1. Pediatric Development and Safety Sarah Lewis MHS PA-C

2.  http://www.aap.org/topics.html  Development http://www.aap.org/topics.html  Link to lecture from peds http://gradprograms.lhup.edu/pa/DesktopDefault.a spx?tabid=27&pid=25&cMod=22&lecID=5810 http://gradprograms.lhup.edu/pa/DesktopDefault.a spx?tabid=27&pid=25&cMod=22&lecID=5810

3.  Motor  Gross  Fine  Communication and Language  Cognition  Social

4.  HPI: This 27 month old male ………  Per parent, he is able to  Social: wash his hands and dress himself,  Fine motor: stack >8 cubes, draw a circle,  Language: speech is understandable, names >4 colors, and  Gross motor: balance on each foot >2 seconds……  PE: can document all of the above in the office, of each developmental area  A: Development advanced for age  P: encouraged reading with child, coloring, singing; playing with balls; inclusion with mealtime conversation

5.  http://www.cdc.gov/injury/index.html http://www.cdc.gov/injury/index.html  Accidents in Kids by Craig at http://gradprograms.lhup.edu/pa/DesktopDefault.a spx?tabid=27&pid=25&cMod=22&lecID=5787 http://gradprograms.lhup.edu/pa/DesktopDefault.a spx?tabid=27&pid=25&cMod=22&lecID=5787

6.  Causes of Death: http://www.cdc.gov/injury/wisqars/pdf/Death_by_A ge_2007-a.pdf http://www.cdc.gov/injury/wisqars/pdf/Death_by_A ge_2007-a.pdf  Non fatal Injuries seen in ERs: http://www.cdc.gov/injury/wisqars/pdf/Nonfatal_20 08-a.pdf http://www.cdc.gov/injury/wisqars/pdf/Nonfatal_20 08-a.pdf

7. Top Ten Home Child Accidental Fatalities n falls n drowning n head injuries n fire n burns: pots, grease irons n poisoning n electrocution n shooting n broken bones n suffocation

8.  ASK!  Open ended safety question  What’s dangerous in your house? Around your home? Where else is the child?  What sorts of safety modifications have you made?  Educate  Reassure  25% of children seen each year for injuries

9. Age\ConcernCar SeatsDrowningFallsSuffocationBurnsPoisonSleepGeneral 1 month Rear facing, neck support; not in front with airbags; Police/Fire can check towel/ mesh beneath reduces slips Changing table; don’t leave, use strap Baby powders  respiratory distress; plastic bags; cords, necklaces, also from blinds Smoke and carbon monoxide detectors; flame resistant clothing; Reduce house water temp to <120 degrees; Get rid of non- essentials from active areas of home; poison control number is? Back to sleep; nothing around child; bumper or not; clothes instead of blankets Home prep- lead, radon, slip hazards 1-3 months Bed or couch, Chair/ seats should not be off the floor; high chair strap Small items are gone; crib mobiles Don’t hold child while smoking, drinking hot liquid or cooking by stove; no microwaving bottles! 4-7 months Sitting, crawling Check seat limits for height and weight; 5 point is best at risk of tipping in tub; falls into toilet Stairs! Pulling stuff down on self Teething on everything Outlet and plug covers; GFCIs (ground fault circuit interruptor) Bumper out Pool, ponds, etc?; yard safety 8-12 months Crawling  running! Rear facing at least till >1 year AND >20 lbs Gates, esp stairs; coffee tables; windows open from top; furniture straps Teething, mouthing objects Heaters? Chemicals Medications: bath, kitchen, garage, laundry Lowest crib level; away from drapes and outlets; mobile gone Gun safety; door locks/knob covers 1-2 years Do not leave alone in a car without you never alone; early Swim lessons Still no plug in toys Crib fall risk? Stackable items? 2-3 yearsBooster seats; 5 point harness best Never alone!Bike helmets; stairs/windows ; playgrounds Candles, matches, etc Out of crib to floor Lock dangerous areas (hide keys); driveway

10.  Example: 20 month old being seen, who climbs up the exam room walls   Consider safety of windows, tub, crib, gates, door knobs

11. Safety - Room by Room

12.  Refer to or give book  Pamphlets or packets of age specific info  Skipping Safety is not an option

13.  Pair up with someone who has had a peds or family practice rotation, and has a peds note  Improve upon the 4 point development history, PE, assessment and a plan that includes predicted milestones, and safety guidance  Email to the student’s advisor to show your increased competency, and upload to portal

14. When you have kids, it’ll make more sense