Transcript Unintentional Injury

Preventing Childhood
Injury
Your name, etc.
High severity
Low numbers
Deaths
Lower severity
Our injury
burden
Emergency
admissions
(2007)
High numbers
Attendances at
emergency
departments
Minor injuries treated at
Health Centres and GP
surgeries or at home
References
Injury pyramid: BMA (2001)
Injury Prevention
Very minor (often untreated) injuries
“Injuries do not occur by chance. They are largely
1.
preventable, non-random events, and not
“accidents”. 2. Certain groups of people with certain
characteristics are more likely to be injured. By
studying how injuries 3. vary within a population,
we can begin to gain an 4. understanding of the
factors that lead to injury, and how the 5. risk of
injury may be reduced”.
Injury Prevention, British Medical Association, 2001
Accidents waiting to happen 1
Accidents waiting to happen 2
Accidents waiting to happen 3
“1..preventable...
not “accidents”
No cause?
Unexpected?
• Four-year-old dies after a tragic accident
“(Exodus Tyson’s) seven-year-old brother found her hanging from a
cord which was dangling from a treadmill in their home in Phoenix,
Arizona”.
• Brothers meet tragic end on Snowdon
“They died after slipping and falling up to 300m from an accident
blackspot at a craggy area on the mountain's west side, Clogwyn
Coch, at the weekend”.
• Ealing boy dies after air rifle tragedy
He died in a “tragic accident”, after being left playing with other 10
year olds and a loaded air rifle.
• Tragic accident as farmer crushed by sheepdog in tractor
“Harry Emslie, 67, left the border collie in the cab of a telescopic
loader with the engine still running - and the handbrake off”.
“an unforeseen event or one without an apparent cause” Collins English Dictionary
Group activity
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What caused these injuries?
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Were they predictable?
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What would have prevented them?
“2...certain groups of people....”
•
Children up to the age of 15 years from unskilled families are 5 times more likely
to die from unintentional injury than those from professional families
•
Children up to age 15 years from unskilled families are 15 times more likely to
die in a fire in the home than those from professional families
Our Healthier Nation, 1999
100
Injury
death rates
in children
0-15 by
social
class.
80
(BMA,
2001.)
20
60
40
1979-1983
1989-1992
0
1
2
3n
3m
4
5
“2...certain groups of people...”
• Children of single parents – (40% to 50%
higher
injury rate than two-parent equivalents. Overpeck, et. al. (1997),
Roberts I (1994), Wadsworth et al (1993)).
• Caregiver alcohol/ drug consumption
(Damaschek et al (2009), Bijur et al., (1992)).
• Children living in rented accommodation
(Kendrick. D, (2005), NICE, (2010)).
• Unemployed parents (9x higher death rate than parents
in highest income occupations. Sethi, D, et al (2008))
• Learning difficulties & Mental Health
problems
Mapping injury rate shows link to deprivation
in Bristol
Families vs neighbourhoods
“The greater variation in injury rates vary between families than
between neighbourhoods suggests reducing inequalities in injury
rates may be achieved more effectively by focussing prevention at
families rather than neighbourhoods, but in practice interventions
at both levels are likely to be necessary”.
Relationships between child, family and neighbourhood characteristics and childhood injury: a cohort
study. Kendrick D, Mulvaney C, Burton P, Watson M. Soc Sci Med. 2005 Nov;61(9):1905-15.
Or in other words
Social, family and domestic circumstances are as important as
neighbourhood characteristics like housing type and road layout as
factors influencing overall rate of childhood injury. Some families in
deprived areas have relatively low rates of injury.
“4.....understanding the factors that
lead to injury”
Group activity
Describe the family with the highest risk of
serious childhood injury.
List the factors you would expect to see in the
worst case scenario, considering the family,
their home, neighbourhood and the public
services they use.
“5(a)...reducing risk.
Working with partners.
Services
•
•
•
•
•
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Retailers stock home safety equipment provision
Daycare providers trained in injury prevention
Trading standards engaged with checks of limitations of supply
(painkillers) and safety testing of toys and other products
Daycare sufficiency assessments – so parents can take a break
Information provision by service providers
Health visiting team, fire and rescue services, etc trained in prevention
Environment / neighbourhood
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•
•
•
Housing providers (fire alarms, TMVs, maintenance)
Speed limits, junction engineering, enforcement, vehicle separation
Enhance employment and training opportunities to tackle economic
deprivation
Suitable provision of safe play areas
“5(b)...reducing risk.
Working with families.
Improve Supervision/reduce social isolation
Home improvements – “Childproofing”
Raise Awareness of injury hazards
Create Routines and rules
(and reminders and repetition!)
SCAR, CRASs, All Children Should dReam
Burns and scalds – Causes
1.
2.
3.
4.
Hot drinks
Hot food
Bathwater
Hair straighteners / irons
Hot water burns like fire
Burns and Scalds - Prevention
• Raise awareness
No. 1 cause = Hot drinks.
• Create routines and rules
Keep children and hot drinks apart.
• Childproofing
Use heat resistant bags for hair straighteners
Most burns and scalds happen in the kitchen.
Use a playpen, or keep children out.
Accidental poisoning - Causes
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.
Accidental poisoning - Prevention
Safe
storage,
straight
away
Accidental poisoning - Prevention
• 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”).
Home fire safety
Avon Fire and Rescue – Free Home Fire
Safety Checks
Tel: 0117 9262061
Falls in under 5’s - Causes
• Stairs and steps
• Falling from furniture (sofas)
• Falling from beds when having nappies
changed
• Baby walkers
• Climbing (floor – furniture- windowsills,
curtains, bookshelves, cupboards)
Falls in under 5’s - Prevention
• Awareness
Falls are the largest cause of childhood
injury
• Childproofing
Use stair gates, break climbing routes by
moving furniture
• Rules
No (stair) climbing without a parent
• Supervision
Use the children’s centre / friends so you
can take a break!
Low numbers, high profile injuries
• Firework injuries – Follow the Firework
Code
• Blind cord strangulation – keeping cords,
chains, and tapes and similar out of the
reach of children.
• Drowning – never leave babies alone in
the bathroom. Children need to learn to
swim.
Group activity
What can we do to reduce injury?
(Refer back to family and neighbourhood level intervention slides for ideas)
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What injury will you focus on?
Who will you target? Where?
How will you reach the target group?
What will you do?
How will you monitor / evaluate?
Further
information
Avonsafe
www.tinyurl.com\avonsafe
RoSPA
www.rospa.com
Child Accident Prevention Trust
www.capt.org.uk