death among children ages 19 and younger. About 33 children die every day because of injuries. Each year nearly 9.2 million children, aged 0-19 years, are seen in emergency departments for injuries, and over 12,000 children die as a result of being injured.

Learn how to keep your children safe and secure to help them live to their full potential. Learn how to prevent the leading causes of child injury. Protect the ones you love.

What are the leading causes of childhood injury?

Unintentional injury such as those caused by burns, drowning, falls, poisoning and road traffic are the leading cause of morbidity and mortality among children in the United States. Male children have a higher injury death rate compared to females in all childhood age groups.

Child walkers are never safe to use, even with an adult close by. A child in a walker can travel three feet in one second. It makes it very easy for them to reach things, to get burned, to get poisoned or to fall down stairs or into water. Most walker injuries happen while adults are watching. Parents or caregivers cannot respond quickly enough.

What can be done to protect children from falls?

Be sure children are playing safely. Check to make sure playground equipment children are using is properly designed and maintained and there is a safe, soft landing surface under them. Supervise young children at all times around fall hazards, such as stairs and playground equipment, whether you are at home or play. Do not allow two children to share the same swing. Teach your child never to walk in front of or behind a swing while another child is on it.

  • Use home safety devices, such as guards on windows that are above ground level, stair gates, and guard rails. These devices can help keep a busy, active child from taking a dangerous tumble.
  • Keep sports safe by making sure children wear protective gear when playing active sports; wrist guards, knee pads, elbow pads and a helmet when in-line skating and bicycling.
  • Although trampolines are often considered a source of fun for children, about 100,000 people per year are injured on them, most on backyard models. Childhood injuries have included broken bones, head injuries, neck and spinal cord injuries, sprains and bruises. Parental supervision and protective netting are not adequate to prevent these injuries.

What should you do to prevent burns from fires?

Every day, 435 children are treated in emergency rooms for burn-related injuries and two children die as a result of being burned. You can help protect children by installing and maintaining smoke alarms in your home on every floor and near all rooms where family members sleep. Test smoke alarms once a month to make sure they are working properly.

  • Have a family escape plan and practice that plan with your children.  Make sure everyone knows at least two ways out of each room and have a central meeting place outside where everyone knows to meet.
  • Never leave food cooking unattended on the stove. Supervise children when they are near
  • cooking surfaces.
  • Fireworks can result in severe burns, scars and disfigurement that can last a lifetime.  Fireworks that are often thought to be safe, such as sparklers, can reach temperatures above 1,000 degrees Fahrenheit, and can burn users and bystanders.

How do you prevent scalding burns?

Younger children are more likely to sustain injuries from scald burns caused by hot liquids or steam. Children have thinner skin than adults and can have more severe burns. To prevent scalds, check your water heater temperature. Set the thermostat to 120 degrees Fahrenheit or lower. Infants who aren’t walking yet can’t get out of water that is too hot. Maintaining a constant thermostat setting can help control the water temperature throughout your home, preventing it from getting too high.

Be careful of boiling water on stoves when toddlers are present. Make sure all handles of pots and pans are turned to the inside of the stove so they do not to tempt little hands to reach for them and pull them off, resulting in scalds. Unattended coffee cups and vaporizers have much the same effect. Always tuck cords from appliances where children cannot reach them. Never hold a child when cooking something hot. Test and stir all food before serving children to make sure it is cool enough to eat.

What to do about drowning?

Drowning is the leading cause of injury death for children ages one to four. Three children die every day as a result of drowning.

  • For backyard swimming pools, install a four-sided fence with self-closing, self-latching gates. This will help keep children away when a parent cannot supervise them in the water or around the pool area. Pool fences should completely separate the house and play area from the pool. Have alarms on every door and window leading into the pool area.
  • Avoid Entrapment: Suction from pool and spa drains can trap an adult underwater so they can definitely trap a child. Do not use a pool or spa if there are broken or missing drain covers.
  • Never leave a child unattended by any pool, not for even a moment. Drowning can occur in only a few inches of water in a pool, bathtub or pond.
  • Be sure all children wear life jackets in and around natural bodies of water, even if they know how to swim. This includes lakes, oceans, rivers, etc. Blow-up water wings, toys, rafts and air mattresses should never be used as life jackets or life preservers.
  • Know cardiopulmonary resuscitation and get recertified every two years.  CPR can help a child stay alive with little or no brain damage.
  • Be alert and on the lookout at all times around water of any kind. Supervise young children in bathtubs, swimming pools and natural bodies of water. Adults watching kids near water need to avoid distractions like playing cards, reading books or talking or texting on the phone.

How do you protect against poisonings?

The emergency departments in the United States treat 374 children and two children die every day as a result of poisonings.  Chemicals that are clearly marked poisonous in your home are not the only danger.  Household cleaners, medicines and many other everyday items in your home can be poisonous to children.  Anything left out and within reach is often perceived as a treat or something to eat or drink to active, curious children who are eager to learn and discover.  You can attempt to poison-proof your home with a few easy steps.

  • Lock up medicines and toxic products, cleaning solutions, etc. in locked or childproof cabinets.  Choose products with child-resistant packaging whenever possible but understand no container is truly child-proof.  Medicines often look like candy or fruit drinks to children; never refer to medicine as candy even if you are struggling to get your child to take it. This may only tempt him/her to ingest more when you are not around, particularly if it tastes or smells good.
  • Post the nationwide poison control center phone number, 1-800-222-1222, on or near every telephone in your home.  You should also program it into your cellular phone.  The poison control center is available 24 hours a day, seven days a week.  Call poison control if you think a child has been poisoned and if they are awake and alert. Call 911 if you have a poison emergency and your child has collapsed or is not breathing.
  • Always read the label and follow the directions on medications even, if it is a medication you have given many times before. Ingredients, directions or contraindications may change. Read labels carefully and preferably with the lights on in the room to make sure you give your child the right dose.
  • If you do not need it, do not keep it. Mix disposed unused, unneeded or expired medicines with coffee grounds or kitty litter to make them less appealing to children.

What can you do to prevent furniture tip-overs?

A baby learning to stand, an unsteady toddler trying to climb or a fearless preschooler who still doesn’t quite understand balance – furniture tip-overs are a real danger for kids. Top-heavy furniture, TVs and appliances can tip over and seriously injure young children. There are devices that anchor furniture to the wall, making furniture more stable and tip-over resistant. These devices are designed for dressers, wall units and anything your little explorer might try to climb.

Secure furniture that is unstable or top-heavy to a stud in the wall using brackets, braces, anchors or wall straps. Large items such as TVs, microwaves, fish tanks, bookcases, heavy furniture and appliances can topple off stands and fall on children. If you have a newer, flat screen TV, make sure it’s properly anchored to the wall. Keep heavier items on lower shelves.

Do not keep remote controls, candy, toys or other items that attract children on top of furniture, as your child might be enticed to reach or climb for these items. Put them out of sight. Also, keep window blind cords secured and out of reach. Supervise young children at all times.

What can be done to protect against road traffic injuries?

Every hour, 150 children between the ages of 0 and 19 are treated in emergency departments for injuries sustained in motor vehicle crashes.  More children ages 5 to 19 die from crash-related injuries than from any other type of injury.

Using seat belts, child safety seats, and booster seats that are appropriate for your child’s age and weight are the best protective measures you can take to protect against road traffic injuries. Make certain that your baby's car safety seat is installed correctly.  Read and follow the instructions that come with the car safety seat and the sections in the owners' manual of your car. Use the car safety seat EVERY time your child is in the car.

  • Typically, babies should be placed in rear facing car seats until they are at least 1 year old and weigh 20 pounds.
  • When babies move into front-facing car seats, they should remain in these seats until they are at least 4 years old or weigh 40 pounds.  These car seats still remain in the back seat for safety.
  • Children should be seated in booster seats from about age 4 to age 8, or until they reach 4’9" tall.
  • All children ages 12 and under should be seated in the back seat of vehicles.

If you’re a parent of a teen who is learning to drive, sign an agreement with them to limit risky driving situations, such as having multiple teen passengers and driving at night.  Be sure to know the graduated driving license rules and have your teen obey those rules.  Remind your teen to not use the cellular phone while driving.  Do not text and drive!

Helmets can help. Children should wear motorcycle or bike helmets any time they are on a motorcycle, scooter, skateboard, or bicycle.

Many children are killed or seriously injured in backover incidents.  A backover incident typically occurs when a car coming out of a driveway or parking space backs over a child because the driver did not see him/her.  Always walk behind your car to be sure a child is not there before you back out of your driveway.  You may not see a child behind your car in the rearview mirror.  Also, teach children not to play in or around cars.

Supervise children carefully when in and around vehicles.  Teach children to move away from a vehicle when a driver gets in it or if the car is started.  Have children in the area stand to the side of the driveway or sidewalk so you can see them as you are backing out of a driveway or parking space.  Make sure to look behind you while backing up slowly in case a child dashes behind your vehicle unexpectedly.  If you drive a large vehicle, be extra careful because they are likely to have bigger blind zones.  Roll down your windows while backing out of your driveway or parking space so you will be able to hear what is around the outside of your vehicle.  Many cars are equipped with detection devices like backup cameras or warning sounds, but they cannot take the place of you actively walking around your car to make sure your children are safely out of the way.  Do not rely solely on these devices to detect what's behind your vehicle.

Never leave a child unattended in a vehicle, even with the window slightly open.  Dial 911 immediately if you see an unattended child in a car.  EMS professionals are trained to determine if a child is in trouble.  Teach children not to play in any vehicle.  Lock all vehicle doors and trunk after everyone has exited the vehicle – especially at home.  Keep keys out of children’s reach.  Cars are not playgrounds or babysitters.  Place a cell phone, purse, briefcase, gym bag or whatever is to be carried from the car, on the floor in front of a child in a backseat.  Be sure to take the keys out of the purse to avoid locking the child inside the car.  This triggers adults to see children when they open the rear door and reach for their belongings.  Set your cell phone or Blackberry reminder to be sure you dropped your child off at day care.  If a child goes missing, first check vehicles and trunks.

What should you do to prevent sports injuries?

Children need to take part in sports and recreational activities as an important part of a healthy, physically active lifestyle for kids.  Injuries can occur, however, if protection and supervision is not provided.  More than 7 million sports and recreation-related injuries each year are sustained by youth ages 5-24.

  • Be sure to use protective gear, such as helmets, wrist guards, knee and elbow pads.  Many sports player positions have their own specific gear to wear appropriate to that sport.  Wear helmets during biking, in-line skating and skateboarding.
  • Maintain sports protective gear correctly and keep it in good condition.  Be sure there are no missing or broken buckles or compressed or worn padding.  Poorly-fitting equipment may be uncomfortable and may not offer proper protection.
  • Children need to learn and practice the skills needed for their chosen activity to prevent injuries during the game.  Being in good condition can protect participants from injury.  Safely and slowly increase activities to improve physical fitness.  Appropriate tackling techniques, correct biomechanics, or movement and alignment also plays a role in preventing injuries.  These techniques apply to football, baseball, softball, soccer and many other activities.
  • Children need time to adjust to temperature environments.  Child athletes need to gradually adjust to hot or humid environments to prevent heat-related injuries or illness.  Parents and coaches should pay close attention to make sure players are hydrated and appropriately dressed.

What to do about firearms in the home?

Firearms can be a hazard in homes where children are located. Children in homes where guns are present are in more danger of being shot by themselves, their friends, or family members than of being injured by an intruder.  Handguns are especially dangerous. If you choose to keep a gun, keep it unloaded and in a locked place, with the ammunition locked separately. Ask if the homes where your child visits or is cared for have guns and how they are stored. Be vigilant about firearms.

Additional resources

cross section image of healthy homeCenters for Disease Control and Prevention
Household Products Database
https://householdproducts.nlm.nih.gov/index.htm

Centers for Disease Control and Prevention
www.cdc.gov

Safe Kids USA
www.SafeKids.org

American Academy of Pediatrics
www.aap.org

Healthy Children
www.healthychildren.org

National Highway Traffic Safety Administration
www.NHTSA.gov