1. Safe at Home Child injury prevention update for Bristols childminders Rob Benington Injury Prevention Manger NHS Bristol

2. This presentation: Injuries in Bristol Injuries and child development 0-6 months Toddlers Growing older Parents Preventing injuries

3. Our (annual) UK child injury burden Deaths (231) Emergency admissions (124,000) Attendances at emergency departments (2,000,000) Minor injuries treated at Health Centres and GP surgeries or at home References Injury pyramid: BMA (2001) Injury Prevention Very minor (often untreated) injuries Low numbers High numbers High severity Lower severity ( (Figures are approximate annual totals for different age groups : deaths 0-18; admissions 0-14, attendances, 0-16)

4. Bristols 0-16 annual injury burden Deaths: one or two 1,000+ emergency admissions 13,000+ emergency attendances

5. Injuries do not occur by chance. They are largely preventable, non- random events, and not accidents. Certain groups of people with certain characteristics are more likely to be injured. By studying how injuries vary within a population, we can begin to gain an understanding of the factors that lead to injury, and how the risk of injury may be reduced. Injury Prevention, British Medical Association, (2001).

6. Accidents waiting to happen

9. ...certain groups of people are more likely to be injured.... Children of poor families have more injuries Injury death rates in children 0-15 by social class. (BMA, 2001.) Social Class 1 (Richer)........Social Class 5 (Poorer)

10. ...certain groups of people... Children... of single parents of alcohol and drug users living in rented accommodation of unemployed parents.....are at higher risk of injury.

11. Mapping injury rate shows link to deprivation in Bristol

12. Relative rates of unintentional injury The Avon Longitudinal Study of Parents and Children (ALSPAC) and accidental injuries

14. 0-6 months Rolling at 3 months Crawling at 6 months Grabbing Hand to mouth Random lashing about

15. 0-6 months injury risks Rolling + Crawling Grabbing + Hand to mouth Random lashing about Falls Suffocation Choking Hot drink scalds

16. Toddlers Head-heavy toddling Exploring, climbing, reaching Hand to mouth

17. Toddlers injury risks Heavy headed toddling Exploring, climbing, reaching Hand to mouth Falls Drowning Hot drink scalds Strangulation Choking Poisoning

18. Getting older Copying (Wanna be like you..) Playing, exploring, learning Climbing No sense of danger..

19. Risks Copying Playing, exploring learning whats nice Climbing Poisoning Bathwater scalds Kitchen hazards Falls Poisoning Falls

21. Prevention = The 5 Es Engineering Enforcement Education Engagement Empowerment

22. Common sense innit? Risk Rob Average Deprived

23. Prevention = The 5 Es EngineeringEnforcementEducationEngagementEmpowerment

24. BURNS and SCALDS under 2 years

25. Burns and scalds – Causes 1. Hot drinks 2. Hot food 3. Bathwater 4. Hair straighteners / irons Hot water burns like fire

27. Cause of burn Kitchen

28. Falls in under 5s - Causes Stairs and steps Falling from furniture (sofas, bunk beds, high chairs) Falling from beds when having nappies changed Baby walkers Climbing routes

29. Falls in under 5s - Prevention Childproofing Use stair gates and window locks, break climbing routes by moving furniture. Rules No (stair) climbing without a parent. No play on bunk beds. Strap into high chairs

30. Causes of poisoning 1. Common painkillers and cold remedies are the single biggest cause of serious childhood poisoning. 2. Things not put away in their safe place. 3. Batteries, coins, small toys, pins, keys and other small objects are left where small children can reach them.

31. Preventing Poisoning Safe storage, straight away

32. Preventing Poisoning Tidy up. Lock away above head height. (Treat all pills, medicines, liquid painkillers and cold remedies like prescription medicines). Straight away. Health visitors in Nottingham found poisoning happens when things are left out because they are still in use, or will be put away later).

33. Things to do (please) Check blind cords Check blind cords Scrutinise the hot drink policy in your setting Scrutinise the hot drink policy in your setting Check where your poisons are kept Check where your poisons are kept Ask for free stuff from health promotion Ask for free stuff from health promotion Tell parents what youre doing and why Tell parents what youre doing and why

34. Avonsafewww.tinyurl.com\avonsafeRoSPAwww.rospa.com Child Accident Prevention Trust www.capt.org.uk Further information