1. Child Home Injury Prevention (CHIP) Training
*insert name and contact details*

2. The single major avoidable cause of death in childhood in England is unintentional injury – death in the home for under-fives and on the roads for over- fives.
The social class gradient in child injury is steeper than for any other cause of childhood death or long-term disability.
'Fair Society Healthy Lives' (The Marmot Review, 2010)

3. Aim
To develop your knowledge about child injury risks in the home and how to engage parents on accident prevention.
Objectives
To understand the national and local context on child injuries
To know the most common, serious and preventable injuries and deliver key safety messages
To explain the relationship between child development and injuries
To know how to engage parents in child accident prevention and assess injury risk
To be able to identify the children who are most at risk
To know what equipment is available that can reduce or increase risks
To be able to identify resources and partnerships that will support practitioners’ child safety work.

4. Quiz

5. National and local context

6. Unintentional injuries in and around the home are a leading cause of preventable death for children under five years and are a major cause of ill health and serious disability. The reduction of unintentional injuries in childhood remains an important public health priority.
Public Health England

7. Injury
Accident
Accidental injury
Unintentional injury
Intentional injury
Avoidable injury

9. 2.07i - Hospital admissions caused by unintentional and deliberate injuries in children (aged 0-4 years) in 2017/18 – comparison of Lincolnshire districts

11. Death rates per year per 100,000 children aged 0-15 years by eight class NS-SEC, , England and Wales
Source: British Medical Journal, 2006

12. The personal cost of injury
A childhood injury can be devastating, often having major effects on a child's education, employment, emotional wellbeing and family relationships.
Distress, pain and follow-up treatments
Anxiety/fear
Physical disability
Emotional effects
Loss of schooling or education
Disruption of family routine
Financial burden on family

13. “It’s been my life” “Anger at being different”
“Having to come out of school for treatment”
“Depression and anxiety”
“Being stared at”
“It’s been my life”
“Stigma”

14. The most common, serious, preventable injuries and the key safety messages

15. Hospital admission causes Causes of death
Falls
Choking, suffocation, strangulation
Struck by objects
Drowning
Poisoning
Falls
Heat/hot substances
Smoke, fire, flames
Struck by Person/Animal
Struck by objects
Choking, suffocation, strangulation
Poisoning
Smoke, fire, flames
Heat/hot substances
Struck by Person/Animal
Drowning
Electric current
Electric current
Public Health England: Main causes of hospital admissions and deaths for under fives following accidents, England 2008/9 – 2012/13

16. Choking, suffocation and strangulation
‘Five for the under 5s’
Falls
Burns and scalds
Poisoning
Drowning
Choking, suffocation and strangulation

17. Choking, suffocation, strangulation
Food and vomit
Small objects
Blind cords
Prop feeding
In bed

18. Falls Stairs and steps From furniture Playground equipment
While being carried
Out of buildings

19. Poisoning Medicines Household chemicals E-cig refills Button batteries
Carbon monoxide

20. Burns and scalds
Hot drinks
Bath
Kitchen

21. Drowning
Bath
Garden

22. Supervision
Supervising children is the best way to prevent them from hurting themselves. That means, watching and listening to children and being within reach if they're attempting to do something that could cause injury.
Parents and carers should always be reminded that spending time with children as they explore their world is the best safety practice of all.
A key message for parents is to turn phones and other technology off at crucial times in the day, such as bath time, meal times or when near the road, so they don't get distracted.

23. The most common, serious, preventable injuries and the key safety messages
Public Health England advise focusing on the top 5 injuries that cause preventable death and serious long-term harm. They are falls; choking, suffocation and strangulation; poisoning; burns and scald; and drowning.
There are lots of resources where they key safety messages can be found:
CHIP E-learning module and Milestone Cards, available via
Public Health England’s ‘Preventing Unintentional Injuries: a guide for all staff working with children under 5’
Child Accident Prevention Trust (CAPT) website
Royal Society for the Prevention of Accidents (RoSPA) ‘Keeping Kids Safe Hub’.

24. The relationship between child development and injuries

25. Accidents and child development
There’s a clear link between a child’s physical, intellectual and emotional development and the injuries they incur.
Every child is different and will reach developmental milestones in their own time. Potentially dangerous and misleading to say child will roll/crawl from x weeks/months.
Breakthroughs can be sudden and newly-acquired abilities can cause serious injuries. Parents frequently report that they aren't prepared for the next stage of development.
Parents enjoy talking about what their child can do – a good opportunity to discuss development and accidents.
‘Encouraging parents to think about the way their children behave and the safety consequences is likely to have a more sustained effect.’ (Keeping Children Safe at Home, Injury Prevention Briefing)

26. Exploratory behaviour Cognitive development
Stage of development
Gross motor skills
Rolling, sitting up, shuffling…
Fine motor skills
Grip an object, open a drawer, manipulate screw tops…
Exploratory behaviour
Mouthing, curious about environment…
General
Large head, thin and delicate skin…
Cognitive development
Realise hidden objects are still there, copy adult behaviour…

27. Child Milestone Cards
Lincolnshire Public Health has produced 6 child milestone cards for families to remember and celebrate their child's first developmental milestones.
On the back of each card is advice on how to keep children safe from accidents as they grow and learn new skills. They can be used for displays and campaigns or as teaching resources in one-to-one or group sessions on child safety.
They can be downloaded and printed at

28. How to engage parents in child accident prevention and assess injury risk

29. CHIP Assessment
‘Targeted households have a structured home safety assessment and tailored support to reduce risks, including provision of safety equipment.’
(NICE: Preventing unintentional injury in under 15s)
Based on child’s developmental milestones and associated risks.
Based on guidance from Public Health England, Child Accident Prevention Trust (CAPT) and Royal Society for Prevention of Accidents (RoSPA).
Assesses environmental risks and parent/carer’s safety practices.
Allows practitioners to:
Take a systematic approach to identifying child injury hazards in the home
Give consistent and correct safety advice
Record identified risks and the action taken to mitigate them.

30. Identifying children who are most at risk

31. For families who are under stress for whatever reason… the challenge is even greater and accidents are more likely to be more frequent than the average.
Keeping Children Safe at Home, Injury Prevention Briefing

32. Identifying children who are most at risk
One of the strongest and most consistent predictors of unintentional injuries in childhood is poverty and deprivation.
Child factors:
Inquisitiveness and energy
Number of children in household
Child being able to do more than anticipated
Parent factors:
Living in poor housing that may be overcrowded, or rented accommodation where can’t make changes; no safe play areas
Lack of money, unemployment, can’t afford safety equipment
Maternal fatigue, multiple demands
Single parents, young and inexperienced mothers, not being close to extended family
(Keeping Children Safe at Home, Injury Prevention Briefing)

33. Equipment that can reduce or increase risks

34. Item Needed? Why Prevents access to stairs
Prevents access to other hazardous areas (e.g. kitchen)
Electric sockets are safe by design
Covers can make the socket more dangerous
Cause of more injuries than any other type of baby equipment
Does not help children to walk

35. Item Needed? Why A suffocation and strangulation risk
Also a climbing risk
Not a safety item
Can create a false sense of security

36. Item Needed? Why
Prevents access to household chemicals and dangerous items
Works better than a safety ‘latch’ or ‘catch’
Prevents access to open fires, gas and electric heaters, and wood burners
Could cause suffocation or increase the risk of SIDS
Not a firm, flat, waterproof mattress

37. Item Needed? Why Prevents strangulation from long looped blind cords
Can also use a cleat
Prevent falls from windows
A good compromise between ventilation, security and escape

38. Equipment that can reduce or increase risk
There’s good evidence that the following items of equipment can prevent child accidents:
Safety gates (to prevent access to and falls on stairs)
Window restrictors (to prevent falls from windows)
Fire guards (to prevent access to open fires)
Cupboard locks (to prevent access to cupboards containing medicines and poisonous household chemicals)
Blind cord cleats (to prevent access to blind cords which could cause entanglement and suffocation)
Hair-straightener pouches (to prevent burns from hot hair straighteners)
Smoke alarms and Carbon monoxide detectors
A baby should be put to sleep on a firm flat waterproof mattress.
Sleep spaces should be kept clear of loose bedding, soft toys and cot bumpers.

39. Useful resources and partnerships

40. Useful resources and partnerships
Child Home Injury Prevention scheme:
Home safety assessment tool (CHIP Assessment)
E-learning, multi-agency training
Safety equipment scheme (CHIP Visits)
Child Milestone Cards and other resources
Lincolnshire Fire and Rescue Safe and Well Checks
District council housing teams

41. Useful resources and partnerships
Child Accident Prevention Trust:
Online information
Lead on Child Safety Week every June and provide downloadable resources
Professionals page and newsletter:
Resources available buy through their online shop
Royal Society for the Prevention of Accidents:
Free resources (nappy sack leaflets/height chart/ Safe at Home DVD)
Regular newsletter
Lullaby Trust:
Safe sleep advice
Free downloadable resources
Access to evidence base