Choking Prevention and First
Aid for Infants and Children
When children begin crawling, or eating table foods, parents must be aware
of the dangers and risks of choking. Children younger than 5 years can easily
choke on food and small objects.
Choking occurs when food or small objects get caught in the throat and
block the airway.This can prevent oxygen from getting to the lungs and the
brain. When the brain goes without oxygen for more than 4 minutes, brain
damage or even death may occur. Many children die from choking each year.
Most children who choke to death are younger than 5 years. Two-thirds of
choking victims are infants younger than 1 year.
Balloons, balls, marbles, pieces of toys, and foods cause the most
choking deaths.
Read more about choking prevention and first aid.
Dangerous foods
Do not feed children younger than 4 years round, firm food unless it is
chopped completely. Round, firm foods are common choking dangers. When
infants and young children do not grind or chew their food well, they may try
to swallow it whole. The following foods can be choking hazards:
• Hot dogs
• Nuts and seeds
• Chunks of meat or cheese
• Whole grapes
• Hard, gooey, or sticky candy
• Popcorn
• Chunks of peanut butter
• Raw vegetables
• Fruit chunks, such as apple chunks
• Chewing gum
Dangerous household items
Keep the following household items away from infants and children:
• Balloons
• Coins
• Marbles
• Toys with small parts
• Toys that can be squeezed to fit entirely into a child’s mouth
• Small balls
• Pen or marker caps
• Small button-type batteries
• Medicine syringes
What you can do to prevent choking
• Learn CPR (cardiopulmonary resuscitation) (basic life support).
• Be aware that balloons pose a choking risk to children up to 8 years of age.
• Keep dangerous foods from children until 4 years of age.
• Insist that children eat at the table, or at least while sitting down. They
should never run, walk, play, or lie down with food in their mouths.
• Cut food for infants and young children into pieces no larger than one-half
inch, and teach them to chew their food well.
• Supervise mealtime for infants and young children.
• Be aware of older children’s actions. Many choking incidents occur when
older brothers or sisters give dangerous foods, toys, or small objects to a
younger child.
• Avoid toys with small parts, and keep other small household items out of
the reach of infants and young children.
• Follow the age recommendations on toy packages. Age guidelines reflect
the safety of a toy based on any possible choking hazard as well as the
child’s physical and mental abilities at various ages.
• Check under furniture and between cushions for small items that children
could find and put in their mouths.
• Do not let infants and young children play with coins.
First aid for the child who is choking
Make a point to learn the instructions on the following pages of this
publication. Post the chart in your home. However, these instructions should
not take the place of an approved class in basic first aid, CPR, or emergency
prevention. Contact your local American Red Cross office or the American
Heart Association to find out about classes offered in your area. Most of the
classes teach basic first aid, CPR, and emergency prevention along with
what to do for a choking infant or child. Your pediatrician also can help you
understand these steps and talk to you about the importance of supervising
mealtime and identifying dangerous foods and objects.
The information contained in this publication should not be used as a substitute for the medical care and
advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend
based on ­individual facts and circumstances.
From your doctor
The American Academy of Pediatrics is an organization of 60,000 primary care pediatricians, pediatric medical ­sub­specialists,
and pediatric surgical specialists dedicated to the health, safety, and well-being of infants, children, adolescents, and young adults.
American Academy of Pediatrics
Web site— www.HealthyChildren.org
Copyright © 2006. All rights reserved.
American Academy of Pediatrics, Updated 3/11
Pediatric Patient Education handouts used with permission. Copyright © 2006–2013 AAP. Use of these handouts beyond the scope of this module must be
approved by the AAP, who can be reached at [email protected].
Choking/CPR
LEARN AND PRACTICE CPR (CARDIOPULMONARY RESUSCITATION).
IF ALONE WITH A CHILD WHO IS CHOKING…
1. SHOUT FOR HELP. 2. START RESCUE EFFORTS. 3. CALL 911 OR YOUR LOCAL EMERGENCY NUMBER.
START FIRST AID FOR CHOKING IF
• The child cannot breathe at all (the chest is not moving up
and down).
• The child cannot cough or talk, or looks blue.
• The child is found unconscious/unresponsive. (Go to CPR.)
DO NOT START FIRST AID FOR CHOKING IF
• The child can breathe, cry, or talk.
• The child can cough, sputter, or move air at all. The child’s
­normal reflexes are working to clear the airway.
FOR INFANTS YOUNGER THAN 1 YEAR
INFANT CHOKING
INFANT CPR
If the infant is choking and
is unable to breathe, cough, cry,
or speak, follow these steps. Have
someone call 911.
To be used when the infant is UNCONSCIOUS/UNRESPONSIVE or when
breathing stops. Place infant on flat, hard surface.
•• Compress chest at least ¹∕³ the depth of
(SLAPS).
2 GIVE 5 CHEST
COMPRESSIONS.
2 OPEN AIRWAY.
•• Open airway (head tilt–chin lift).
•• If you see a foreign
below the ­nipple line.
1GIVE 5 BACK BLOWS
ALTERNATING with
1 START CHEST COMPRESSIONS.
•• Place 2 fingers of 1 hand on the breastbone just
Alternate back
blows (slaps)
and chest
compressions
until the object
is dislodged
or the infant
becomes
unconscious/
unresponsive.
If the infant
becomes
unconscious/
unresponsive,
begin CPR.
the chest, or about 4 cm
(1.5 inches).
•• After each compression,
allow chest to return
to normal ­position.
Compress chest at rate of at least
100 times per
minute.
•• Do 30
­compressions.
body, sweep it out
with your finger.
Do NOT do
blind finger
sweeps.
3 start RESCUE BREATHING.
4 RESUME CHEST COMPRESSIONS.
•• Take a normal breath.
•• Cover infant’s mouth and •• Continue with cycles of 30 compressions to nose with your mouth.
•• Give 2 breaths, each for 1 second. Each breath should make the chest rise.
2 breaths.
•• After 5 cycles of compressions and breaths (about 2 minutes), if no one has called 911 or your local
emergency
­number,
call it
yourself.
If at any time an object is coughed up or the infant/child starts to breathe,
stop rescue breaths and call 911 or your local emergency number.
Ask your pediatrician for information on choking/CPR instructions for children
older than 8 years and for information on an approved first aid or CPR course
in your community.
Copyright © 2011 American Academy of Pediatrics. All rights reserved.
Choking/CPR
LEARN AND PRACTICE CPR (CARDIOPULMONARY RESUSCITATION).
IF ALONE WITH A CHILD WHO IS CHOKING…
1. SHOUT FOR HELP. 2. START RESCUE EFFORTS. 3. CALL 911 OR YOUR LOCAL EMERGENCY NUMBER.
START FIRST AID FOR CHOKING IF
• The child cannot breathe at all (the chest is not moving up
and down).
• The child cannot cough or talk, or looks blue.
• The child is found unconscious/unresponsive. (Go to CPR.)
DO NOT START FIRST AID FOR CHOKING IF
• The child can breathe, cry, or talk.
• The child can cough, sputter, or move air at all. The child’s
­normal reflexes are working to clear the airway.
FOR CHILDREN 1 TO 8 YEARS OF AGE
CHILD CPR
CHILD CHOKING
(HEIMLICH MANEUVER)
Have someone call 911. If the child
is choking and is unable to breathe,
cough, cry, or speak, ­follow these steps.
1. P
erform Heimlich
maneuver.
•• Place hand, made into a fist, and cover with other
hand just above
the navel. Place
well below the
bottom tip of the
breastbone and rib cage.
•• Give each
thrust with
enough force to
produce an artificial
cough designed to relieve airway
obstruction.
•• Perform Heimlich maneuver until
the object is expelled or the child
becomes ­unconscious/unresponsive.
2. If the child becomes UNCONSCIOUS/UNRESPONSIVE,
begin CPR.
To be used when the child is UNCONSCIOUS/UNRESPONSIVE or when breathing stops.
Place child on flat, hard surface.
1 START CHEST COMPRESSIONS.
•• Place the heel of 1 or 2 hands over the lower half of the sternum.
•• Compress chest at least ¹/3 the depth of the chest, or about 5 cm (2 inches).
•• After each compression, allow chest to return to normal position. Compress chest at rate of at least 100 times per minute.
•• Do 30 compressions.
1-hand technique
2-hand technique
2 OPEN AIRWAY.
3 start RESCUE BREATHING.
•• Open airway (head tilt–chin lift).
•• If you see a foreign body, sweep it •• Take a normal breath.
•• Pinch the child’s nose closed, out with your finger. Do NOT do blind finger sweeps.
and cover child’s mouth with your mouth.
•• Give 2 breaths, each for 1 second. Each breath should make the chest rise.
4 RESUME CHEST COMPRESSIONS.
•• Continue with cycles of 30 compressions to 2 breaths until the object is expelled.
•• After 5 cycles of compressions and breaths (about 2 minutes), if no one has called 911 or your local emergency number, call it
yourself.
If at any time an object is coughed up or the infant/child starts to breathe,
stop rescue breaths and call 911 or your local emergency number.
Ask your pediatrician for information on choking/CPR instructions for children
older than 8 years and for information on an approved first aid or CPR course
in your community.
Copyright © 2011 American Academy of Pediatrics. All rights reserved.
A Parent’s Guide
to Water Safety
Drowning is one of the top causes of injury and death in children. Children can
drown in pools, rivers, ponds, lakes, or oceans. They can even drown in a few
inches of water in bathtubs, toilets, and large buckets.
The following is information from the American Academy of Pediatrics
(AAP) about how to keep your children safe in or around water.
Water safety at home
Parents need to keep a close eye on infants and young children, especially as
they learn to crawl. To keep your child safe, make sure you
• Never leave your child alone in the bathtub—even for a moment.
Many bathtub drownings happen (even in a few inches of water) when a
parent leaves a small child alone or with another young child. Also, bath
seats are just bathing aids. Bath seats can tip over and your child can slip
out of them, so they won’t prevent drowning.
• Empty water from containers, such as large pails and 5-gallon
buckets, immediately after use.
• Keep bathroom doors closed. Install ­doorknob covers or a hook-and-eye
latch or other lock that is out of the reach of your small child.
• Keep toilets closed. Always close the toilet lid, and consider using a toilet
lid latch.
Water safety at the pool
An adult should actively watch children at all times while they are in a pool.
For infants and toddlers, an adult should be in the water and within arm’s
reach, providing “touch supervision.” For older children, an adult should be
paying constant attention and free from distractions, like talking on the phone,
socializing, tending to household chores, or drinking alcohol. The supervising
adult must know how to swim.
Pool rules
If you have a pool, insist that the following rules are followed:
• Keep toys away from the pool when the pool is not in use.
• Empty small blow-up pools after each use.
• No tricycles or other riding toys at poolside.
• No electrical appliances near the pool.
• No diving in a pool that is not deep enough.
• No running on the pool deck.
• Have no more than 4 inches between vertical slats. Chain-link fences are
very easy to climb and are not recommended as pool fences. If they must
be used, the diamond shape should not be bigger than 1¾ inches.
• Have a gate that is well maintained and is self-closing and self-latching. It
should only open away from the pool. The latches should be higher than a
child can reach—54 inches from the bottom of the gate.
• For above-ground pools always keep children away from steps or ladders.
When the pool is not in use, lock or remove ladders to prevent access by
children.
Other protection products, when used with an “isolation” fence, may be of
some benefit; however, these are not substitutes for adequate fencing. These
may include the following:
• Automatic pool covers (motorized covers operated by a switch). Pool
covers should cover the entire pool so that a child can’t slip under them.
Make sure there is no standing water on top of the pool cover. Be aware
that floating solar covers are not safety covers.
• Door alarms.
• Doors to the house that are self-closing or self-latching.
• Window guards.
• Pool alarms.
Swimming lessons
Children need to learn to swim. The AAP ­supports swimming lessons for most
children 4 years and older and for children 1 to 4 years of age who are ready
to learn how to swim. Keep in mind that because children develop at different
rates, each child will be ready to swim at her own time. Also, swimming lessons
do not provide “drown-proofing” for children of any age, so supervision and
other layers of ­protection are necessary—even for children who have learned
swimming skills.
Some factors you may consider before starting swimming lessons for
younger children include frequency of exposure to water, emotional maturity,
physical limitations, and health concerns related to swimming pools (for
WRONG!
RIGHT!
POOL
POOL
Pool fences
Children can climb out a window, climb though a doggy door, or sneak out a
door to get to the backyard and the pool. To prevent small children from entering
the pool area on their own, there should be a fence that completely surrounds
the pool or spa. Combined with the watchful eyes of an adult, a fence is the best
way to protect your child and other children who may visit or live nearby.
Pool fences should also
• Be climb-resistant and not have anything alongside them (such as lawn
furniture) that can be used to climb them.
• Be at least 4 feet high and have no foot-holds or handholds that could
help a child climb them.
HOUSE
HOUSE
A fence should completely surround the pool, isolating it from the house.
example, swallowing water, infections, pool chemicals). While some swim
programs claim to teach water survival skills to children younger than 12
months, evidence does not show that they are effective in preventing drowning.
Swim classes should be taught by qualified teachers. For children younger
than 3 years, the World Aquatic Babies & Children Network recommends
that parents must participate, the time the head is submerged under water
is limited (swallowing too much water can make your child sick), and classes
should be fun and include one-on-one teaching.
Pool conditions should be monitored to make sure chemical and water
temperature levels are safe. Another safety measure is to check with the pool
operator if there are protective drain covers or vacuum release systems.
Diving
Serious spinal cord injuries, permanent brain damage, and death can occur
to swimmers who dive into shallow water or spring upward on the diving board
and hit it on the way down.
Keep safe by following these simple commonsense diving rules.
• Check how deep the water is. Enter the water feet first, especially when
going in for the first time.
• Never dive into above-ground pools; they are usually not deep enough.
• Never dive into the shallow end of a pool.
• Never dive through inner tubes or other pool toys.
• Learn how to dive properly by taking classes.
Water safety in other bodies of water
Swimming in a pool is different from swimming in other bodies of water. In
addition to rules for pool safety, parents and children should know the rules
for swimming in oceans, lakes, ponds, rivers, and streams. These include
• Never swim without adult supervision.
• Never dive into water unless an adult who knows the depth of the water
says it’s OK.
• Always use an approved personal flotation device (life jacket) when
boating, riding on a personal watercraft, fishing, waterskiing, or playing in
a river or stream. Water wings and other blow-up swimming aids should
not be used in place of life vests.
• Never try water sports such as skiing, scuba diving, or snorkeling without
instructions from a qualified teacher.
• Never swim around anchored boats, in motorboat lanes, or where people
are waterskiing.
• Never swim during electrical storms.
• If you swim or drift far from shore, stay calm and tread water, or float on
your back until help arrives.
• Other water hazards found near many homes include canals, ditches,
postholes, wells, fishponds, and fountains. Watch your child closely if he
is playing near any of these areas.
Life jackets and life preservers
If your family enjoys spending time on the water, make sure everyone wears
an approved personal flotation device or life jacket. Some people think life
jackets are hot, bulky, and ugly. However, today’s models have improved in
looks, comfort, and protection. Many states require the use of life jackets and
life preservers. They must be present on all boats traveling in water supervised
by the US Coast Guard. Remember, without wearing a life jacket, your child is
not protected.
Keep the following tips in mind:
• A life jacket should not take the place of adult supervision.
• Choose a life jacket that fits your child’s weight and age. It should be
approved by the US Coast Guard and tested by Underwriters Laboratories
(UL). Check the label to be sure. The label should also say whether the
jacket is made for an adult or a child.
• Teach your child how to put on her own life jacket and make sure it is
worn the right way.
• Blow-up water wings, toys, rafts, and air mattresses should never be
used as life ­jackets or life preservers.
In an emergency
The following are ways to be ready for an emergency:
• Learn CPR. Anyone caring for or watching children should know CPR
(cardiopulmonary resuscitation). CPR can save a life and help reduce
injury after a near drowning. The American Red Cross, the American Heart
Association, and your local hospital or fire department offer CPR training.
• Always have a phone near the pool. Clearly post your local emergency
phone number (usually 911).
• Post safety and CPR instructions at poolside.
• Make sure all rescue equipment is nearby. This includes a shepherd
hook, safety ring, and rope.
The following are things to do in an emergency:
• Yell for help. Carefully lift the child out of the water.
• Start CPR right away. Have someone call emergency medical services
(911).
Don’t drink and swim
Swimmers are at serious risk of drowning when they drink alcohol or use
other drugs while swimming, diving, and playing water sports. These activities
require clear thinking, coordination, and the ability to judge distance, depth,
speed, and direction. Alcohol impairs all of these skills. People who are
supervising other swimmers should not be using alcohol or drugs.
Never swim alone
No one, adult or child, should ever swim alone. Children should be
supervised at all times in and around water. Even a child who knows
how to swim can drown a few feet from safety.
Older children and teens are also at risk from drowning, even if they
know how to swim. They often drown while swimming in unsupervised
places such as water-filled quarries, rivers, or ponds. Although many
teens can swim well, they often encounter risky situations that they
might not recognize, such as rough currents, surf, and sharp rocks.
Alcohol is also a factor in many drownings among teens.
The information contained in this publication should not be used as a substitute for the medical care and advice of
your pediatrician. There may be variations in treatment that your pediatrician may r­ ecommend based on individual
facts and circumstances.
The American Academy of Pediatrics is an organization of 60,000 primary care pediatricians, pediatric medical s­ ub­specialists,
and pediatric surgical specialists dedicated to the health, safety, and well-being of infants, children, adolescents, and young adults.
American Academy of Pediatrics
Web site— www.HealthyChildren.org
Copyright © 2010
American Academy of Pediatrics, Updated 08/2013
All rights reserved.
Pediatric Patient Education handouts used with permission. Copyright © 2006–2013 AAP. Use of these handouts beyond the scope
of this module must be approved by the AAP, who can be reached at [email protected].
Protect Your Child
From Poison
Children can get very sick if they come in ­contact with medicines, household
products, pesticides, chemicals, or cosmetics. This can happen at any age
and can cause serious reactions. How­ever, most children who come in contact
with these things are not perma­nently hurt if they are treated right away.
The following is information from the American Academy of Pediatrics on
how to prevent and treat poisonings in and around your home.
Prevention
Most poisonings occur when parents are not paying close attention. While
you are busy doing other things, your child may be exploring closets or under
bathroom sinks, where dangerous household items are often stored. Children
are at risk for poisoning because they like to put things into their mouths
and taste them. Remember to always keep a close eye on your child. Watch
your child even more closely when you are away from home—especially at
a grandparent’s home, where medicines are often left out and within a child’s
reach.
The best way to keep your child safe from poisoning is to lock up
dangerous household items out of your child’s reach, including
• Medicines (especially those that contain iron)
• Cleaning products like dishwasher and ­laundry detergents, bleach, ammonia, and ­furniture polish
• Antifreeze, paint thinners, and windshield ­washer fluid
• Gasoline, kerosene, lamp oil
• Pesticides
• Alcohol
Always store medicines and household products in their original
containers. Children can get confused if you put them in containers that were
once used for food, especially empty drink bottles, cans, or cups. Also,
many ­dangerous items look like food or drinks. For example, your child may
mistake powdered dish soap for sugar or lemon liquid ­cleaner for lemonade.
Poison Help
• 1-800-222-1222 is a nationwide toll-free number that directs your call to
your local poison center.
• Call 1-800-222-1222 if you have a poison emergency. This number will
connect you right away to your nearest poison center. A poison expert in
your area is available 24 hours a day, 7 days a week. Also call if you have a
question about a poison or poison prevention. You can find prevention
information at http://poisonhelp.hrsa.gov.
• Be prepared. Post the Poison Help number by every phone in your home
and program the number in your cell phone. Be sure that care­givers and
babysitters know this number.
How to make your home poison-safe
In the kitchen
• Store medicines, cleaners, lye, furniture polish, dishwasher soap, and
other dangerous products in locked cabinets, out of sight and reach
of ­children.
• If you must store items under the sink, use safety latches that lock every
time you close the cabinet.
In the bathroom
• Keep all medicines in containers with safety caps. But remember, these
caps are child ­resistant, not childproof, so store them in a locked cabinet.
• Get rid of leftover or expired medicines.
–– Take medicines to your police department if they have a drug collection program.
–– Check if your community has a household hazardous waster disposal
program that takes medicines.
–– Mix medicines with coffee grounds or kitty litter, seal tightly in a plastic
bag or container, and discard where children cannot get them.
Remember to remove labels with personal information from prescription medicines.
–– Only flush medicines down the toilet or pour down the drain if the
patient information materials say it’s OK to do so.
• Store everyday items like toothpaste, soap, and shampoo in a different
cabinet from ­dangerous products.
• Take medicine where children cannot watch you; they may try to copy
you.
• Call medicine by its correct name. You don’t want to confuse your child by
calling it candy.
• Check the label every time you give medicine. This will help you to be sure
you are giving the right medicine in the right amount to the right person.
Mistakes are more common in the ­middle of the night, so always turn on
a light when using any medicine.
In the garage and basement
• Keep paints, varnishes, thinners, pesticides, and fertilizers in a locked
cabinet.
• Read labels on all household products before you buy them. Try to find the
safest ones for the job. Buy only what you need to use right away.
• Open the garage door before starting your car to prevent carbon monoxide poisoning.
• Be sure that coal, wood, or kerosene stoves and appliances are in good
working order. If you smell gas, turn off the stove or gas burner, leave the
house, and call the gas company.
In the entire house
• Install smoke alarms and carbon monoxide detectors. Contact your local
fire department for information on how many you need and where to
install them.
Treatment
Swallowed poison
If you find your child with an open or empty container of a dangerous nonfood
item, your child may have been poisoned. Stay calm and act quickly.
First, get the item away from your child. If there is still some in your child’s
mouth, make him spit it out or remove it with your fingers. Keep this material
along with anything else that might help determine what your child swallowed.
Do not make your child vomit because it may cause more damage.
If your child is unconscious, not breathing, or ­having convulsions or
seizures, call 911 or your local emergency number right away.
If your child does not have these symptoms, call the Poison Help number,
1-800-222-1222. You may be asked for the following information:
• Your name and phone number
• Your child’s name, age, and weight
• Any medical conditions your child has
• Any medicine your child is taking
• The name of the item your child swallowed (Read it off the container and
spell it.)
• The time your child swallowed the item (or when you found your child),
and the amount you think was swallowed
If the poison is very dangerous, or if your child is very young, you may
be told to take him to the nearest hospital. If your child is not in danger, the
Poison Help staff will tell you what to do to help your child at home.
Poison on the skin
If your child spills a dangerous chemical on her body, remove her clothes and
rinse the skin with room-temperature water for at least 15 minutes, even
if your child resists. Then call Poison Help at 1-800-222-1222. Do not use
ointments or grease.
Poison in the eye
Continue flushing the eye for 15 minutes. Then call the Poison Help number,
1-800-222-1222. Do not use an eyecup, eyedrops, or ointment unless
Poison Help staff tells you to.
Poisonous fumes
In the home, poisonous fumes can come from
• A car running in a closed garage
• Leaky gas vents
• Wood, coal, or kerosene stoves that are not working right
• Space heaters, ovens, stoves, or water heaters that use gas
If your child is exposed to fumes or gases, have her breathe fresh air right
away. If she is breathing, call the Poison Help number, 1-800-222-1222, and ask
about what to do next. If she has stopped breathing, start cardiopulmonary
resuscitation (CPR) and do not stop until she breathes on her own or someone
else can take over. If you can, have someone call 911 right away. If you are alone,
wait until your child is breathing, or after 1 minute of CPR, then call 911.
Remember
You can help make your home poison-safe by doing the following:
• Keep all medicines and household products locked up and out of your
child’s reach.
• Use safety latches on drawers and cabinets where you keep objects that
may be dangerous to your child.
• Be prepared for a poisoning emergency. Post the Poison Help number by
every phone in your home and program the number in your cell phone.
1-800-222-1222 will connect you right away to your nearest poison center. (Be sure that your babysitter knows this number.)
Listing of resources does not imply an endorsement by the American Academy of Pediatrics (AAP). The AAP is
not responsible for the content of external resources. Information was current at the time of publication.
The information contained in this publication should not be used as a substitute for the medical care and advice
of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on
individual facts and circumstances.
From your doctor
Flush your child’s eye by holding the eyelid open and pouring a steady stream
of room-temperature water into the inner corner. It is easier if another adult
holds your child while you rinse the eye. If another adult is not around, wrap
your child tightly in a towel and clamp him under one arm. Then you will have
one hand free to hold the eyelid open and the other to pour in the water.
Important information about syrup of ipecac
Syrup of ipecac is a drug that was used in the past to make children
vomit (or throw up) after they had swallowed a poison. Although this
may seem to make sense, this is not a good poison treatment. You
should not make a child vomit in any way, including giving him syrup of
ipecac, making him gag, or giving him salt water. If you have syrup of ipecac
in your home, throw it out (see “In the bathroom” second bullet point).
The American Academy of Pediatrics is an organization of 60,000 primary care pediatricians, pediatric medical s­ ub­specialists,
and pediatric surgical specialists dedicated to the health, safety, and well-being of infants, children, adolescents, and young adults.
American Academy of Pediatrics
Web site— www.HealthyChildren.org
Copyright © 2003
American Academy of Pediatrics, Updated 4/2013
All rights reserved.
Pediatric Patient Education handouts used with permission. Copyright © 2006–2013 AAP. Use of these handouts beyond the scope
of this module must be approved by the AAP, who can be reached at [email protected].
Prescription Medicines
and Your Child
There are 2 types of medicines you can buy:
1) over-the-counter (OTC) medicines and
2) prescription medicines. OTC medicines are
those you can buy without a doctor’s order.
Prescription medicines are those you can only
buy with a doctor’s order (a prescription). This
handout is about prescription medicines.
Ask the Doctor or Pharmacist
Many parents have questions about their children’s
prescription medicines. Labels can be hard to read
and understand. But it’s important to give medicines
the right way for your child’s health and safety.
Before you give your child any medicine, be sure
you know how to use them. Here are some
questions you can ask the doctor or pharmacist*:
• How will this medicine help my child?
• How much medicine do I give my child?
When? For how long?
• Should my child take this medicine with
food or on an empty stomach?
• Are there any side effects* from this medicine?
• How can I learn more about this medicine?
• When will the medicine begin to work?
• What should I do if my child misses a dose?
• What if my child spits it out?
• Can this prescription be refilled? If so,
how many times?
Also, always tell your child’s doctor:
Call the Doctor Right Away If...
...your child throws up a lot or gets a rash after
taking any medicine. Even if a medicine is safe for
other children, your child may be allergic* to it.
Your child may or may not have side effects with
any drug. Be sure to tell the doctor if your child
has any side effects with a medicine.
Read the Label
Here is what the parts of a prescription label
mean. (See example on second page of this
handout.)
a. Prescription number. Your pharmacy will
ask for this number when you call for a refill.
b. Your child’s name.
c. Name of the medicine. Make sure this matches
what your child’s doctor told you. The strength
of the medicine may also be listed (for example,
10 mg tablets).
d. QTY. “Quantity” or how much is in the package.
• If your child is taking any other medicines (even
OTC medicines) and
• If your child has any reactions to the medicines.
e. Expiration date (Mfr Exp). The medicine in
this package will only work until this date.
Throw away any medicine left after this date.
Words to Know
allergic (uh-LER-jik)—to have a bad
reaction to something that doesn’t bother
most people. For example, some people
may get hives if they are stung by a bee.
pharmacist (FARM-uh-sist)—a
person who has special training to
fill prescriptions and teach people
about their medicines.
side effects—symptoms that come from
taking a drug and are not part of the
treatment. For example, some medicines
can make you feel sick to your stomach.
Continued on back
Medication and Dosing Over-the-Counter and Prescription
AAP_PLP_225-268.indd 239
239
9/2/08 11:33:30 AM
Continued from front
j. Pharmacy’s name, address
Example of a Prescription Label
a. Prescription number
(use number to get refills)
b. Child’s name
f. Directions for taking the
medicine
• How much to take
• How to take the medicine
• When to take it and for
how long
c. Name of medicine
i. Doctor’s name
Your Pharmacy
k. Special messages
h. Date prescription was filled
324 Main Street
New York, NY 10000
DEA AB 1234567
RX 7654321
RODRIGUEZ, MELISSA
123 Street, New York, NY 10000
09/18/07
Dr. Smith, Mary
IMPORTANT: Finish All
Of This Medicine Unless
Otherwise Directed By
Your Doctor
CHEW 2 TABLETS 3 TIMES A DAY
FOR 10 DAYS
AMOXICILLIN 200MG CHEWABLE TABLETS
Refills 0
QTY 60
Rph.SVS
Mfr Exp: 09/18/08
g. Refills: How many times the
medicine can be refilled
d. Quantity: How much is in the package e. Expiration date: When you should throw the unused medicine away
f. Directions. This tells you how your child needs
to take the medicine and what it is for. The label
should match what your child’s doctor told you.
Here are some examples:
• “Take 4 times a day.” Give the medicine to your
child 4 times during the day. For example, at
breakfast, lunch, dinner, and before bed.
• “Take every 4 hours.” Give the medicine to your
child every 4 hours. This adds up to 6 times in a
24-hour period. For example, 6:00 am, 10:00 am,
2:00 pm, 6:00 pm, 10:00 pm, and 2:00 am. Most
medicines don’t have to be given at the exact time
to work, but some do.
• “Take as needed as symptoms persist.” Give the
medicine to your child only when needed.
• “Take with food.” Give the medicine to your child
after a meal. This is for medicines that work better
when the stomach is full.
g. Refills. The label will show the number of
refills you can get. “No refills—Dr. authorization
required” or “0” means you need to call your
child’s doctor if you need more. The doctor may
want to check your child before ordering more
medicine.
h. Date prescription was filled.
i. Doctor’s name.
j. Pharmacy’s name, address.
k. Special messages. The medicine may have extra
bright-colored labels with special messages. For
example, you may see, “Keep refrigerated,”
“Shake well before using,” or “May cause
drowsiness.” Be sure to ask if you don’t
understand what they mean.
Tips
• Use safety caps. Always use child-resistant caps.
• Store medicines in a locked, childproof cupboard
if you have children at home.
• Store medicines in a cool, dry place. Wetness can
hurt medicines. So don’t store them in a bathroom.
Some medicines need to be kept in a refrigerator.
• Never let your child take medicine alone. Don’t
call medicine “candy.” (If you do, your child may
try to eat some when you’re not around.)
• Watch your child carefully. Children can find
medicine where you least expect it. Your child
might find it in a visitor’s purse or at other
people’s homes. On moving day, medicines and
poisons may be out where children can find them.
To learn more, visit the American Academy of Pediatrics (AAP) Web site at www.aap.org.
Your child’s doctor will tell you to do what’s best for your child.
This information should not take the place of talking with your child’s doctor.
Adaptation of the AAP information in this handout into plain language
was supported in part by McNeil Consumer Healthcare.
© 2008 American Academy of Pediatrics
240
Plain Language Pediatrics: Health Literacy Strategies and Communication Resources for Common Pediatric Topics
Pediatric Patient Education handouts used with permission. Copyright © 2006–2013 AAP. Use of these handouts beyond the scope of this module must be approved by the AAP, who can be reached at [email protected].
AAP_PLP_225-268.indd 240
9/2/08 11:33:31 AM
Playground Safety
Each year, about 200,000 children get hurt on playground equipment with
injuries serious enough to need treatment in the emergency department.
About 15 children die each year from playground injuries. While many
of these injuries happen on home equipment, most occur at school and
public playgrounds.
Read on to find out how you can tell if the playground equipment at your
home or child’s school or in your neighborhood is as safe as possible.
How are children injured?
Most playground injuries occur when children fall off tall equipment like
monkey bars. Other injuries happen when children
• Trip over equipment
• Get hit by equipment, such as a swing
• Get bruises, scrapes, or cuts from sharp edges
Some injuries, such as head injuries, can be serious or even fatal.
Other injuries may include broken bones, sprains, and wounds to the teeth
and mouth.
How to prevent playground injuries
To check if play equipment is safe, ask yourself the following questions:
• Is the equipment the right size? For example, smaller swings are
for smaller children and can break if larger children use them.
• Is the play equipment installed correctly and according to the
manufacturer’s directions?
• Can children reach any moving parts that might pinch or trap any
body part?
• What’s underneath the equipment? The best way to prevent serious
injuries is to have a surface that will absorb impact when children land
on it. This is especially needed under and around swings, slides, and
climbing equipment. (See “What are safer surfaces?”).
• Is wooden play equipment free of splinters and nails or screws that
stick out?
Here are some other things to check for.
Slides
• Slides should be placed in the shade or away from the sun. Metal slides
can get very hot from the sun and burn a child’s hands and legs. Plastic
slides are better because they do not get as hot, but they should still be
checked before using.
• Slides should have a platform with rails at the top for children to hold.
There should be a guardrail, hood, or other device at the top of the slide
that requires the child to sit when going down the slide. Open slides
should have sides at least 4 inches high.
• Make sure there are no rocks, glass, sticks, toys, debris, or other children
at the base of a slide. These could get in the way of a child landing safely.
The cleared area in front of the slide should extend a distance equal to
the height of the slide platform, with a minimum of 6 feet and a maximum
of 8 feet cleared.
Swings
• Swings should be clear of other equipment. Make sure there is a
distance in front of and behind a swing that is twice the height of
the suspending bar.
• Swing seats should be made of soft materials such as rubber, plastic,
or canvas.
• Make sure open or “S” hooks on swing chains are closed to form a
figure 8.
• Walls or fences should be located at least 6 feet from either side of a
swing structure.
• Swing sets should be securely anchored according to the manufacturer’s
instructions to prevent tipping. Anchors should be buried deep enough so
that children can’t trip or fall over them.
• Swings should not be too close together. There should be at least
24 inches between swings and no more than 2 seat swings (or 1 tire
swing) in the same section of the structure.
Remember, even with these measures, children still need to be
watched closely while they are playing.
Climbing structures
• Platforms higher than 30 inches above the ground intended for use by
school-aged children should have guardrails or barriers to prevent falls.
• Vertical and horizontal spaces should be less than 31⁄2 inches wide
or more than 9 inches wide. This is to keep a small child’s head from
getting trapped.
• Rungs, stairs, and steps should be evenly spaced.
• Round rungs to be gripped by young hands should be about 1 to
11⁄2 inches in diameter.
The danger of wearing drawstrings and bicycle
helmets on playground equipment
Drawstrings on clothing and bicycle helmets can strangle a child if they
get caught on playground equipment. The best way to prevent this is to
take drawstrings off jackets, shirts, and hats and shorten drawstrings on
coats and jackets. Bicycle helmets should be worn while riding a bicycle,
but not while playing on playground equipment.
What are safer surfaces?
Safer surfaces make a serious head injury less likely to occur if a child
falls. This is because they are made to absorb the impact of a fall. Some
examples of safer surfaces include the following:
• Wood chips, mulch, or shredded rubber—at least 9 inches deep for
play equipment up to 7 feet high.
• Sand or pea gravel—at least 9 inches deep for play equipment up to
5 feet high.
• Rubber outdoor mats—make sure they are safety tested for playground
equipment.
Check loose-fill surfaces often. They should be raked at least once a
week to keep them soft. They also should be refilled often to keep the correct
depth. Poured-in-place surfaces should be checked continually for wear.
Concrete, asphalt, packed earth, and grass are not safe surfaces and should
not be used under playground equipment.
No surface is totally safe. Many injuries are preventable, but they can
sometimes occur even at the safest playgrounds and with the best supervision. Be prepared to handle an injury if it does occur.
For more information about playground safety and safer surfaces or to
get a copy of the Handbook for Public Playground Safety, visit the US
Consumer Product Safety Commission Web site at www.cpsc.gov.
The information contained in this publication should not be used as a substitute for the medical care and
advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend
based on individual facts and circumstances.
From your doctor
The American Academy of Pediatrics is an organization of 60,000 primary care pediatricians, pediatric medical subspecialists,
and pediatric surgical specialists dedicated to the health, safety, and well-being of infants, children, adolescents, and young adults.
American Academy of Pediatrics
Web site— www.aap.org
Copyright © 2006
American Academy of Pediatrics, Updated 10/05
Pediatric Patient Education handouts used with permission. Copyright © 2006–2013 AAP. Use of these handouts beyond the scope of this module must be
approved by the AAP, who can be reached at [email protected].