Accidents

Accident Prevention

Accidents are the number one cause of death in children between the ages of 1and 16. Most accidents are preventable. Start “child-proofing” at 6 months.

REMEMBER: PREVENTION IS EASIER AND BETTER THAN TREATMENT

Do’s And Dont’s For Accident Prevention

  • Keep crib sides securely fastened.
  • Use restraints in baby feeder, carriage, stroller, car seats, etc.
  • Never prop baby bottles.
  • Do not hang or tie toys to the crib (Your baby may become entangled in the string).
  • Avoid use of pillows.
  • High chairs should have a broad base to prevent tipping, a safety strap, and a latch on the tray.
  • Teach your child the meaning of the word “HOT”
  • Use gates on stairways to prevent falls.
  • Windows should open from the top or have guards attached.
  • In the kitchen area, be alert for spattering grease, keep pot handles turned inward, keep hot containers in the middle of the table at mealtime.
  • Always check bath water temperature; never run hot water first, as child may fall in.
  • Be alert for small objects – peas, buttons, popcorn, beads, nuts. Avoid nuts and popcorn until your child is 4-5 years old; raisins and gum until 3.
  • Be sure broken glass and razor blades are safely disposed of.
  • Use safety plugs in unused wall sockets; be sure electric cords are not frayed and secure electrical cords so lamps cannot be pulled over.
  • Be careful when using plastic bags, especially dry-cleaner bags.
  • Make sure that your child can’t got into the Drano, oven cleaner, furniture polish, medicines, alcohol or any other toxic substance. Keep them locked up. If you are using one of these items, put it away in a secure place before answering the phone or doorbell.
  • Always use a car seat or seat belts, even when in someone else’s car.
  • Turn water heater temperature down lower than 130 degrees so even the hottest faucet water won’t burn as much.
  • Don’t use a lawn mower when children are playing nearby.
  • No peanuts or popcorn in the house until your youngest child is 4-5 years old.
  • Don’t turn your back on your baby when he’s on the bed, table or bathinette. Never leave the baby alone in the bath, even for a few seconds.
  • Keep your baby away from loose cords (Venetian blind cords). Make sure no cord hangs in or near your baby’s crib.
  • Never tie a pacifier around your baby’s neck.
  • Consider a smoke alarm near the children’s sleeping area. Develop and practice escape routes with children in case of fire.
  • Discourage your child from running with food in his mouth.
  • Teach road safety, i.e., never run into the street, look both ways before crossing. Etc.
  • Teach bicycle safety. Require bicycle helmet use.
  • Teach water safety. Never consider a child “water-safe.”
  • Never leave your baby alone in a room with pets, no matter how gentle.
  • Put plants up and out of reach.
  • Use safety latches for cabinets.
  • Wood stoves are a leading cause of winter burns. Use safety screens.
  • Curling irons are a leading cause of burns. Keep them out of reach of your child.

More About Car Seats

Automobile accidents are the leading cause of accidental death in children. For this reason, utilization of a car seat each time your child rides in the car is an absolute requirement. Unrestrained babies and children become flying missiles during a collision. Their flight is stopped not usually by a parent, but rather by the dashboard or car window. Don’t bring your child to our office unless he/she is properly restrained!

Use of the car seat should start on your baby’s first ride home from the hospital. You will find that children accept car seats very well. Car rides are much more enjoyable and relaxing when children know they must be in a car seat when riding in a car.

NC LAW IS 5 YEARS OR 40 POUNDS. Booster seats should be used for children 8 YEARS or up to 80 pounds. Also, make sure the seat belt rides over the lap and not the midsection, as major abdominal injury occurs in accidents.

CHILDREN UNDER AGE 12 MUST BE IN BACK SEAT! We are big believers that the front seat is not the place for children. It is the danger seat in a car, so why purposely place your child in danger. The air bags can cause injury to young children as the force of the bag meets the force of the head going forward, which snaps the head and neck backwards – causing paralysis or death. Also the explosive material causes burns and major eye injuries in children.

Car seats must be approved by the National Highway Traffic Safety Administration and must be used as directed. If you have questions about a particular car seat, please contact the office.

Poisoning

Poisoning is one of the most common medical emergencies. Each year about 500 children in the United States die from poisoning. Most, if not all, poisonings are preventable.

Children are naturally inquisitive and curious and will open drawers and doors to find toxic materials. Make sure that anything potentially dangerous is locked up and away from your child. They’re especially bad about getting into Grandma’s purse, too! Make sure purses are empty or unavailable. ALL MEDICINES AT ALL LOCATIONS SHOULD BE LOCKED UP!

The most common ingestants are medicines, gasoline and other petroleum products, furniture polish, household washing products, and Drano-like products. All are potentially lethal and should be safely stored high and away from children. Don’t store dangerous material in “friendly containers” (i.e., gasoline in coke bottles).

  • Keep activated Charcoal in the house.
  • Identify the drug or chemical that was ingested. Have the bottle next to you when you call and estimate the amount taken.
  • Call the Duke Poison Control Center at 1-800-848-6946 or the Hospital Emergency Room.
  • Keep these phone numbers on an emergency list by your phone.
  • Do not give Ipecac unless instructed to do so.
  • If Ipecac is needed, children under 6 should be given 1/2 ounce of Ipecac followed with lots of water or other fluid., If the child hasn’t vomited in 15 minutes, the dose should be repeated. Children over 6 should receive a full ounce of Ipecac.

Minor Accidents

Cuts And Scratches

Wash for 5 minutes with an antibacterial soap (i.e., Dial, Safeguard) and water. Cover with a Band-Aid or gauze. Don’t use alcohol or Methiolate on open wounds; they sting and can cause tissue damage. If bleeding hasn’t stopped after 10 minutes of continuous pressure with gauze or cloth or if the wound edges are gaping open, you will need to have the laceration sutured. After the first few days of the cut, if the wound begins to appear infected with pus or red streaks around it, call for advice as a visit and the starting of antibiotics is needed. If your child’s immunizations are up to date please check as we are now recommending a tetanus booster within 5 years if there is a major laceration. If your child hasn’t had a routine tetanus booster within the past 10 years, call the office during regular office hours to arrange for a booster.

Abrasions Or Scrapes

Wash for 5 minutes with soap and water. Remove any dirty particles from the wound with tweezers. If there is tar in the wound, it can be removed with Vaseline. Cut any loose pieces of dirty skin away with sterile scissors. If the wound is small, leave it open to air. If large, cover with a Telfa pad for 24 hours. Acetaminophen or ibuprofen may be given for pain. If a very large area of your child’s body is involved, call the office.

Puncture Wounds

Soak in hot, soapy water for 15 minutes. These soapy water soaks should be continued twice daily until healing occurs. Initial bleeding is good as it helps clear the puncture of bacteria. A sterile dressing should be applied between soaks. If the wound begins to look infected, call the office. If your child is up to date on immunizations, an additional tetanus booster is only needed if it has been over 5 years since the tetanus or DTAP vaccine. If you child is 15 years of age or older and hasn’t had a recent tetanus booster, it may be time for one. Call the office during regular office hours to arrange for a booster within 24 hours of injury.

Animal Bites

The animal involved should be located and trapped as soon as possible. If it is a wild animal and still on the premises, call the police or animal control agency immediately. Animals most likely to transmit rabies are: bats, skunks, raccoons, foxes or large wild animals. Mice, rats, gerbils, hamsters, gophers, chipmunks and rabbits are usually considered free of rabies. Rarely, squirrels have carried rabies so if a squirrel was the culprit and seemed sick, further investigation is needed. The wound should be washed immediately with soap and water for 15 minutes, then another 5 minutes with alcohol. It may then be left open to air or a loose dressing applied. The offending animal must be isolated for 10 days to observe for signs of rabies. You must also call the county health department to report the attack. If your child’s immunizations are up to date, an additional tetanus booster is not needed. Antibiotics are needed only if the would is very large or requires sutures. Any wound involving the hands or face should be seen by a physician.

Human Bites

These are treated basically the same as animal bites with 2 exceptions:

  • Because human bites are actually more likely to become infected, antibiotics are more often prescribed. Call the office for advice.
  • The human (in most cases) does not need to be put in a cage for 10 days.

Nosebleeds

These are common with trauma and during the winter when the air is dry. During a nosebleed, pinch your child’s nose shut for 10 minutes by the clock. (Have him breathe through his mouth.) This may be repeated once if the bleeding hasn’t totally stopped following the first 10 minutes. If bleeding still hasn’t stopped after a second attempt, call the office. Do not have your child lay on his/her back and hold their nose, as one can lose a large amount of blood and not realize it. At night, open up the window, use a vaporizer to put moisture into the air, and put a small amount of Vaseline in the nose over the area bleeding.

Head Injury

If your child doesn’t lose consciousness, chances are no major harm was done. Your child should be kept awake for one hour after significant head trauma; after this, he or she may nap. Your child should be aroused every 2 hours during the night following a significant blow to the head to be sure his or her pupils are equal in size and that no unusual signs (listed below) are present.

Call immediately if your child develops:

  • Persistent vomiting (more than twice), stiff neck or fever
  • Unequal sized pupils or a pupil that doesn’t get smaller when you shine a flashlight on it
  • Confusion or unusual drowsiness
  • Seizures or loss of consciousness
  • Stumbling, problems talking or using the arms and legs
  • Significant bleeding or leakage of fluid from the nose or bruise behind the ear
  • Headaches not relieved by acetaminophen or ibuprofen

If in doubt, call-especially in children under 6 months of age.

Burns

Very large burns, burns of the face, neck or genitals or burns encircling an arm or leg should be seen as soon as possible by a physician. Any electrical burns should also be seen as soon as possible. Other burns can often be managed at home. Call the office with any questions.

The burned area should be rinsed immediately (don’t take time to remove clothing) with cold water for 10 minutes.

No butter, ointment or creams should be applied.

Extensive burns should be wrapped in a wet sheet or Saran Wrap and brought to the office or emergency room.

Minor burns (red with only a few blisters) may be managed at home. They should be washed with antibacterial soap twice daily. Blisters should NOT be opened; the outer skin protects against infection. Small burns need not be covered. Acetaminophen may be given for pain. Cold compresses may also be used. If your child is unable to sleep because of pain, call for advice. If several blisters are present, we will probably want to see the burn in the office and will probably recommend an antibiotic cream. Bacitracin and Neosporin are both available over-the-counter and work well for minor burns.

Choking

Any foreign body in the airway may be life threatening. If your child is choking but can make noise and speak, do NOT pound on his back but do seek immediate medical attention. If the choking child is unable to breathe or make a sound, turn her face down over your knees and forcefully give 4-5 back blows with your open hand. If this fails, deliver rapid thrusts to the chest. Repeat en route to an emergency facility if there has been no response. If you can actually see the object, you may try to remove it with your fingers, but only if you can actually SEE it! If you are comfortable performing the Heimlich maneuver, this is very effective in older children.