Injury prevention for toddler and preschooler

LORs

At the end of the lesson, students will be able to-

• Describe the injury of toddler and preschool children’s
• Listed the risk factors for injury
• Explain the injury prevented guideline
• Identify nurses’ responsibilities to prevent injury.

Introduction:
Children are naturally curious and impulsive, making accidental injuries a leading cause of
hospitalization and death among children. Certain factors like a child's age, gender, environment
and supervision level can predispose them to different types of accidents. Common accidental
injuries among different age groups include falls, burns, suffocation, drowning, and poisoning.
Nurses can help prevent accidents by educating families on childproofing homes, supervising
children appropriately based on their age, and providing emergency care to reduce disabilities
from accidental injuries.

Definition of Injury:
An accident is an event, independent of human will be caused by an outside force acting rapidly
and resulting in physical or mental injury.
-WHO

It is an intentional/unintentional damage to body due to exposure to an external agent which can

be thermal, GL mechanical, electrical, or chemical energy or agent.
Definition of toddler
A toddler is a child aged 1–3 years who is in Erikson’s psychosocial stage of Autonomy vs.
Shame and Doubt, where the main developmental task is gaining independence and self-control.

Erik Erikson

Definition of preschooler

A preschooler is a child aged 3–6 years who is in Erikson’s stage of Initiative vs. Guilt, where the
primary developmental task is initiating activities, exploring, and developing a sense of purpose.

Erik Erikson

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Behavioral Characteristics Toddler and Preschool Aged Children (1- to 6-year-olds)

➢ Are proficient at most simple large muscle skills

➢ Are developing improved hand coordination
➢ Engage in physical testing with confidence — jumping from heights, climbing,
hanging by arms, rolling, spinning, etc.
➢ Like to throw and retrieve objects
➢ Are very curious
➢ Are interested in nature, science, animals, and how things work
➢ Have short attention spans
➢ Have a strong desire for independence

Reasons Why toddler and preschool children are More at Risk for Injuries

• Age: Accidents are more common between 2 and 10 years of age.

• Sex: Boys are more prone to accidents
• Personality: Bright and alert children are more prone to accidents because they are eager
to do new activities.
• Ordinal position: Elder and younger children are more protected but middle ones are
neglected, so they are more prone to accidents.
• Time of day: Most accidents occur in afternoon.
• Weather condition: Accidents occur more in rainy season.
• Place: Accidents may occur in home or on roadside.
Common injury in toddler and preschool children

▪ Fall
▪ Burns
▪ Cuts and injury
▪ Suffocation
▪ Foreign body aspiration
▪ Drowning
▪ Poisoning
▪ Electrocution
▪ Bite and stings
▪ Vehicle or road traffic accident
▪ Sports injury.

FALL
Unstable gait of the toddler, presence of objects on floor, lack of supervision, curiosity of the
children, etc.

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Prevention:
• Keep floors free of toys and obstructions.
• Exercise close supervision when toddler learns to walk.
• Never leave babies unattended on raised surfaces.
• Check constantly floor surface for wear and tear.
• Keep floor dry.
• Always ensure bed-rail of the baby cot is raised when the baby is in the cot.
• Always use a securely fitted safety harness in a pram, pushchair or highchair.
• Windows and doors must be locked to avoid misadventure by children.
• Avoid placing "step-stones" such as a chair next to a window.
• Take extra care to avoid side-turning of a baby chair.

CHOKING

Accidental swallowing of foreign body, strangulation, covering of head by blan accidental

suffocation by pillow while baby sleeps in a prone position, near-drowning
Prevention:
• Choose toys appropriate to the age of children. Avoid toys with detachable small parts.
• Ensure small objects are kept out of reach of children.
• Pull cords on curtains and blinds should be kept short and out of reach of children.
• plastic bags should be kept out of reach of children.
• Instruct children not to play while eating.
• Never let children use milk bottle by themselves without adult's supervision.
• Never use pillow for baby under one year of age. Do not use large and heavy blanket.
Never let the blanket cover the face of children during sleep.
• Avoid sleeping with baby on the same bed.
• Never leave children alone in a bath tub or basin filled with water.
• Bucket filled with water must be covered and keep children away from it.

BURN/SCALD

Scald by hot water, burn by fire, touch on hot objects such as cookins utensils, etc.

Prevention:
• For adults, never hold a hot drink/food and a child at the same time

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 • Ensure milk, congee or other foodstuff is at a reasonable temperature before feeding.
• Ensure proper fence or door is installed at the entrance of kitchen. Such must be closed at
all times. Instruct children not to go into kitchen.
• While cooking, pay extra attention to the stove fire and the cooking utensil. Turn the pan
handle away from the front, and close to the wall.
• When running a bath for a child, always test water temperature beforehand.
• All hot objects including an iron or containers with hot matter must not be placed near the
margin of a table. Avoid using tablecloth. Matches and lighters should be placed out of
reach of children.
• Instruct children not to wander around when adults are preparing for a meal.
• Install proper cover to sockets.
• Warn children never play with fire.

POISONING
Food poisoning, accidental swallowing of drugs, detergent insecticides,

Prevention:

• Keep medicines and chemicals out of sight and reach of children.

• store chemicals in their original containers with appropriate labels.
• Ensure toys and dining utensils bought meet the international standard, e.g. coloring
materials being non-toxic.

DROWNING

Children can drown in less than 3cm of water. They should be under constant supervision when
in or near any water.
Prevention

• Never leave children or babies in the bath unsupervised, even for a moment
• Never leave uncovered bowls or buckets of water around the home
• Paddling pools should be emptied
• Garden ponds should be filled in while children are small or securely fenced off. Take
special care when visiting other people's gardens.
Vehicle or road traffic accident
Most fatal injuries in school-age children are the result of motor vehicle crashes.

Prevention

• Use age-appropriate car seats and seat belts.

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 • Teach safe crossing habits.
• Ensure adult supervision in driveways or near roads.
• Approved bicycle helmet to reduce the risk of head injury

NURSING RESPONSIBILITIES IN PREVENTION OF ACCIDENTS

➢ Health education
➢ Provision of safe environment
➢ Safe child care should be organized provided to prevent accidental hazardous.
➢ Assisting medical care to prevent disabilities
➢ emergency care at comprehensive trauma care improves survival rate.
➢ Public health measures
➢ Participate in policy making and research activities related prevention of accidents

Conclusion:

Many injuries can be prevented by modifying children's environments and teaching parents’
safety practices. Pediatricians and pediatric nurse are in a unique position to encourage and
support such injury prevention efforts. Not only do pediatricians have continuing access to
parents, but parents rate them as an important source of information on injury prevention.
Reference:

Currie, L. M. (2006). Fall and injury prevention. Annual review of nursing research, 24, 39.

Rivara, F. P., Grossman, D. C., & Cummings, P. (1997). Injury prevention. New England journal
of medicine, 337(9), 613-618.

Ganz, D. A., Yuan, A. H., Greene, E. J., Latham, N. K., Araujo, K., Siu, A. L., ... & Gill, T. M.
(2022). Effect of the STRIDE fall injury prevention intervention on falls, fall injuries, and health‐
related quality of life. Journal of the American Geriatrics Society, 70(11), 3221-3229.
Ganz, D. A., Yuan, A. H., Greene, E. J., Latham, N. K., Araujo, K., Siu, A. L., ... & Gill, T. M.
(2022). Effect of the STRIDE fall injury prevention intervention on falls, fall injuries, and health‐
related quality of life. Journal of the American Geriatrics Society, 70(11), 3221-3229.

Hastuti, R. P., & Musiana, M. (2024). The Impact of Child Injury Prevention Package (CIPP) on
Injury Prevention in Toddler. Jurnal Kesehatan, 15(3), 465-471.

Gielen, A. C., Wilson, M. E., Faden, R. R., Wissow, L., & Harvilchuck, J. D. (1995). In-home
injury prevention practices for infants and toddlers: the role of parental beliefs, barriers, and
housing quality. Health education quarterly, 22(1), 85-95.