1. Pediatric Safety and Prevention
Susan Beggs, RN MSN
Summer 2008

2. Safety risks to developmental levels
Infant
Toddler
Preschool
School age
Adolescent

3. Major childhood prevention measures
Aspiration
MVA
Burns
Drowning
Bodily injury/fractures

4. Aspiration Leading cause of fatal injury under 1 year of age
Prevention:
Inspection of toys, small parts
Out of reach objects
Selective elimination of certain foods
Proper posturing of the infant for feeding
Pacifier with one piece construction

5. Motor Vehicle Accidents
Vehicular risk greatest when child improperly restrained
Pedestrian
Prevention

6. Burns Children are inquisitive Become able to climb and explore
Prevention of household injury:

7. Drowning Child does not recognize danger of H2O
Unaware of inability to breath underwater
No conception of water depth
Hypoxia greatest concern
Prevention

8. Bodily injury/fractures
Still developing sense of balance
Easily distracted from tasks
Prevention:

9. Poisonings Common in early childhood (2 yrs) 75% poisons are ingested
Major reason for poisoning:

10. Poisonings Sources of poison: Cosmetics Household cleaners Plants
Drugs
Insecticides
Gasoline
Household items

11. Stats on drug poisonings

12. Poisonings, cont Therapeutic interventions
In every instance, medical eval is necessary
Call poison control center 1st
Remove child from exposure
Identify poison
Prevent absorption

13. Ask yourself:
Why do you think the American Pediatric Association no long advises parents to keep syrup of Ipecac in the home?

14. Lead Poisoning Ingestion of lead-based materials
“Maybe it’s the lead poisoning!”

15. Lead poisoning, cont Lead poisoning can cause: Brain and nerve damage
Behavior problems
Learning disabilities
Slowed growth
Headaches
Low energy

16. Implications of lead poisoning
Life threatening
More likely to drop out of school
Become disabled
Disturbed brain and nervous system function
Prevent child from full potential

17. Lead poisoning, cont Pathophysiology of lead poisoning
System assessments
Therapeutic Interventions

18. Criteria for treatment of lead poisoning
< 9 not lead poisoned
10-14: prescreen
15-19: nutritional and educational interventions
20-44: environmental eval and medication
45-69: chelation therapy
>70: medical emergency

19. Prevention is the key! Make environment lead-free
Inspect buildings >25 years of age
Areas painted with lead paint should be covered with plywood or linoleum
Educate the parents
Follow up testing for lead levels
Screening all school age children (required in some states)

20. Immunizations Specific recommendations by APA:
Minor infections without fever are not contraindication
If reaction occurs, consult dr. before next immunization

21. Immunization schedules
4mos-6 yrs of age:
DTaP (4 doses)
IPV (3 doses)
HepB (3 doses)
MMR 12 months)
PCV (1 dose)
7-18 yrs of age
Td (every 10 years after initial immunizations)
IPV (not rec. if >18 yrs of age)

22. Nurses responsibilites with immunizations
Know the action of the vaccine
Careful history of patient
Aspirate when injecting
Educate parents (schedule, side effects)
Proper documentation

23. Don't Forget! Assess for reaction 15-30 min after injection
Epinephrine 1:1000 available
Check immunization records with each visit
Parent teaching: fever, or other symptoms