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Injury and Violence Prevention Program CA4, American Academy of Pediatrics. Keep Kids Safe Prevent Injuries. Injuries are the leading cause of death and disability for children 0- 44 yrs. Raise safe, strong, resilient kids.

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injury and violence prevention program ca4 american academy of pediatrics
Injury and Violence Prevention Program CA4, American Academy of Pediatrics

Keep Kids Safe

Prevent Injuries

Injuries are the leading cause of death and disability for children 0- 44 yrs

Raise safe, strong, resilient kids

learning objectives presentation for san francisco department of public health conference 5 29 09
Learning ObjectivesPresentation for San Francisco Department of Public Health Conference 5/29/09
  • Discuss child development and risk of injury
  • Identify at least 2risk factors for injury including health disparities
    • Intentional must be discussed with unintentional- most risk factors shared
  • List 3 of the most common injuries of children 0-14 years and one prevention strategy for each
  • Know at least two resources for injury prevention
  • Create strategies for integrating injury prevention into the work that you do
slide3

Leading Causes of Injury Deaths by Age, CA 2007

(CA4, AAP Injury & Violence Prevention Program (D. Winn RN, MPH) (State of CA EPIC web site data)

unintentional neglect intentional shared risk factors
Unintentional, Neglect, Intentional Shared Risk Factors

Injury is a Health Disparities Issue

  • Poverty
  • Poor environment: physical and social
  • Substandard housing
  • Lower educational level
  • Lower literacy
  • Lack of social capital/support systems
  • Gender, age and race/ethnicity
  • Children with challenging behaviors (Autism, ADHD)
vision keep kids safe how do we promote injury prevention
Vision: Keep Kids SafeHow do we promote injury prevention?
  • Focus on most serious and preventable
  • Professional education
  • Parent education culturally and linguistically appropriate
  • Readiness to learn
  • Aware of risk factors for both intentional and unintentional
  • Need comprehensive approach with families
  • Advocate for public health policies
the e s of injury prevention strategies
The E’s of Injury Prevention Strategies
  • Education
    • Parents, Care Providers, Educators
    • Public Policy Makers
  • Environmentand Product Modification
    • Car seats; Lap/Shoulder belt in school bus
    • Bike helmets
  • Enactmentof Legislation and Public Policies
  • Enforcementof Legislation
    • Mandatory car seat and seat belt laws
    • Graduated licensing law for teens and new drivers
    • Ban cell phone/electronics use
the spectrum of prevention
The Spectrum of Prevention

Influencing policy and legislation

Changing organizational practices

Fostering coalitions and networks

Educating providers

Promoting community education

Strengthening individual knowledge and skills

CA4, AAP Injury and Violence Prevention Program strives

to work at multiple levels to create a cultural norm

Car Safety Seats – A Success Story

Larry Cohen, 1991; Cohen and Swift, 1999

evolution of a child kids are not mini adults
Evolution of a Child Kids Are Not Mini-Adults

UNAWARE

OF

DANGER

Wiggling, kicking, rolling over

Crawling

Walking, curiosity

Climbing

Running

CA 4 AAP Injury and Violence Prevention Program

slide10

Leading specific causes of serious injury by 3-month age intervals. CA 1996-98 (Agran, Winn, Anderson, Trent,Walton-Hayes, Pediatrics. 2001:108-45

Other fall from ht

Battering

Fall- furniture

Non-airway FB

Hot liquid

Poisoning - med

Pedestrian

Rate

Age in 3 month intervals

birth to 2 months babies cry
Birth to 2 monthsBabies Cry
  • Risk Factor for Abusive Head Trauma
  • Crying is normal
  • Colic is a normal part of
  • infant development
  • Sometimes feeding, holding, changing, rocking and soothing may help
  • Sometimes nothing we do can stop the baby from crying
  • Make sure your baby is OK by having your pediatrician check her

CA4, AAP

birth to 2 months what should you do when the baby doesn t stop crying
Birth to 2 monthsWhat should you do when the baby doesn’t stop crying

…and you feel like you need a break for a few minutes?

  • It is OK to let your baby cry
    • Place your baby on his back in the crib
    • Do something to calm yourself
    • Call a friend or relative
    • Call your
    • Period of Purple Crying
    • (R. Barr, MD, PhD- National Center On Shaken Baby Syndrome)

CA4, AAP

period of purple crying ronald barr md http www dontshake org
Period of Purple CryingRonald Barr MDhttp:www.dontshake.org

P for Peak of Crying—Crying peaks during the second month, decreasing after that;

U for Unexpected—Crying comes and goes unexpectedly, for no apparent reason;

R for Resists Soothing—Crying continues despite all soothing efforts by caregivers;

P for Pain-like Face—Infants look like they are in pain, even when they are not;

L for Long Lasting—Crying can go on for 30-40 minutes, and as much as 5 hours, and longer;

E for Evening Crying—Crying occurs more in the late afternoon and evening.

Risk factor for abusive head trauma, family dysfunction

and possibly depression

CA4, AAP

birth to 2 months how do we keep kids safe
Birth to 2 monthsHow do we keep kids safe?
  • Suffocation is a leading cause of death for infants
  • Back to Sleep
  • Use a firm mattress
  • no soft things in bed
  • No co-sleeping
  • No smoking

CA4, AAP

6 to 12 months
6 to 12 Months
  • 8 to 10 Months
  • Crawls
  • Picks up very
  • small objects
  • (pincer grasp) and puts in mouth
  • 6 to 8 Months
  • Rolls over
  • Sits up
  • Grabs things
  • Puts things in
  • mouth
  • 10 to 12 Months
  • Stands
  • Walks
  • Finds hidden objects

CA4, AAP

6 12 months how do we keep kids safe
6-12 Months How do we keep kids safe?
  • Safe Home
  • Barriers and Locks
  • Get on floor- check for small objects
  • Medicines and cleaning agents high, locked, and out of reach

CA4, AAP

1 to 3 years
12 to 18 Months

Walks and climbs

Pulls and carries things

Still puts things into mouth and can choke

Imitates

2 to 3 Years

Jumps and climbs

Opens containers

Unscrews lids and caps

Makes things work

1 to 3 Years
  • 18 to 24 Months
  • Runs and climbs
  • Finds hidden objects
  • Turns knobs and containers
  • Opens doors and drawers

CA4, AAP

cause of burn injuries children 0 4 yr 2004 2006 complied for ca aap by d winn from epic data base
Cause of Burn InjuriesChildren 0-4 yr, 2004-2006 (complied for CA, AAP by D. Winn from EPIC data base)

Toddlers at highest risk

temperature and duration
Temperature and Duration
  • 70o C (160oF) instant full-thickness
  • 65o C (149oF) instant partial-thickness
  • 60o C (140o F) 2.0 seconds
  • 55o C (131o F) 7.5 seconds
  • 50o C (122o F) 1.5 minutes
  • (M. Cinat, MD, Director Burn Unit (UCIMC)
furniture
Furniture

Toddlers

  • Able to open drawers, climb
  • Curious about environment
  • Poor coordination & balance
  • Poor danger recognition
keep kids safe how we started
Keep Kids Safe: How we started

1998: CA Tobacco tax initiative – School Readiness

First 5 and County Commissions. The Children and Families Commission of Orange County

If we want children ready for school and not in need of special education because they were injured

We must address injury – the leading cause of death and disability for children.

Funded the CA4, AAP Injury and Violence Prevention Program

Raise safe, strong, resilient kids

injury prevention program
Injury Prevention Program
  • Capacity Building
  • Integrate injury prevention into health, education and social services for kids
  • Link the health of the families to the public health of the community
  • Bridge program silos
  • Create innovative strategies
slide24

Medical/

Dental Care

OC

Nurse-Family

Partnership

School

Readiness

Nurses

School

Districts

Public Health

Nursing

Injury and Violence

Prevention Program

CHOC & UCI

Pediatric

Residents

Police

Departments

Libraries

Family

Resource

Centers

Early

Childhood

Education

Centers

California Chapter 4, American Academy of Pediatrics

slide25

IVPP Resources www.ockeepkidssafe.org

Newer Tools

Connected Kids

Parent Education Curriculum

connected kids aap violence prevention program
Connected Kids:AAP Violence Prevention Program

Infancy & Early Childhood

2 days – 4 years

Middle Childhood

5 – 10 years

Adolescence

11 – 21 years

community connections from connected kids american academy of pediatrics
Community Connections (from Connected Kids- American Academy of Pediatrics)

Community Connections

Child-Centered

Social capital

  • Connections with people
  • Connections with community

Connect families to community resources

*Identify local community connections

Parent- Centered

Physical Safety

California Chapter 4, American Academy of Pediatrics

bullying it s not ok
Bullying: It’s Not OK

You are on a home visit with a family with a newborn.

The mother lets you know that her older child will not go to school.

He cries each morning and claims he has a stomachache.

What are you gong to do?

California Chapter 4, American Academy of Pediatrics

summary
Summary
  • 1. Injury: leading cause of death and disability
  • 2. Work with pediatricians, public health professionals, social workers, early child educators, child care providers
  • 3. Address intentional with unintentional
  • 4. Most preventable
  • 5. Consistent messages
  • 6. Relate to development
  • 7. Give tools
  • 8. Multiple doses
how do we work with families to prevent injury
How do we work with families to prevent injury

Teachable moments

Simple messages

Readiness to learn

Can the family do what is needed?

Is it individual family issue? Do they have resources?

Is it code or regulatory issue?

resources
Resources
  • http://www.ockeepkidssafe.org
  • http://www.cippp.org/
  • www.sfdph.org/dph/comupg/oprograms/CHPP/Injury/
  • http://.www.aap.org
  • http://www.cdc.gov/ncipc
  • http://www.dontshake.comNational Center on Shaken Baby Syndrome
  • http:www.nhtsa.gov