1. Keep Kids Safe Prevent Injuries
Injury and Violence Prevention Program CA4, American Academy of Pediatrics
Keep Kids Safe
Prevent Injuries
Keep Kids Safe was developed by the Injury and Violence Prevention Program of the California Chapter 4, American Academy of Pediatrics (AAP) with funding from the Children and Families Commission of Orange County.
Our mission is to increase the capacity of professionals and parents to prevent childhood injury and violence in accordance with National AAP injury and violence prevention policies.
Children change rapidly and develop new skills. During the first year of life children learn to crawl and then walk. They learn to reach for and grab things. They explore objects by putting them in their mouth. As children grow and develop, the leading causes of injury change.
By reviewing some developmental milestones parents, grandparents, child care providers, and others who care for children will be able to anticipate how to keep children safe and free from major injury.
Injuries are the leading cause of death and disability for children yrs
Raise safe, strong, resilient kids

2. Learning Objectives Presentation for San Francisco Department of Public Health Conference 5/29/09
Discuss child development and risk of injury
Identify at least 2 risk factors for injury including health disparities
Intentional must be discussed with unintentional- most risk factors shared
List 3 of the most common injuries of children 0-14 years and one prevention strategy for each
Know at least two resources for injury prevention
Create strategies for integrating injury prevention into the work that you do

3. Leading Causes of Injury Deaths by Age, CA 2007
(CA4, AAP Injury & Violence Prevention Program (D. Winn RN, MPH) (State of CA EPIC web site data)
<1
(n=129)
1-4
(n=195)
5-9
(n=99)
10-14
(n=150)
15-19
(n=1089)
Suffocation 46
Drowning 53
MVT Occupant 23
Homicide 28
Homicide 385
Homicide 35
Pedestrian 37 (21MVT, 16NT)
MVT Unspec 16
MVT Unspec 22
MVT Unspec 188
Drowning 10
Homicide 29
Pedestrian 12 (11MVT, 1 NT)
MVT Occupant 20
MVT Occupant 122
MVT Occupant 7
MVT Unspec 23
Homicide 11
Pedestrian 14 (13+ 1)
Suicide 122
MVT Unspec 4
MVT Occupant 15
Burn 9
Suicide 12
Poisoning 71
Burn 3
Fall 8
Drowning 8
Bicyclist 11
Pedestrian 40 (36 + 4)
Fall 3
Suffocation 8
Bicyclist 6
Drowning 9
Motorcyclist, Drowning 18

4. Unintentional, Neglect, Intentional Shared Risk Factors
Injury is a Health Disparities Issue
Poverty
Poor environment: physical and social
Substandard housing
Lower educational level
Lower literacy
Lack of social capital/support systems
Gender, age and race/ethnicity
Children with challenging behaviors (Autism, ADHD)

5. Vision: Keep Kids Safe How do we promote injury prevention?
Focus on most serious and preventable
Professional education
Parent education culturally and linguistically appropriate
Readiness to learn
Aware of risk factors for both intentional and unintentional
Need comprehensive approach with families
Advocate for public health policies

6. The E’s of Injury Prevention Strategies
Education
Parents, Care Providers, Educators
Public Policy Makers
Environment and Product Modification
Car seats; Lap/Shoulder belt in school bus
Bike helmets
Enactment of Legislation and Public Policies
Enforcement of Legislation
Mandatory car seat and seat belt laws
Graduated licensing law for teens and new drivers
Ban cell phone/electronics use

7. The Spectrum of Prevention
CA4, AAP Injury and Violence Prevention Program strives
to work at multiple levels to create a cultural norm
Car Safety Seats – A Success Story
Influencing policy and legislation
Changing organizational practices
Fostering coalitions and networks
Educating providers
Promoting community education
Strengthening individual knowledge and skills
Larry Cohen, 1991; Cohen and Swift, 1999

8. Developed by California Chapter 4, American Academy of Pediatrics and Indiana Chapter of the American Academy of Pediatrics

9. Evolution of a Child Kids Are Not Mini-Adults
Wiggling, kicking, rolling over
Crawling
Walking, curiosity
UNAWARE OF
DANGER
Climbing
Running
CA 4 AAP Injury and Violence Prevention Program

10. Leading specific causes of serious injury by 3-month age intervals
Leading specific causes of serious injury by 3-month age intervals. CA (Agran, Winn, Anderson, Trent,Walton-Hayes, Pediatrics. 2001:108-45
Other fall from ht
Battering
Fall- furniture
Non-airway FB
Hot liquid
Poisoning - med
Pedestrian
Rate
Age in 3 month intervals

11. Birth to 2 months Babies Cry
Risk Factor for Abusive Head Trauma
Crying is normal
Colic is a normal part of
infant development
Sometimes feeding, holding, changing, rocking and soothing may help
Sometimes nothing we do can stop the baby from crying
Make sure your baby is OK by having your pediatrician check her
CA4, AAP

12. Birth to 2 months What should you do when the baby doesn’t stop crying
…and you feel like you need a break for a few minutes?
It is OK to let your baby cry
Place your baby on his back in the crib
Do something to calm yourself
Call a friend or relative
Call your
Period of Purple Crying
(R. Barr, MD, PhD- National Center On Shaken Baby Syndrome)
P for Peak of Crying—Crying peaks during the second month, decreasing after that;
U for Unexpected—Crying comes and goes unexpectedly, for no apparent reason;
R for Resists Soothing—Crying continues despite all soothing efforts by caregivers;
P for Pain-like Face—Infants look like they are in pain, even when they are not;
L for Long Lasting—Crying can go on for minutes, and as much as 5 hours, and longer;
E for Evening Crying—Crying occurs more in the late afternoon and evening.
CA4, AAP

13. Period of Purple Crying Ronald Barr MD http:www.dontshake.org
P for Peak of Crying—Crying peaks during the second month, decreasing after that;
U for Unexpected—Crying comes and goes unexpectedly, for no apparent reason;
R for Resists Soothing—Crying continues despite all soothing efforts by caregivers;
P for Pain-like Face—Infants look like they are in pain, even when they are not;
L for Long Lasting—Crying can go on for minutes, and as much as 5 hours, and longer;
E for Evening Crying—Crying occurs more in the late afternoon and evening.
Risk factor for abusive head trauma, family dysfunction
and possibly depression
CA4, AAP

14. Birth to 2 months How do we keep kids safe?
Suffocation is a leading cause of death for infants
Back to Sleep
Use a firm mattress
no soft things in bed
No co-sleeping
No smoking
CA4, AAP

15. 6 to 12 Months 8 to 10 Months 6 to 8 Months Crawls Rolls over Sits up
Picks up very
small objects
(pincer grasp) and puts in mouth
6 to 8 Months
Rolls over
Sits up
Grabs things
Puts things in
mouth
Parent Education curriculum ppt
Q: What can you expect as your child grows and develops between 6 and 8 months?
** Click four times to display answers.**
Rolls Over
Sits up
Grabs things
Puts things in mouth
Q: What can you expect as your child grows and develops between 8 and 10 months?
**Click two times to display answers.**
Crawls
Picks up very small objects – the “pincer grasp” is when a baby begins to pick up very small objects with her thumb and forefinger. This is an exciting developmental milestone, but babies also put everything in their mouths when they get to this age.
Q: What can you expect as your child grows and develops between 10 and12 months?
**Click three times to display answers. **
Stands
Walks
Finds hidden objects
10 to 12 Months
Stands
Walks
Finds hidden objects
CA4, AAP

16. 6-12 Months How do we keep kids safe?
Safe Home
Barriers and Locks
Get on floor- check for small objects
Medicines and cleaning agents high, locked, and out of reach
CA4, AAP

17. 1 to 3 Years 12 to 18 Months Walks and climbs Pulls and carries things
Still puts things into mouth and can choke
Imitates
18 to 24 Months
Runs and climbs
Finds hidden objects
Turns knobs and containers
Opens doors and drawers
2 to 3 Years
Jumps and climbs
Opens containers
Unscrews lids and caps
Makes things work
CA4, AAP

18. Cause of Burn Injuries Children 0-4 yr, (complied for CA, AAP by D. Winn from EPIC data base)
Toddlers at highest risk

19. Temperature and Duration
Current Burn Management 2009
Temperature and Duration
70o C (160oF) instant full-thickness
65o C (149oF) instant partial-thickness
60o C (140o F) 2.0 seconds
55o C (131o F) 7.5 seconds
50o C (122o F) 1.5 minutes
(M. Cinat, MD, Director Burn Unit (UCIMC) 19

21. Furniture Toddlers Able to open drawers, climb
Curious about environment
Poor coordination & balance
Poor danger recognition

22. Keep Kids Safe: How we started
1998: CA Tobacco tax initiative – School Readiness
First 5 and County Commissions. The Children and Families Commission of Orange County
If we want children ready for school and not in need of special education because they were injured
We must address injury – the leading cause of death and disability for children.
Funded the CA4, AAP Injury and Violence Prevention Program
Keep Kids Safe was developed by the Injury and Violence Prevention Program of the California Chapter 4, American Academy of Pediatrics with funding from the Children and Families Commission of Orange County.
Our mission is to increase the capacity of professionals and parents to prevent childhood injury and violence in accordance with National AAP injury and violence prevention policies.
Raise safe, strong, resilient kids

23. Injury Prevention Program
Capacity Building
Integrate injury prevention into health, education and social services for kids
Link the health of the families to the public health of the community
Bridge program silos
Create innovative strategies

24. Medical/ OC Dental Care Nurse-Family Partnership School Public Health
Districts
CHOC & UCI
Pediatric
Residents
Libraries
Early
Childhood
Education
Centers
Family
Resource
Police
Departments
Public Health
Nursing
Readiness
Nurses
Medical/
Dental Care
Injury and Violence
Prevention Program
California Chapter 4, American Academy of Pediatrics 24

25. IVPP Resources www.ockeepkidssafe.org
Developed tools and materials linguistically and culturally appropriate to our demographics
All of our materials are available with English and Spanish
Many are available in Vietnamese
Partners offer to adapt to other languages
Newer Tools
Connected Kids
Parent Education Curriculum

26. New Tool: Parent Education Curriculum

27. Connected Kids: AAP Violence Prevention Program
Infancy & Early Childhood
2 days – 4 years
Middle Childhood
5 – 10 years
Adolescence
11 – 21 years

28. Community Connections
Community Connections (from Connected Kids- American Academy of Pediatrics)
Social capital
Connections with people
Connections with community
Connect families to community resources
*Identify local community connections
Child-Centered
Parent- Centered
Community Connections
Physical Safety
California Chapter 4, American Academy of Pediatrics

29. California Chapter 4, American Academy of Pediatrics
Bullying: It’s Not OK
You are on a home visit with a family with a newborn.
The mother lets you know that her older child will not go to school.
He cries each morning and claims he has a stomachache.
What are you gong to do?
California Chapter 4, American Academy of Pediatrics

30. Summary 8. Multiple doses
1. Injury: leading cause of death and disability
2. Work with pediatricians, public health professionals, social workers, early child educators, child care providers
3. Address intentional with unintentional
4. Most preventable
5. Consistent messages
6. Relate to development
7. Give tools
8. Multiple doses

31. How do we work with families to prevent injury
Teachable moments Simple messages Readiness to learn Can the family do what is needed? Is it individual family issue? Do they have resources? Is it code or regulatory issue?

32. Resources http://www.ockeepkidssafe.org http://www.cippp.org/
National Center on Shaken Baby Syndrome