Prevention of accidental injuries in children
I. Background:
1, accidental injury is a sudden occurrence of a variety of practices or accidents on the human body caused by injury, including a variety of physical, chemical and biological factors.
2, the International Classification of Diseases (ICD-10) has classified it as a separate category, which includes traffic accidents, drowning, suffocation, poisoning, burns (scalding), falls, animal bites, suicide or other killings, etc..
3, the latest show that more than 1 million children under the age of 14 years old die each year in the world from accidental injuries, China’s accidental injuries accounted for 26,1% of the total number of child deaths, and the number is still increasing rapidly at the rate of 7%-10% per year. It is urgent to keep children “safe from accidental injuries”! Early childhood teachers, school teachers, and parents need to know about the prevention of childhood accidental injuries.
Second, the distribution of :
1, the occurrence of many categories, the proportion of accidental injuries in China in the order of: traffic accidents, poisoning, fall injuries, burns, drowning, other accidental injuries (asphyxiation, animal bites)
2, the city to car accidents, mainly drowning in rural areas
3, the south to drowning, suffocation, car accidents, the north is more suffocation, poisoning, car accidents
III. Main reasons:
1, the main reason for the occurrence of some parents (guardians) busy with work and neglect the care of children, rural roads and rivers are not managed in place, health education is not widespread, the rescue system is not sound, the layout of the room or the use of goods placed, unreasonable management
2, children’s accidental injuries mostly occur in parents, teachers and other guardians paralysis, many parents or teachers lack awareness of preventing children’s accidental injuries, simply do not think that children will happen accidental injuries
Therefore, schools, child care institutions, stores, playgrounds and other public places, must have a sense of crisis, not paralyzed, into a variety of accidents as expected, to prevent children’s accidental injuries as far as possible
Fourth, the most common types of common accidental injuries
Trauma (car accidents, falls, bruises, etc.), burns, animal bites, drowning, poisoning, tracheal foreign bodies, mental injuries, etc. Several special types.
Accidental suffocation of infants
Newborns and small infants do not lift their heads or turn over, and when mothers and infants sleep in the same bed or even under the same blanket with their babies, suffocation often occurs because the blanket blocks the baby’s mouth and nose. When breastfeeding infants, children eat while sleeping, when the mother and infant sleep, the breast blocked the baby’s mouth and nose, asphyxiation can also occur, newborns and young infants, will not turn over, if the supine position to sleep, once the child vomits, vomit into the trachea, can also cause asphyxiation and death
In addition, improper feeding, water or medicine for infants, easy to cause choking or choking medicine, and caused by asphyxiation death
1, tracheal foreign body inhalation (airway blockage)
Foreign body inhalation refers to a variety of foreign bodies inadvertently inhaled by the child’s respiratory tract, the foreign body may stay in any part of the respiratory tract, serious cases can cause immediate death by asphyxiation.
2. Drowning
Among the drowning victims, most of them are children and teenagers. Especially those children who go swimming on their own without an adult accompanying them. In early winter and early spring, the water surface has just frozen, or the ice has begun to melt, the ice layer becomes thin, at this time children are most likely to drowning accidents by stepping on the ice. The death of young children due to drowning is also extremely common. According to statistics, drowning was the third leading cause of death among children aged 1-4 years in 2004. These children are not mainly due to swimming drowning, but more often due to inadvertent death by falling into the water
3.Drug poisoning
The first is that parents do not understand the knowledge of children’s medication and abuse the drugs on their own, and the second is that children steal drugs to cause poisoning. 1-3 years old children are curious and often take the pills when adults are not paying attention, resulting in poisoning.
V. Classification:
1, minor injuries: general tearing injuries, does not affect the life, generally in the outpatient treatment, no hospitalization.
2.Moderate injuries: including long bone fractures of the limbs, extensive soft tissue damage, requiring hospitalization.
3.Serious injuries: including severe shock, internal organ damage and brain damage, etc., which are life-threatening and must receive emergency treatment.
VI. Location :
1. Home 52%a
2.Street 19%
3. School (kindergarten) 12%
4.Other 17％
Seven, accidental death distribution characteristics:
1, the top seven causes of accidental death of children in the order of drowning, asphyxiation, car accidents, mechanical asphyxiation, poisoning, trauma, burns
2, urban areas are mainly trauma, suburban areas are mainly drowning, car accidents, asphyxiation,.
3, accidental death of children boys is 1, 7 times more than girls, of which drowning deaths of boys is 3 times more than girls
4, accidental deaths in May, June, July, August death levels are higher, with the highest proportion of deaths in June
5.Among the children who died accidentally, 87.45% of them were raised by their parents or others at home
VIII. Risk factors
1. Age
Early childhood and preschool age children can walk independently and have an increased range of activities. They have a strong curiosity and are prone to burns, drowning and falls. School-age children are prone to trauma while walking, such as injuries related to bicycles or motor vehicles, due to underestimation of danger.
2.Socio-economic status
Poverty is the most important risk factor in childhood trauma, and the number of deaths due to burns, drowning and car accidents is 2-4 times higher for children from poor families than for other families, and the injury mortality rate is inversely proportional to family income.
3. The causes of non-fatal injuries among children at different ages are different.
Infants are mainly falls (falls), burns (burns) or cuts; preschoolers are mainly collisions, cuts, falls (falls) of preschoolers, bicycling, skating, trauma related to sports activities and motor vehicle traffic accidents are gradually increasing.
IX. Prevention and control.
1, accidental injuries have their own occurrence, development of the law, there are risk factors that match them, and there are effective methods of prevention and diagnosis and treatment
2, many parents or teachers, and even some preventive health care personnel lack of awareness to prevent accidental injuries to children
3, through health education effective intervention, health promotion and comprehensive intervention activities to prevent children’s accidental injuries, to protect the healthy growth of children, is very necessary, its social and economic benefits are very huge
4.Strengthen the knowledge of child safety education and social publicity
5.Establish a natural protection system for children’s accidental injuries
6, the whole society to pay attention to child safety
7, in the United States, in 1989 began the “National Child Safety” campaign, 16 years, the death rate of children’s unintentional injuries in the United States has been reduced by 39%
Ten, prevention and intervention.
1, three levels of prevention.
Primary prevention: before the injury, through the mechanism of reducing exposure to prevent the occurrence of injuries.
Secondary prevention: when the injury occurs, to reduce the extent of the injury.
Tertiary prevention: after the occurrence of injury, control the consequences of injury.
2, active intervention: their own choice of safety measures or adopt certain behavioral approaches to avoid the occurrence of injuries.
3, passive intervention: outside equipped with safety measures to reduce the occurrence of injuries.
4, the two must be organically combined to effectively reduce the incidence of childhood injuries and mortality.
5, conventional intervention measures: engineering intervention, economic intervention, mandatory intervention, educational intervention
Specific interventions.
For different injury causes and influencing factors to take the appropriate interventions
Medical sociology psychology behavior of scholars and relevant departments of the people to work together.
Strengthen health promotion to avoid child injuries.
Develop relevant regulations to strengthen the regulation of road vehicle movement and pesticides. Create a safe environment for children, and set up some safety signs or safety protection devices in dangerous areas, such as warning signs at the edge of lakes.
XI. Handling of several accidental injuries.
1, emergency treatment after burns
Leave the heat source, do not take off clothes, immediately rinse with clean water to cool down, do not apply things on the wound at will.
1, the emergency treatment of stab wounds
Do not pull out the foreign body stuck into the human body, promptly sent to the hospital.
2, animal bite emergency treatment
Rinse the wound with clean water, squeeze the contaminated blood out of the body, and go to the hospital for rabies vaccination
3.Emergency treatment of foreign bodies in the trachea
Pat the back method — let the child lie on the rescuer’s knees, head down, hold his chest, pat his back, so that the child cluck out foreign bodies. Emetic method — use fingers into the mouth, stimulate the root of the tongue to induce vomiting, suitable for foreign bodies closer to the throat trachea. Forced squeeze stomach method — rescuer hold the child’s waist, with both hands index finger, middle finger, ring finger top pressure on its upper abdomen, forcefully squeeze backward and upward, pressure and then relax, repeated and rhythmic, in order to form an impact airflow, the foreign body flushed out. Encourage the child to cough. If the above methods do not work, the child should be sent to the ENT department of the hospital as soon as possible, and mouth-to-mouth artificial respiration should be given when breathing stops.
4.Emergency treatment of gas poisoning Cut off the gas source, open the window, carry the patient to a well-ventilated place, keep the patient in a lateral position, and pay attention to keeping warm.
5, the emergency treatment of drowning clear the airway, observe whether the drowning person is breathing, if the breathing is weak, timely, cardiopulmonary resuscitation.
6, the emergency treatment of the fall from height quickly remove the child’s body of hard objects and various appliances, unbutton the collar, body level to the stretcher or hard board, smooth and fast to the hospital, do not pick up the child or lift the side of the body.
7, trauma bleeding routine treatment of blood from the wound slowly seeping out, just home disinfection simple dressing can be; if it is a large vascular bleeding, need to be sent to the hospital before the pre-emergency hemostasis: first of all, the wound is higher than the heart plane, and then covered with clean cloth (preferably sterile dressing) on the wound, with hands to apply appropriate pressure to help stop bleeding, can be added with a tourniquet ligature to stop bleeding (time should not be too long, every ten minutes loose (once every 10 minutes) and send to the doctor as soon as possible.