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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.

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Injury and Violence Prevention Program CA4, American Academy of Pediatrics

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  1. 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

  2. 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

  3. 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)

  4. 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)

  5. 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

  6. 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

  7. 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

  8. 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

  9. 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

  10. 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

  11. 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

  12. 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

  13. 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

  14. 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

  15. 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

  16. 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

  17. Cause of Burn InjuriesChildren 0-4 yr, 2004-2006 (complied for CA, AAP by D. Winn from EPIC data base) Toddlers at highest risk

  18. 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)

  19. Furniture Toddlers • Able to open drawers, climb • Curious about environment • Poor coordination & balance • Poor danger recognition

  20. 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

  21. 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

  22. 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

  23. IVPP Resources www.ockeepkidssafe.org Newer Tools Connected Kids Parent Education Curriculum

  24. New Tool: Parent Education Curriculum

  25. Connected Kids:AAP Violence Prevention Program Infancy & Early Childhood 2 days – 4 years Middle Childhood 5 – 10 years Adolescence 11 – 21 years

  26. 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

  27. 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

  28. 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

  29. 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?

  30. 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

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