Pediatric Safety and Pediatric Safety and PreventionPrevention

Pediatric Safety and Pediatric Safety and PreventionPrevention

Susan Beggs, RN MSN CPNSusan Beggs, RN MSN CPNSummer 2010Summer 2010

Levels of Preventive Health Maintenance

Activities• Primary• Secondary• Tertiary

Safety risks to developmental levels

• Infant• Toddler• Preschool• School age• Adolescent

Major childhood prevention measures

• Aspiration• MVA• Burns• Drowning• Bodily injury/fractures

• Leading cause of fatal injury under 1 year of age

• Prevention:– Inspection of toys, small parts– Out of reach objects– Selective elimination of certain foods– Proper posturing of the infant for feeding– Pacifier with one piece construction

• Vehicular risk greatest when child improperly restrained

• Pedestrian• Prevention

• Children are inquisitive• Become able to climb and explore• Prevention of household injury:

• Child does not recognize danger of H2O

• Unaware of inability to breath underwater

• No conception of water depth• Hypoxia greatest concern• Prevention

• Still developing sense of balance• Easily distracted from tasks• Prevention:

• Common in early childhood (2 yrs)• 75% poisons are ingested• Major reason for poisoning:

• Sources of poison:– Cosmetics– Household cleaners– Plants– Drugs– Insecticides– Gasoline– Household items

Stats on drug poisonings

• Therapeutic interventions• In every instance, medical eval is

necessary• Call poison control center 1st

• Remove child from exposure• Identify poison• Prevent absorption

Ask yourself:• Why do you think the American

Pediatric Association no long advises parents to keep syrup of Ipecac in the home?

• Ingestion of lead-based materials

• “Maybe it’s the lead poisoning!”

• Lead poisoning can cause:– Brain and nerve damage– Behavior problems– Learning disabilities– Slowed growth– Headaches– Low energy

• Life threatening• More likely to drop out of school • Become disabled• Disturbed brain and nervous

system function• Prevent child from full potential

• Pathophysiology of lead poisoning • System assessments• Therapeutic Interventions

Criteria for treatment of lead poisoning

• < 9 not lead poisoned• 10-14: prescreen• 15-19: nutritional and educational

interventions• 20-44: environmental eval and

medication• 45-69: chelation therapy• >70: medical emergency

• Make environment lead-free• Inspect buildings >25 years of age• Areas painted with lead paint should be

covered with plywood or linoleum• Educate the parents• Follow up testing for lead levels• Screening all school age children

(required in some states)

• Specific recommendations by APA:– Minor infections without fever are not

contraindication– If reaction occurs, consult dr. before

next immunization

4mos-6 yrs of age:• DTaP (4 doses)• IPV (3 doses)• HepB (3 doses)• MMR (@ 12

months)• PCV (1 dose)

7-18 yrs of ageTd (every 10 years

after initial immunizations)

IPV (not rec. if >18 yrs of age)

Nurses responsibilites with immunizations

• Know the action of the vaccine• Careful history of patient• Aspirate when injecting• Educate parents (schedule, side

effects)• Proper documentation

• Assess for reaction 15-30 min after injection

• Epinephrine 1:1000 available• Check immunization records with

each visit• Parent teaching: fever, or other

symptoms