By Susan Rzucidlo, R.N.
Injuries are both predictable and preventable and the leading cause of death and disability for all children 1 to 14 years of age. All children and their families need information on keeping their children safe as they grow and wherever they are – for example at a babysitter’s home, school, a playground or staying with grandparents.
Injury prevention for children with special health care needs requires a thorough assessment of each child’s unique risks. There are medical and emotional conditions that can lead to challenges for keeping the child safe. The issues and strategies will change as the child grows.
It is important to assess your child’s individual skills that include: mobility, sensory-neuro, and cognitive abilities. Your child’s therapist, physician, teachers, injury prevention specialists and others can help to develop a plan to keep your child safe.
Safe at Home
Falls: Caregivers often assume that children with limited mobility are not at risk for falling. Your child should never be left unsupervised, because he could possibly roll or creep to danger. Even a fall from a bed or low elevated surface can cause injury. Children with seizure disorders may need to wear a helmet during play and in the shower. Avoid bunk beds, and for younger children, learn about safe sleep techniques.
Choking: Children with special needs are more at risk for choking. Make sure you remove all strings from your child’s clothes, and cover Band-Aids with clothing. Do not allow your child to play with latex balloons. She may bite it and choke on the pieces. Food that has been dropped or loose pieces from an older child’s game may become choking hazards if your child puts them in his mouth. Cut food into small pieces, and make sure your child is sitting upright and supported when eating or being fed.
Fire: Install smoke detectors outside each bedroom. Change the batteries when you adjust your clock every Spring and Fall or purchase an alarm with a ten-year Lithium battery. Install a carbon monoxide detector, as children are more at-risk than adults for poisoning. Contact your local fire department and EMS to share that your child has special healthcare needs so they’re aware in the event of an emergency.
Drowning: Never leave your child alone near water, whether a tub, pool, bucket or toilet.
Safe at Play
You can help your child have fun and be safely included at the playground. Supervision at all times with an adult present is a must to watch for dangers and assure safe play. Playground equipment is designed for different abilities and developmental levels. Look for playgrounds with separate equipment for younger and school-age children. Talk with your child about safety and teach your child how to safely use the playground equipment.
More than 70 percent of all playground injuries are related to falls. Avoid playgrounds with surfaces of concrete, asphalt, blacktop, packed dirt, grass or rocks. Good surfaces should have wood chips, mulch, sand, or rubber mats. Be prepared for emergencies and carry a first aid kit.
The Americans with Disabilities Act (ADA) requires that playgrounds be accessible.
Safe on the Way
Children with special health care needs are subject to the same hazards in vehicles and must obey Pennsylvania’s child passenger safety laws. Many children can use standard car seats, booster seats or seat belts. If your child needs a special restraint, seek the assistance of a certified car seat technician with special needs certification who can assist your child’s therapist and physician to identify the best child restraint.
Special needs aren’t limited to chronic conditions, such as cerebral palsy and spina bifida. Any child could have temporary special needs. A child in a cast after a sports injury has special needs. Less obvious conditions, such as behavioral disorders, can also present special considerations. Perhaps the most common situation is a premature birth especially for smaller babies and if born before 37 weeks. A premature baby needs to be placed in a car seat and evaluated by a medical professional before leaving the hospital. Some premature babies may need to be transported in special car beds instead of car seats until they are more fully developed.
To find a car seat technician with special needs training or other resources for preventing injuries, call Penn State Hershey Children’s Hospital Injury Prevention Program health educators at 717-531-SAFE (7233).
Susan Rzucidlo, R.N., is coordinator of the Dauphin County Safe Kids Coalition and the pediatric trauma program nurse manager at Penn State Hershey Children’s Hospital.
