Safety Flashcards
Falls in infants
Frequent after 4m when learn to roll over
- Pillows WONT keep from falling off bed or sofa
- changing tables, cribs, beds, sofas, high chairs, infant walkers.
- Gates helpful when child begins to crawl or walk.
- Socks, long pants, rubber soled shoes contribute to imbalance
- injured in the walker by pulling hot foods off the table, or pulling
heavy objects like TV’s onto themselves.
Infant burns
Curiosity leads the infant to explore potentially dangerous items such as
- electrical outlets 🔌
- electrical wires 🔌
- hot stove
- furnace vents
- scalding liquids
- cigarettes 🚬
Infant Choking/Asphyxiation
Since infants explore so much with their mouths, small objects or hard foods pose a choking hazard.
➢Rattles containing beads, buttons, or plastic pieces off of stuffed animals.
➢Infants crawling or playing on the floor can pick up coins
➢Food
- hot dogs, candy, nuts, grapes, peanuts, popcorn, marshmallow, large amounts of peanut butter
➢Baby Powder - sprinkled on infant and letting them play with the container.
➢Bottle propping(cant get out mouth) HOLD THEM !
Infant suffocation
- Mechanical suffocation:
- covering of the airway
- pressure on throat or chest
- exclusion of air(refrigerator entrapment)
➢Nonfood items (latex balloons) - Pacifiers should not be restrained in the infants mouth
- Monitor older siblings toys and keep out of reach
➢The bed or crib poses a number of hazards. (Tucked in blankets and sheets, pillows, and stuffed animals.)
➢Co-sleeping puts the infant at high risk of suffocation if the parent rolls over them.
➢Back to Sleep!!
Infant Strangulation
Hazards include:
➢toys with strings ➢cribs too close to window blinds ➢restraining straps (high chairs, strollers) ➢bib strings ➢unsafe crib design ➢strings and cords on clothes and wall-mounted lamps ➢strings on household items ➢chains, ribbons and strings on soothers ➢headbands ➢hairbands ➢jewelry
Infant Motor Vehicle Injuries
Infants should never be left unattended in a motor vehicle (hyperthermia, kidnapping)
•Infant should never be placed in a front seat that is equipped with an airbag
•A rear-facing car seat provides the best protection
•keep children in rear-facing car seats until age 2.
Infant Drowning
●can occur in just an inch or two of water.
●most often drown in bathtubs, buckets, or toilets
Toddlers injury most due to
Most common age group to get injured besides adolescent
curiosity, mobility, and lack of impulse control
Toddler falls
have a limited concept of body boundaries and essentially no fear of danger.
•Playground injuries, jungle gyms
•Stairs, accessible windows without guards
•balconies, porches, decks, bleachers
•Cribs, vehicles, high chairs, shopping carts, strollers
•Falls from wheeled toys such as tricycles ( always wear a helmet ⛑ )
Prevention: never leave a toddler unsupervised out of doors, install safety gates at the top and bottom of stairs, ensure that window locks are operable, secure window screens if windows are open.
Toddler burns
ability to climb, stretch, and reach objects above their head makes hot surfaces a potential source of danger.
•Scalds from pulling pots off the stove, and high temperature of tap water
•Radiators, fireplaces, furnaces, kerosene heaters, or wood-burning stoves
•Portable electric heaters, hair curling irons, clothes irons
•Candles, incense, cigarettes, cups of tea or coffee
•Matches and lighters
•Sunburn
Prevention measures: smoke detectors, fire evacuation plan, “drop and roll” techniques, lowering water heater temperature, keeping lighters and matches out of reach
Toddler Choking/Aspiration and Suffocation
•Trouble chewing large pieces of food, such as meat and whole hot dogs
- Dry cleaning bags
- Small toys, or toys with small, detachable parts
- Coins, paper clips, pins, button batteries, jewelry
•Suffocation from old refrigerators, oven, and other large appliances
- child prof house appliance!!!
Toddler Exposure to Tobacco Smoke
●Increased risk of
- respiratory disease/ infection
- ear infections
- symptoms and medication use in children with asthma
●It is also believed to hinder neurodevelopment and be associated with behavior problems
Toddler
Motor vehicle injuries
➢Improperly restrained in the car
➢Motor vehicle back-over injuries and deaths
➢Heat stroke when left in the car
Toddler drowning
With well developed skills of walking, toddlers are able to reach potentially dangerous areas (bathtubs, toilets, buckets, swimming pools, hot tubs, and ponds or lakes)
They are too heavy making it hard for them to right themselves
Preschoolers injury
at an ideal age to be taught about safety, able to learn safe behaviors
- continue to display poor judgment related to safety issues; therefore, close supervision is still required
- Engagement in fantasy is so strong they lack the ability the master cause and effect
●Handguns, matches, bodies of water, bicycle riding, and poisons.
●Falls account for the highest percentage of nonfatal injuries
●Motor vehicle accidents are responsible for most fatal injuries, followed by drowning.
Preschool Bicycles/Riding Toys
Teach basic safety measures (look both ways, walk bike across the street, hold hands, wear helmets)
School age injury
Still act on impulse
• become more independent with age. Increased self-confidence and decreased fears may contribute to accidents and injuries.
●Additional safety issues include: sports safety, skateboarding and inline skating safety, and All-terrain vehicle safety.
Adolescents injury
Unintentional injuries are the leading causes of death in adolescents
●Influencing factors include:
- increased physical growth, insufficient psychomotor coordination for the task, abundance of energy, impulsivity, peer pressure, and inexperience
Adolescent Motor Vehicle-Related Injuries
• Teenagers are not likely to wear a seat belt.
●More accidents occur when other teenagers are present in the car, driving at night, or driving under the influence.
●Texting and using cell phone
Firearms
Provide education about gun safety.
Guns in the home must be locked in a safe location, with ammunition kept separately.
Fire arms safety courses
Teach a child never point a gun at someone
Adolescent Sports Injuries
• Caused primarily because of sports competition between young people who differ greatly in strength and agility.
●Overuse injuries are the most common type of injury.
●Sports program should have a warm-up procedure and hydration policy.
●Sports physical should be done before start of activity.
●Wear appropriate protection devices for individual sport.
●Coaches should be trained in CPR and first aid.
Common Adolescent Social Problems
1) Teen dating violence (TDV)
2) Human Trafficking/Gang Activity
●During the pandemic young people spent more time at home and on their phone, which made them more vulnerable to human traffickers.
Adolescent Psychosocial Assessment
HEEADSSS screening tool to assess risks
●Home & Environment ●Education & Employment ●Eating & Exercise ●Activities ●Drugs/Substances ●Sexuality ●Suicide/Depression ●Safety
Near Drowning
What is it?
When do most incidents occur?
Near drowning is described as an incident in which a child has suffered a submersion injury and has survived for at least 24 hours.
Most incidents are accidental and result from:
•inadequately supervising children who are in or near water,
•lack of personal flotation devices while on boats, and
•diving accidents
•children who are able to swim but overestimate their endurance.
3 priority Nursing Assessment of Near-drowning Victims (ABC)
1) Hypoxia
- irreversible damage after 4 to 6 minutes of submersion
- some drowning victims die without aspirating fluid (Acute asphyxia may occur from prolonged reflex laryngospasm)
2 Aspiration of fluid
- pulmonary edema, atelectasis, airway spasm, and pneumonitis, which contribute to hypoxia
3) Hypothermia occurs rapidly in infants and children because of their large body surface area relative to body mass
Management of Near-Drowning
•Resuscitative ASAP when child is pulled from water, transported to a hospital immediately
- Management depends on amount of cerebral damage
●Promotion of OXYGENATION and monitoring for INFECTION are primary nursing concerns
- Complications may occur 24 hours after the incident.
●The child may need rehabilitation and long-term follow-up
Poisoning nursing management/assessment
If a young, healthy child suddenly deteriorates without a known cause suspect a toxic ingestion.
●The first and most important is to treat the child first, not the poison
- Assess Airway, Breathing, Circulation, and initiate CPR if needed
●Ingestion of medications or chemicals may result in a wide variety of clinical manifestations
- Perform a through examination and monitor vital signs, noting alterations that may occur (BP,RR, Temp, Pupil)
- Pay attention to mental status, skin moisture and color, and bowel sounds. Maintain ongoing assessment for LATE effects
Emergency Treatment of Poisoning
Treatment is based on what 3 principles of therapy
1) Rapid evacuation of the poison
2) Administration of a specific antidote or chemical neutralizer; and
3) Concurrent institution of supportive and symptomatic therapy.
General Treatment of Poisoning
- Gastric Lavage- NG or OG is inserted and the gastric contents removed by suction. Saline or water is then used to wash the stomach. NOT to be used for corrosive substances.
- Activated Charcoal- Binds with the substance and prevents absorption. Bowel irrigation is often used with polyethylene glycol. It is not effective for iron overdose.
- Antidotes-a few specific antidotes are available for medications or other toxins
- Dialysis- Occasionally required to lower the level of toxin in the bloodstream.
- Naloxone- Administered if opiates or other narcotics are ingested to reverse respiratory depression or altered level of consciousness.
Preventing Poisoning
●Store all substances in original containers only
●Ensure all medications have child-proof caps and are kept in a locked cabinet
●Never coax a child to take medicine by calling it “candy”
●Do not expose children to hazardous vapors such as paints, cleaners, tobacco smoke, and especially street drugs such as crack and marijuana
●Remove house plants from the home or keep them out of reach
●Post Poison Control Center number and call before initiating any intervention
Acetaminophen Over the counter
●Infants and Children’s formulations are now both 160 mg/5 mL
●Toxicity in children is: single dose ≥ 200 mg/kg
Nursing Care of Acetaminophen Poisoning
•Monitor labs (serum acetaminophen level, liver enzymes, INR, bilirubin, creatinine, urea, glucose, and electrolytes)
●Monitor vital signs
●I & O
●Observe for signs of liver involvement (RUQ pain, abnormal liver function tests)
●Support and teach parents poison prevention
Lead poisoning
● lead does not decompose, still present in soil and dust.
●caused by putting hands or objects covered with lead in mouth, breathing in lead, or eating paint chips or soil that contains lead.
• main concern is the developing brain and nervous system
• rarely have symptoms
- Even children who seem healthy can have high levels of lead in their bodies.
●Children younger than 6 years are especially vulnerable
Diagnosis of Lead Poisoning
Determined by a venous blood specimen from venipuncture. The skin must be cleaned well before drawing the specimen to avoid contamination by lead on the skin.
Screening for Lead Poisoning
recommends screening high risk children at ages 9 to 12 months, with a repeat screening at 24 months.
It is required that all children receiving Medicaid are screened.
Prevention of lead poisoning
•Ensure a balanced diet low in fat, and with adequate iron, calcium, and zinc.
●Wash fruit and vegetables before eating.
●Remove shoes at the door.
●Minimize dust. Wet-wash hard surfaces.
●Wash children’s toys frequently.
●Brush pets outside
●Encourage children to wash their hands and around their mouth before eating
Febrile Seizures
•Seizure associated with a febrile illness in the absence of CNS infection.
●May be inherited.
●Criteria for diagnosis
- Child cannot have a history of afebrile seizures/epilepsy
- Temperature of at least 100.4 F
- Between the age of 6 and 60 months
Management of febrile seizure
• Most stop on own, and require no treatment.
●Antipyretic therapy during febrile illness prevents seizures
●Parent teaching:
- Turn the child on his or her side
- Never put anything in the child’s mouth
- Tepid sponge baths are not recommended ( cool from inside not outside body)
Important information to know about near drowning
➢Length of time of submersion
➢How long was it until CPR was initiated
➢Site of submersion (freshwater or saltwater, natural or man made, contaminated water?)
➢The water temperature (cold water→ hypothermia, however less risk of pneumonia)
“Over use” injuries: most common in school age children
What are they caused by
No apparent or identifiable injury
Pain worsens with continued participation in the activity
Can cause permanent damage to muscle, tendons, bones
Caused by:
Starting sports too early
Participating in sports activities year round
Participating in multiple sports activities
Encouragement to play through an injury
Performing certain sports activities that should not be performed in school-
age/adolescent years (throwing curve balls in baseball)
How to prevent “over use” injury
encourage to 1 to 2 days off per week
2 to 3 months away per year from a particular sport
monitor time spent in weekly training session or repetitions done per week
Common Sources of Lead
Paint Soil Drinking water Folk medicines and cosmetics Children's jewelry and toys Imported candies or foods Lead ammunition Batteries, some colors of ink Pool cue chalk and sidewalk chalk
