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Keeping Kids Safe: The Things Curious Kids Get Into
Dakota Conference on Rural & Public Health
June 2014
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Objectives
• List at least 4 emerging injury trends that are being seen in children in emergency rooms around the United States. • Discuss the action steps that are required by medical providers should a button battery or high powered magnet ingestion take place.
• Discuss action steps that parents and caregivers can take to prevent these types of unintentional injuries from occurring.
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Who Is Safe Kids Grand Forks?
• We are a coalition who has as our mission to prevent unintentional injuries and death to children under age 19.
• Altru Health System is the lead agency but we are a community/regionally focused group who come together around the common cause of injury prevention.
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Contact Information: Connecting With Safe Kids Grand Forks
• Safe Kids Grand Forks is based at Altru Health System. You can connect with us via:
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Facebook – Safe Kids Grand Forks
E‐mail: [email protected]
Web site: www.safekidsgf.com
Coordinator: Carma Hanson
• [email protected] or 701.739.1591
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SAFE KIDS GRAND FORKS COVERAGE AREA
• Safe Kids Grand Forks covers northwest Minnesota
and northeast North Dakota. We welcome new
members to our coalition any time.
Causes of Childhood Deaths
Unintentional Injury 39%
All Other Causes 27%
HIV 1%
Suicide 2%
Heart Disease 4%
Pneumonia/Influenza 2%
Birth Defects 8%
Cancer 11%
Homicide 6%
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Areas of Focus For
Safe Kids Grand Forks
Motor Vehicle
Toy Injury
Falls
Fires and Burns
Bicycle/Wheeled Sports
Poisoning
Home/School Injuries
Gun Safety
Drowning/Water Safety
Choking
Sports/Recreation Injuries
Rural Injuries/ATV
*** This is not a comprehensive list but a sampling of areas where we focus our attention and coalition’s efforts.
Injury Prevention Trends
Since Safe Kids Worldwide was started in 1988, there has been a 54% decrease in unintentional injuries.
Most risk areas are declining but new injury trends are emerging.
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Emerging Areas of Injuries
• Television Tip‐Overs
• High Powered Magnets
• Button Batteries
• Medication Poisonings
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TELEVISION AND FURNITURE TIP‐OVER
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THE ISSUE: TELEVISION & FURNITURE TIP‐OVERS
Prevent death and injury to children in the United States from television and furniture related tip overs
THE FACTS
• 245 children died from tip overs (2000 – 2010)
• Of those 245, 169 children died from TV tip overs during same period
• Children under 5 are most at risk for death and injury
• Tip over deaths are increasing
Research
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Television & Furniture Tip‐Overs: Research
Research Objectives
1. To conduct survey of families with small children to better
understand attitudes and behaviors related to securing TVs
and other furniture in the home; gauge awareness of TVs as a
home safety risk
2. To create research report featuring data about television and
furniture tip overs and the impact on child safety
3. To print and distribute report to key stakeholders in child safety
Television & Furniture Tip‐Overs: Research
Television tip‐over related injuries have risen in the youngest age group, 2002 ‐ 2011
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Children aged 5 and under at the greatest risk of an injury caused by a TV tip‐over
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Top 5 diagnoses for television tip‐over‐related injuries in children aged 19 and under, 2002 ‐ 2011
Rise in the number of injuries to the head among children aged 5 years and younger, 2002 ‐ 2011
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Televisions are most often placed on a dresser or TV stand, and are not secured
22% of parents didn’t mount their flat screen television because they thought that it didn’t matter
46% of parents with flat screen televisions feel that securing it to the wall is the safest place to position their TV
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What can we do?
• TV Safety Check • Secure Furniture
• Rearrange Household Items
• Share What You Learn 22
 TV Safety Check
• Assess the stability of TVs in each room in the home. • Secure TVs
• Mount flat screen TVs to the wall.
• When mounting is not an option, secure flat screen TVs using a TV safety strap or anti‐tip‐strap.
• Place CRT TVs on a low stable piece of furniture
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Secure Furniture
• Use brackets, braces, or wall straps to secure unstable or top‐heavy furniture to the wall
• Install stops on dresser drawers 24
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Rearrange Household Items
• Keep heavier items on lower shelves or in lower drawers
• Avoid placing items where kids might be tempted to reach them. For example:
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Remote controls
Food
Toys
Books
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Share the information
• Educate others about the dangers of TV and furniture tip‐overs
• Encourage family and friends to conduct a TV Safety Check in their home
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High Powered Magnets
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The Issue: High Powered Magnets
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Ingested neodymium magnets are a serious health hazard for children, with an extremely high risk of intestinal obstruction and perforation as loops of bowel may be trapped between multiple magnets. •
Neodymium or rare‐earth magnets are composed of iron, boron, and neodymium.
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They are at least 5 to 10 times more powerful than traditional magnets. (They were first invented in 1982)
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These special magnets are used in many of the following items:
Toys Office supplies or desk toys
Jewelry Pain relief products Machines and tools (hybrid electric engines) Hard drives 28
The Issue: High Powered Magnets
• These magnets are usually small in size and round in shape, like BBs or ball bearings. Magnet ball brand names include BuckyBalls™ and Neocube™ • Though intended for adult use, they are difficult to keep out of the reach of children.
• Shiny and attractive to toddlers • Used by “tweens” and teens to mimic body piercing jewelry 29
The Issue: High Powered Magnets
Extremely powerful magnetic attractions are produced when more than one magnet is swallowed, the magnetic force can bring two pieces of intestine tightly together, and make holes in the intestines 30
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The Incidence
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The Incidence
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Management Algorithm After Ingestion
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Safety Tips
• Remove toys or other products from the home that contain these high powered magnets.
• Keep older children’s toys separated from those of younger children.
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Safety Tips
• Increase parent/caregiver understanding of the importance of the medical care needed if a magnet is swallowed.
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Button Batteries
• This is a “You don’t know what you don’t know issue” = a.k.a. ‐ “hidden danger”.
• Most parents and caregivers are unaware that button batteries pose a danger.
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The Problem
• Results from a March 2012 survey conducted by The Battery Controlled campaign indicate:  62% of parents have not read, seen or heard anything about the risks of
coin-sized button batteries.
 59% of parents said their children seem to like electronic devices more
than their own toys.
 About half of the surveyed parents said their children like to play with
the various remotes in their house.
 43 percent of all parents surveyed were aware of having coin-sized
button batteries in their homes. However, 95% of parents said they have
at least one device in their home that could contain a coin-sized lithium
button battery, including remote controls, electronic key fobs, flameless
candles and singing books and cards.
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The Problem
• Children’s products are required to have a screw‐on cover over the batteries.
• “Adult” products are not regulated in the same way and yet children have access to many of these items.
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The Problem
• Button batteries are commonly used in many household items.
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The Incidence
• 3,500 cases of button battery ingestion are reported each year
• 17 serious injuries in 2012 and 2 deaths (reported)
• Severe cases quadrupled from 2006 to 2010
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The Problem
The battery is often ingested without the parents knowing it has been.
Symptoms can mimic other problems such as the flu or a stomach ache.
The saliva causes a reaction with the battery that can cause burning through the stomach and intestines.
Physicians may mistake the battery for a coin which would be allowed to “pass through” vs. a battery which is a surgical emergency.
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The Solution
• Creation of a partnership with Safe Kids Worldwide and Energizer (The Battery Controlled)
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The Solution
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Take action. Act now.
1. Keep Out of Reach
2. Get Help Fast
3. Tell Others 43
The Solution
TheBatteryControlled.com Facebook.com/TheBatteryControlled
@BatteryControl
National Battery Ingestion Hotline: 202‐625‐3333
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The Solution
• Materials and resources have been created and distributed to educate on this topic.
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The Solution
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The Solution
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Thinking Outside the Box On Who & How To Educate
• Home Visitor Training
• Social Workers
• Nurses
• New Parents Support Program Workers
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Thinking Outside the Box On Who & How To Educate
• Presentations at Child Care Centers
• What goes in your mouth?
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Thinking Outside the Box On Who & How To Educate
• Education of physicians, nurses, paramedics and other health care providers.
• Distribution of materials for clinic offices
• Letter and copy of medical care instructions
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Pediatricians
ER physicians
Family Practice
ENT
Radiology
Residents
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Thinking Outside the Box On Who & How To Educate
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Thinking Outside the Box On Who & How To Educate
• Battery stores conducting Point‐of‐Sale messaging.
** This partnership is being pursued and is not currently formalized.
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Timing of Message
• Consider some of the following as key messaging times:
• Christmas – sale of electronic items
• March – Poison Prevention Week
• September ‐ Baby Safety Month
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Medication Poisonings 54
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Why is medication safety important?
Every minute a parent or caregiver calls a poison control center about a medication poisoning
More than 67,000 children
are seen in emergency departments for
medication poisoning
12,390 children
are hospitalized each year for medication poisoning It’s preventable
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2013 Report: Recap
• U.S. Consumer Product Safety Commission NEISS data
• +67,000 ER visits for medicine
• Grandparent’s medicine in 38% of cases
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2014 Report
• Survey of 1,185 grandparents ages 50 and over who regularly take care of young grandchildren
• Exploring medication storage and dosing behaviors
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Infographic
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Infographic
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Infographic
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Infographic
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Infographic
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New Findings
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New Findings
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New Findings
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New Findings
Among grandparents who give their grandchildren medicine:
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Talking Points
The Situation
• 3 out of 4 ER visits (77 percent) for medicine poisoning are due to kids getting into parents’ or grandparents’ medicine. • A surprising 38 percent of the time, a child got into a grandparents’ medicine. (39 percent of the time, a child got into a parents’ medicine.)
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Talking Points
Changing the “Typical” Household
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Since 2005, there has been a 23 percent increase in the number of grandparents living with their grandchildren. •
13 percent of grandparents provide care for a grandchild on a regular basis.
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Older adults only make up 13 percent of the population, but they account for 34 percent of all prescription medicine use.
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74 percent of grandparents in our survey reported taking prescription medicine every day.
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This new dynamic of children being exposed to more adult medicine in the home makes medicine safety a more important topic than ever for families.
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Talking Points
Grandparents’ Behavior
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The research revealed that, like parents, most grandparents know how to keep medicine up and away from children. But there are clearly exceptions being made to this habit that are driving nearly half a million calls to Poison Control Centers each year.
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About 28 percent of grandparents who take care of their grandkids every day keep their medicines in easy‐open containers or bottles without a child‐resistant cap.
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42 percent of those who use easy‐open containers keep prescription medicine on a bathroom or kitchen sink, counter, table or shelf – locations that are easily accessible to young children.
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12 percent of grandparents who take care of grandkids every day keep prescription medicine on a nightstand or dresser, places where kids can easily get into it. •
13 percent keep medicine on a counter or table between doses when giving medicine to a child.
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Talking Points
Tips to Keep Kids Safe Around Medicine
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Keep all medicine up and away when young children are around, even medicine that is taken every day. •
Be alert to potential hazards of medicine stored in other locations, like pills in purses, vitamins on counters, and medicine in nightstands. •
Even if caregivers are tempted to keep it handy in between doses, put medicine out of reach after every use.
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Choose child‐resistant caps for medicine bottles, if able. If pill boxes or non‐child resistant caps are the only option, it’s even more important to store these containers up high and out of sight when caring for kids. •
Program the nationwide Poison Help Number (1‐800‐222‐1222) into your phones.
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Visit safekids.org for more tips on safe storage, safe dosing and safe disposal of medicine.
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Safe Kids Resources
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OTC Literacy
• Medicine safety for 5th and 6th graders
• Free lesson plans, student activities and additional outreach materials
• Resources for parents, teachers and nurses
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http://www.scholastic.com/otcliteracy
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Kids’ Wellness Tracker
• Build custom profiles of children’s health histories
• Track child’s medicine and calculate dosing
• Track symptoms, vaccines, height, weight and BMI
http://www.kidswellnesstracker.com 74
Additional Safety Tips
• Store medicines safely
• Give medicines safely
• Get rid of expired or unused medicines
safely
• Talk to family and friends about medication safety
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Where is medicine being stored?
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In a purse or backpack?
On a table or nightstand?
On kitchen or bathroom counters?
In low cabinets or drawers?
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Store medicines safely
• Keep medicines and vitamins up and away and out of sight, where children can’t see or reach them
• Put medicines up and away after every use
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Store medicines safely
• Store medicine in original container
• Buy medicine in child‐resistant packaging when available and close it tightly after each use
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Set reminders
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Give medicines safely
• Read and follow the label
• Know the active ingredients in the child’s medicine
• Don’t give the child more than one medicine with the same active ingredient
• Read the warnings, know the side effects, and understand when to stop taking the medicine and call a doctor
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Give medicines safely
• Check the dosing
• Make sure you give the right dose at the right time
• When measuring liquid medicine, use the dosing device that comes with the medicine you are giving
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Avoid double dosing
• Write down the child’s medicine schedule:
• Child’s name
• Date and time medicine should be given
• Amount of medicine that should be given
• If the scheduled dose was given
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Get rid of medicines safely
• Remove personal information and instructions from the medicine bottle or package
• Put medicine into a sealable plastic bag
• Add water to dissolve solid medicines like pills, tablets and capsules
• Add kitty litter, sawdust or coffee grounds to the plastic bag
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Take‐back program
• Take medicines that are out of date and medicines you don’t use any more to a community take‐back program
• Grand Forks Law Enforcement Building –
Downtown Grand Forks
• Fargo Police Department
• Trail County Sheriff’s Office
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Poison control centers
Know the number – put it in your home and cell phones
• 1‐800‐222‐1222
When can you call the poison center?
• 24 hours a day, 7 days a week
• It’s free and confidential
Who answers the poison center number?
• Nurses, pharmacists, doctors and other poison experts
Source: http://www.aapcc.org
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Poison control centers
When should you call the poison center?
• If you have questions about giving a child medicine
• If a child was given the wrong amount of medicine
• If a child has taken medicine that he or she was not supposed to
When should you call 911?
• If a child stops breathing
• If a child collapses
• If a child has a seizure
Source: http://www.aapcc.org
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Share the information
• Talk to caregivers and babysitters about storing and giving a child medicines safely
• Ask guests and family members to keep their medicine up and away when they are visiting
• Give a copy of the child’s medicine schedule
to caregivers who will be giving the child medicine • Know the Poison Control Center phone
number: 1‐800‐222‐1222
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Contact Information
• Carma Hanson, MS, RN
• Coordinator – Safe Kids Grand Forks
• Phone: 701.780.1489 (office) or 701.739.1591 (cell)
• E‐mail: [email protected]
• Web page: www.safekidsgf.com
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