Pediatric Safety Pediatric Safety and Prevention and Prevention Susan Beggs, RN MSN Susan Beggs, RN MSN Summer 2008 Summer 2008
Pediatric Safety and Pediatric Safety and PreventionPrevention
Pediatric Safety and Pediatric Safety and PreventionPrevention
Susan Beggs, RN MSNSusan Beggs, RN MSNSummer 2008Summer 2008
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