Keeping Children Safe at Home and at Play

Keeping Children Safe at
Home and at Play
NHSA Parent Conference
December 3, 2012
Dr. Charlotte Hendricks, Coordinator
JCCEO Head Start Center of Excellence
President
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Choking Hazards
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Healthy CHILDCare Magazine: Safe Spaces for Infants and Toddlers
Connie Jo Smith, Ed. D. and Amy S. Hood, Ed.D, Western Kentucky University
Environments can appear to adults to be delightful, healthy and safe, yet many
harbor hidden dangers for children. Evaluating the total environment for safety is critical,
yet many times hazards are overlooked, even by the most diligent caregiver. Hazards
may include equipment and facilities, toys and supplies, personal items, clothing and
accessories worn by adults, and even clothing and accessories worn by children.
Sometimes furnishings and equipment can cause safety concerns. For example,
rocking chairs frequently are found in childcare programs for young children and can
contribute to positive interactions between caregivers and children as they rock together.
However, in infant and toddler settings, young children can have fingers smashed under
the rockers or fall as they try to crawl up onto the rocking chair. An alternative is a
well-anchored hammock with a solid cloth material, or a glider, which has fewer safety
issues than a rocking chair. These also allow adults to sit with two children more
comfortably than does a rocking chair.
Infant walkers sometimes are used in childcare programs even though the
dangers of young children using the walkers are becoming more well known. More
children are injured with baby walkers than with any other nursery product. In 1995, the
American Academy of Pediatrics (AAP) recommended a ban on the manufacture and
sale of infant walkers because the risks have been found to be high and the benefits
unproven.
Some childcare programs have a small refrigerator for storing milk and other baby
food. A refrigerator in the room may eliminate the need for caregivers to leave to retrieve
milk, thus ensuring better supervision and proper adult-to-child ratio. However, the
refrigerator should not be placed on the floor where children can open the refrigerator and
have access to the contents. Possible entrapment is another concern. Small refrigerators
should be locked at all times or secured on a very sturdy cabinet, high out of children's
reach children. The cord also should be out of the children's reach to avoid strangulations
and electrical shock.
There are numerous safety concerns regarding the use of microwaves for heating
baby bottles. It is difficult to truly determine the temperature of the milk, so the use of a
microwave may increase the chance of burning a baby's mouth and throat. Some cases
of nipples exploding off the bottle and scalding the adult or infant also have been
reported. Changes in the milk during microwave heating may result in a decrease in the
vitamins it provides. Some foods, like jelly donuts, heat unevenly and are extremely hot
inside, although they do not feel it outside. Therefore, microwaves should be avoided for
heating drinks or food for young children.
Some experts have questioned the developmental appropriateness of television
for young children, but a more serious issue is the potential safety hazard of TVs or other
heavy equipment. If televisions, stereos, boom boxes, aquariums, refrigerators, and other
equipment are in a childcare setting, they should be well secured to ensure that they
cannot be pulled over by climbing children. Tall shelving and furniture also should be
safely secured to the wall.
Trash is another often overlooked safety issue with young children. Small trash
cans are just the right size to grab the attention of children, and their hands can move into
the trash quickly. Trash cans both inside and outside may contain dirty diapers, sharp can
lids that can cut, or many small items that pose choking hazards.
(Safe Spaces for Infants and Toddlers - Page 2)
Paying close attention to the location of trash cans, using covers, and being aware of
what is in the trash cans may help ensure that young children will not be harmed by trash.
Choking hazards and poisoning are two of the most significant hazards for infants
and toddlers, so extreme care should be given to safety in these areas. Because young
children spend a great deal of time on the floor, the carpet should be inspected frequently
to ensure that it is free from small pieces of toys or caregiver supplies such as rubber
bands or paperclips. Although multi-age grouping has many developmental and social
benefits, choking hazards may increase in these settings because older children need
toys and supplies with smaller parts than younger ones.
In addition to ensuring that small parts are not left on the floor, also check for the
security of all materials with small parts on tables and shelves, as well as hanging
mobiles. Childcare settings are likely to contain button batteries, cleaning supplies,
bleach, medications, glues and other caregiver supplies, which all can be toxic and
should be stored accordingly. Plants, which can enhance the atmosphere of the space,
should be nontoxic. Check with the regional poison center for guidance on poisonous
plants and other toxic substances.
Purses, diaper bags, coat pockets, and other containers may contain vitamins,
medicine, cosmetics, and even items like guns, knives, or pepper spray. Therefore,
policies to ensure that all containers are kept in a secure place away from children are an
important contribution to safety. Visitor purses and containers also may pose a safety
concern, so policies should include visitors.
Clothing and accessories worn by adults may impact the safety of children,
especially those with allergies. Fragrances worn by caregivers can sometimes be a safety
issue for young children, especially infants. Adults who are holding or hugging children
close to them should be aware of how their clothes and hair feel and smell. Because
children's faces may come in direct contact with the adult's hair and clothes, they are
inhaling these odors. Hair spray, shampoo, perfume, detergent, fabric softener, and
similar products intended to add a pleasant smell may be too strong for direct contact with
children's skin and result in allergic reactions or worse. Dyes in some clothes also may
contain smells and unsafe chemicals. Adults who smoke or are exposed to smoke have
smoke odors in their clothes. Some programs provide staff with smocks or aprons
washed with unscented detergent to minimize potential problems.
Accessories worn by caregivers can create safety hazards for themselves and for
the children. Earrings or rings can scratch children or cause eye injuries while caregivers
hold and hug them. Earrings capture the attention of young children, who may reach and
pull them, thus causing pain or injury for the caregiver. Accessories worn by young
children also can be hazardous. Necklaces, bracelets, rings, and earrings may catch on
equipment, causing strangulation. Rings, pins, buttons, hair beads, small barrettes, and
other accessories are additional choking hazards for young children. In addition,
remember that long fingernails may also interfere with safe contact with children.
Increased awareness of safety can result in a more pleasant and secure
environment for adults and children. Looking for potential safety concerns where they are
least expected is important and may make a major difference in the health and well-being
of young children.
Healthy CHILDCare Magazine: Prevention & Treatment of Poisoning
Elaine Abrams, RN, CHES
Protecting children from exposure to poisonous substances is essential. More than
one million poisonings in children under age five years are reported to poison control
centers annually. More than 100,000 of these poisonings result in hospitalization.
Children are at risk for serious consequences from poisoning because of their
natural curiosity. One way they explore is to put everything they encounter in their
mouths. Children also mimic their parents’ or caregivers’ behaviors, and so they are
attracted to the cosmetics, cleaning supplies, and medications that they see adults use.
When exposed to poison, children are more likely to have serious consequences
than adults because they are smaller, they have faster metabolic rates, and their bodies
are less capable of handling toxic chemicals. As a result, their bodies absorb the toxins in
poisonous products more readily than adults’ bodies and they can become ill very quickly.
What Is Poisonous?
Many common substances and items are considered poisonous. A poison is any
substance--including solids, liquids, sprays, and gases--that can cause an unintended
symptom. “Toxic” or “poisonous” does not necessarily mean the substance is deadly. A
substance is toxic or poisonous if it can cause any negative symptom, even if only a mild
rash.
Poisonings occur most commonly when the parent or caregiver is distracted for a
moment. Remember, children act fast, and so do poisons! While most poisonings take
place in the home, childcare providers also must be diligent about keeping potentially
poisonous products or plants out of reach of young children. Here are some suggestions
to help protect the children in your care from poisonous products:
 All cleaning or aerosol products should be considered poisonous to young
children and must be stored appropriately and out of children’s reach. Keep
cleaning products in original labeled containers. Discard old, leaking, odorous,
or unidentified products.
 Cosmetics and personal care products are the most commonly reported
substances ingested by young children. Personal care products such as
perfume or cologne, hair spray, shampoo, mouthwash, nail polish remover,
and cosmetics, should be kept out of reach and out of sight of children.
 All prescription and over-the-counter drugs, cough syrups, skin ointments,
vitamins, and dietary supplements should be kept in their original labeled
containers and stored in locked cabinets. No medication, whether intended for
children or adults, should ever be referred to as “candy.”
 Art materials and other creative materials should be certified non-toxic and
intended for use by children. The Art and Creative Materials Institute, Inc.
(ACMI) is recognized as the leading authority on these types of materials.
ACMI has evaluated more than 60,000 art and craft materials, and 100 percent
of the children’s products and 85 percent of those meant for adults are certified
as non-toxic. They are not intended for ingestion, however, so all such
materials should be kept locked up and out of reach of children. In addition, old
or expired materials should be discarded regularly. The ACMI website provides
a searchable database for a variety of arts and crafts materials.
(Prevention & Treatment of Poisoning - page 2)
Plants and Insects
Although many plants are ingested each year, serious poisoning from the plants is
extremely rare in both children and adults. Although very few plants are capable of
causing severe poisoning if eaten in small amounts, as is usually the case, many plants
are still toxic. For example, oleander, castor beans, daffodil bulbs, delphinium, foxglove,
jimson weed, angel’s trumpet, mistletoe (especially berries), and western yew are toxic.
Any plants that cannot be clearly identified as non-toxic should be removed from
children’s environments. Teach children never to eat leaves, stems, bark, seeds, nuts, or
berries unless an adult has identified it as safe. Never assume a plant is safe because
birds or other wildlife eat it. Know the names of all plants in your childcare environment.
The staff at your local nursery or garden shop or cooperative extension service may help
with plant identification. If a plant has toxic berries or other parts, it should be removed
from the childcare setting.
Mushrooms and other fungi can be extremely toxic. Teach children to avoid
touching or eating any mushrooms they may find outside. Check children’s outdoor play
areas, especially after rainfall, and remove any mushrooms regularly.
Young children playing outdoors also may eat insects. While most insects are
harmless, some can cause illness if ingested. If you suspect a child has eaten an insect,
call Poison Control. Never use pesticides around children.
Poison Control Center
The Poison Control Center’s national toll-free hotline, 800-222-1222, connects you
directly to your local poison control center. Poison treatment and prevention experts are
available at the center daily around the clock. Keep the phone numbers of the poison
control center and emergency medical service next to each telephone. If the victim has
collapsed or is unconscious, call 911.
Some 30 children die every year due to accidental poisonings, and approximately
one million phone calls are placed to Poison Control Centers annually by adults seeking
help when children have swallowed something harmful. If you call the Poison Control
Center, have the following information ready:
 The child’s age and weight and any symptoms of suspected illness.
 The name of the product and ingredients ingested. Take the product container
with you to the telephone.
 How much of the product was ingested.
 The time when the ingestion occurred.
 Your name and phone number.
Remain calm! The Poison Control Center or doctor will tell you what to do next.
If you suspect that a child may have ingested something toxic, immediately remove
anything from the child’s mouth, call the Poison Control Center, and stay with the child.
In case of poisoning, do not induce vomiting. As of November 2003, the American
Academy of Pediatrics no longer recommends that ipecac syrup (which induces vomiting)
be used routinely as a poisoning treatment. Why the change? Neither vomiting nor ipecac
has ever been proven effective in treating poisoning, and it may be administered
incorrectly.
Healthy CHILDCare Magazine: Window Wonders
Connie Jo Smith, Ed.D and Charlotte M. Hendricks, HSD, CHES
Windows play an important role in the young child’s day. Young children learn much
about their world through observation, and windows provide an opportunity. Natural light
shining through windows can brighten everyone’s day. Windows may provide ventilation for
a healthy environment. It also is common for windows to serve as a fire escape route.
Unfortunately, windows can also pose risks--more than 4,000 children are injured by
falls from windows each year. A fall from even a first-floor window can kill a child or cause
serious injury. The wonders of windows can turn into nightmares unless safety precautions
are followed.
Escape Routes in Emergencies
Emergency situations can arise anywhere, anytime. In preparation, it is important that
there be two clearly identified ways of escaping from each room. These escape routes may
include windows. Providers should consult with their local fire departments for advice about
the feasibility of using windows as escape routes. If the windows can provide an escape
route, it is then essential to ensure that the windows can be easily opened in an emergency.
Check windows regularly to ensure that they are not painted or nailed shut.
Security bars, though intended to keep you safe from outside threats, can become a
trap in an emergency. Window guards, security bars, and grilles or grates on windows should
have quick release mechanisms and the mechanisms should be checked regularly to be
sure they work properly.
Ask local fire fighters to practice fire drills with children, including how to safely go out
the windows. Many fire departments or community safety groups have model “Fire Safety
Smoke Houses” where children can experience a fire emergency and use a variety of
different kinds of escape routes, including windows.
Remember, it is important for children to know how to escape through windows in an
emergency with the help of caregivers. They should be taught to go out, but not unattended,
and never in non-emergency situations. Windows should have secure latches (not locks)
that can be easily and quickly opened by all adult caregivers.
Prevent Falls
Looking and listening through an open window can provide a unique learning
opportunity. But as with any activity, safety should be a primary concern. If windows are to be
opened, they should have screens to keep out insects. However, screens are not effective
barriers to prevent children from falling out. If possible, only windows that are above
children’s reach should be left open. For windows at the child’s level, precautions are in
order.
 Use “window guards” that only allow windows to open to a specified point. Make
sure guards are in compliance with all fire and building code requirements, and
that all adults know how to release the window guards for escape in case of fire.
 Position a barrier in front of low windows. Plastic child safety fencing can be
attached to the wall on either side of the window for a barrier through which
children can still see, but be protected. Furniture is not recommended as a barrier
since children may climb on the furniture, resulting in falls and injury.
 Consider planting soft shrubs or dense ground cover under windows. If a fall does
occur in spite of the other precautions, the softer landing surface may help avert
serious injury or death.
(Window Wonders - page 2)
Prevent Breakage
It may be hard to tell if a clean glass door or large window is open or closed. Just
running into hard glass can cause minor injuries; breaking through glass can cause much
more severe and life-threatening wounds. Glass doors can be made more visible by taping
children’s art work to them. Avoid using decorations, such as vinyl decals, that might be put
into mouths and cause choking hazards.
When regular glass breaks, it can shatter into hundreds of sharp fragments that can
propel through the air, causing injury. An additional danger, especially if the breakage is
caused by some type of explosion or blast, is tiny fragments of glass in the air, which can be
inhaled and cause serious injury or death. Approved safety glass or tempered glass will
break, but not shatter; it is required for doors and recommended for windows, especially
those within children’s reach.
Installing safety or tempered glass provides additional safety for children. However, if
glass replacement is not feasible, an economical option is to have security film installed.
Security films protect against breakage and shattering glass from blasts, flying objects, or
vandalism. Additional benefits of security film are that it reduces sun glare (blocking up to 99
percent of dangerous UV rays that can cause skin cancer), provides privacy, and improves
energy efficiency.
Other Hazards
Children sometimes chew on window sills or pick at flaking paint and eat the chips. If
a window sill was painted before 1977, the paint may contain lead and be toxic. Remove any
flaking paint, and be sure windows and sills are properly painted.
If window fans are used, they must have safety screens to protect small fingers.
Window fans and air conditioning units must be securely bolted in place. Avoid dangling or
loose electrical cords on fans and air conditioning units.
Another danger is strangulation when infants and young children become tangled in
window covering cords--not only the pull cords, but also the inner cords (the ones that go
through the slats). Entrapments may occur when a child pulls on an inner cord and it forms a
loop that can hang a child. The risk is greatest when children’s cribs or playpens are placed
next to windows. Pull cords should be cut so there is no loop and then fastened high above
children’s reach. Continuous-loop cords can be anchored to the floor or wall.
Many newer window treatments incorporate safety improvements, and caregivers
should check out the new features or consider installing cordless window coverings. The
Window Covering Safety Council offers consumers free retrofit devices for repairing cord
hazards on older windows.
In proper working order with lead-free paint, windows can be safe diversions as well
as escape routes. Use of safety glass and updated window treatments, combined with
correct use of screens, adds to the safety of windows. To prevent falls and strangulation,
cribs and other furniture should be placed away from windows. Planning and ongoing
supervision of children should help prevent window-related accidents and make the windows
safe for watching the world go by.
Healthy CHILDCare Magazine: Airway Obstruction Injuries
Janie Sailors, RN, Western Kentucky University
Do you know the sound made by a child who is choking, strangling, or suffocating?
None! By the time you realize there is an airway obstruction crisis, it could be too late.
According to the National Safe Kids Campaign, airway obstruction injury (suffocation,
choking, and strangulation) is the leading cause of death by unintentional injury among
infants. Choking occurs when food or an object blocks the trachea (airway). Strangulation
occurs when something such as a cord or string, jewelry, railings and crib slats, or an
accordion-style gate wraps around or compresses the child's neck. Suffocation occurs
because materials such as plastic bags, fluffy pillows, or cushions, block or cover the
child's nose and mouth.
Why are there so many injuries related to airway obstruction? Children are curious
and learn by exploration. For example, one developmentally appropriate way young
children explore their world is with their mouths. Parents and caregivers should anticipate
that anything the child finds can go straight into his or her mouth.
Here are some suggestions to uncover hazards indoors and out as well as some
prevention strategies.
Tips to prevent choking
 Choose toys with the youngest possible users in mind. Balloons, one of the
leading causes of death in children under age five, do not belong in a childcare
setting. Many toys designed for older children have small pieces that present a
choking hazard to younger ones. Marbles, buttons, beans, beads, coins, small
pieces of toy food, and tiny toy figures are all choking hazards for young
children. It makes sense to separate toys by children's ages, remembering that
parts of toys for older children can break off and become an unintended hazard
for younger ones. Damaged toys should be removed immediately. The 1994
Child Safety Protection Act requires warnings on toys intended for children
three_five years of age that contain small parts. An inexpensive "no choke
testing tube" from a toy store, which is about the size of a toilet paper tube, can
help identify choking potential. If the toy fits entirely inside, children under age
three and any other children who still put small objects in their mouths, should
not use it.
 Meals for young children must be designed to avoid foods that can choke.
 Check outdoor play areas. Children will put bits of cushioning surfaces like
gravel or bark in their mouths.
 Staff and visitor purses and backpacks pose another danger because they may
include tempting choking items! Provide staff with a place to lock belongings.
Encourage visitors to leave their items locked in their cars.
 Refrain from using tacks or push pins on bulletin boards. Use tape to post
children's artwork and also cover staples with tape.
Tips to prevent strangulation
 Cords on window blinds or draperies that hang in a loop should be cut into two
separate pieces and then tied or clipped near the top of the window and out of
reach. Avoid placing cribs, cots, or high chairs near these windows.
 Toys should have no strings or cords longer than seven inches dangling into
the crib. Crib gyms or mobiles should not be used in the childcare setting.
(Airway Obstruction Injuries - page 2)
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Do not attached strings or cords to pacifiers and rattles. Pacifiers and rattles
should be large enough not to lodge in an infant's throat.
Cords on pull toys should be 12 inches or less in length and have NO beads or
attachments at the end. Do not overlook the cord on a play telephone. It, too,
should be 12 inches or less in length. Keep in mind that attractively packaged
unsafe toys are on the market! If a toy looks unsafe, do not purchase it.
Remove drawstrings from children’s clothing because they can catch on
protrusions on a stairway or slide. Recommend clothing for infants and toddlers
that utilize snaps instead of buttons. Discourage jewelry, rings, and small pins.
Young children should not wear necklaces of any type.
Tips to prevent suffocation:
 Fluffy comforters, pillows, or mattresses can lead to suffocation. Young children
should rest on firm surfaces without pillows and be covered with very lightweight
blankets. Crib mattresses should fit snugly against the side rails. Waterbeds and
featherbeds are not safe for children's naps. Couches and reclining chairs also
are unsafe as children can become entrapped in the footrests of recliners and
between the cushions and backs of couches.
 Beanbag chairs can pose both an inhalation and suffocation hazard. Children
have been known to crawl inside the cover and suffocate from inhaling the foam
"beans." Also, their soft surfaces can obstruct breathing for young children.
 There should be no stuffed toys in cribs. Crib slats should be no more than 2 3/8
inches (60 mm) apart. Crib corner posts should be no higher than 1/16 inch to
prevent entanglement of babies' clothing. Do not use a crib with decorative
cutouts on the headboard or footboard that could allow a baby's head to become
trapped.
 Dispose of all plastic bags safely, especially those from dry cleaners.
 Freezers, refrigerators, and other closed containers such as toy chests can trap
and suffocate a child. Secure these items carefully.
Even with all the safeguards listed here in place, airway obstruction might happen. It
is crucial to recognize choking or suffocation immediately and take quick steps to help the
child. In a breathing emergency, most adults and children will reach for their neck. This is
considered the universal sign of choking. The victim might also flail his arms. In the
unfortunate situation where the choking continues long enough to restrict air flow, the child
may become lifeless and still.
There is very little time to act in an airway obstruction crisis. In as little as four
minutes, permanent brain damage can begin, and death can occur in as little as six
minutes. There may not be time for emergency help to arrive. If the victim is coughing, allow
him to attempt to clear the obstruction by himself. DO NOT hit or pat the child on the back or
try to remove an object with your fingers. This may drive the object further into the airway.
Childcare staff should be trained in the Heimlich maneuver and in rescue breathing for
children, and there should be at least one staff member available at all times who is
certified in infant/child CPR (Cardiopulmonary Resuscitation). All victims who have
suffered a choking incident should be examined by a medical authority, even though they
appear to be doing fine. Contact parents and insist that the child be seen by his pediatrician
immediately.
Healthy CHILDCare Magazine: Preventing Burns
Janie Sailors, RN, NCSN, TTAS, Western Kentucky University
Every day, children investigate the world through the use of their five senses.
While you may first think of this as learning with the eyes and ears, there is another sense
that is critical to much of what children discover--the sense of touch.
Stop and reflect for just a minute about all the ways you use touch in daily living,
even as adults. You test for heat or cold, identify firmness and flexibility, and explore
texture and balance. When things do not go as planned, you sometimes say, “Guess I lost
my touch!”
This sense of touch greatly enriches your world, but it is important to remember
that it also can place a developing child in harm’s way. Children learn that certain things in
the world are hot, and some are cold; but the issue is complicated by the fact that some
things, like stoves and water faucets, can be both hot and cold.
As caregivers, you are charged with protecting children from hazardous touching
while still encouraging them to go about the work of childhood--playing and learning.
Burns
Probably the most common injury from touching involves burns. Contrary to the
beliefs of many parents and childcare staff, most burns suffered by children are not from
fire, but from common household appliances and substances. Burns are caused by dry
heat (fire), wet heat (steam, hot liquids), radiation, friction, heated objects, the sun,
electricity, and chemicals.
Thermal burns are the most common type of burn. Thermal burns occur when hot
metals, scalding liquids, steam, or flames come in contact with skin. A few simple
precautions can prevent thermal burns in the childcare setting.
In the Kitchen
 Make burners and hot pot handles as hard to reach as possible. Use the back
burners when cooking on top of the stove, and turn handles so they point away
from where little hands could grab them.
 Similarly, place hot items taken from the oven or off a burner up high and to the
back of counter tops.
 Keep the cords of crock pots, fryers, electric skillets/griddles, and toasters high
and behind these appliances.
 Do not allow little ones in the kitchen when items are being removed from the
oven or stove. Consider establishing a marked “Child-free Zone” in front of the
oven/stove.
 Do not drink or carry hot beverages or food while holding a child.
 Set hot foods out of reach of young hands during meal time. Do not use
tablecloths--they can cause hot items to fall if they are pulled.
 Store tempting foods like snacks away from all cooking surfaces.
 Check the temperature of microwaved foods, as microwave ovens typically
heat foods unevenly, leaving hot spots that can burn the child. Never
microwave bottles or formula for infants.
(Preventing Burns - continued)
In the Childcare Setting
 Do not iron when children are present, and never leave an iron on an ironing board or
allow its cord to dangle. When irons fall they can cause burns as well as injuries from
the force of the iron’s weight.
 If you are a home provider, keep curling irons out of children’s reach.
 Set water heaters at 120 F. More than 4,000 children are scalded by tap water every
year. According to the TOMA Foundation for Burned Children, scalds are the leading
cause of accidental death in the home for children from birth to age four. At 130 F, it
takes 30 seconds to cause a serious burn; at 140 F, it only takes five seconds!
 When running water, turn on the cold faucet first, before turning the hot one. Never
turn on any faucet when the child is in the tub. Never leave a child alone or turn your
back to a child at bath time.
 Place heat resistant screens around or in front of electric heaters, space heaters,
radiators, and other heat sources so that children will not be able to reach them.
 Carefully supervise children any time you are using an outdoor grill, such as on a field
trip.
 Remember that even plastic surfaces can burn young skin when they get hot. Check
the surface of a slide, car seat, seatbelt buckle, or swing for overheating by the sun.
 Light bulbs and halogen lights get hot, and metal shades on any light are burn
hazards. Table lamps should be securely anchored and have screens around the
bulbs to protect exploring hands.
 Take a minute to look at your center or home care site from a child’s point of view: is it
really safe or can a child easily put herself in danger, such as by climbing from the
chair to the counter to the stove or from that bookshelf to the table? Remember,
young children are in the business of exploring of their world and they do not yet know
what can be dangerous.
 Chemicals also are a burn risk. Do not spread insecticides, fertilizers, or other
chemicals when children are present--chemical burns from agents like these are only
one of their multiple hazards.
Treatment
The correct way to treat any burn depends on several factors, including its depth, size,
and cause, as well as which area is affected area and the age and health of the victim. Babies
and young children can have a more severe reaction to a burn than an adult because of the
potential for serious fluid loss.
Minor burns with unbroken skin should be submerged in or flooded with cool (not ice
cold) water for at least five minutes. A clean, cool compress can help reduce pain. After the
cooling, cover the site with a dry sterile bandage or clean dressing.
Never apply ointments, creams, medications, butter, ice, oil spray, or any household
remedy to treat a burn. Do not disturb blisters or damaged skin. Call 911 if the burn is
extensive--larger than your palm--or if you are not sure how serious it is.
Contact the parent immediately and advise parents to contact their medical providers for
guidance. Be on the lookout for infection, a common burn complication. Carefully document the
entire situation, from how the incident occurred through any interventions and parent
discussions.
Suffering a burn is never a pleasant experience. Teach children about burns; do not
let them learn about burns by having one!
Safe Outdoor Fitness
Diona L. Reeves, Consultant
Children are curious, adventurous, and energetic, particularly at a young age--so use that to
their advantage. Give them the chance to blow off some steam while also promoting important
physical skills!
Providing opportunities for outdoor activity furthers physical growth and helps maintain
appropriate weight while promoting cognitive, exploratory, and social development. Outdoor activity is
an important part of health promotion, so schedule time for daily outdoor play. Knowing how to help
children obtain the most from their outdoor experiences can help them burn off energy and stay fit.
Value of Exercise
Exercise is an essential component of health promotion. Just 30 minutes of physical activity a
day will have a long-term impact on a child’s physical and emotional well-being. Children who get
regular exercise are better able to focus on tasks and challenges presented to them and are less
likely to be overweight or have weight-related issues.
Exercise is important in its own right, but being outdoors offers additional benefits. Fresh air,
exposures to the wonders of nature, and the opportunity to run freely are all important for children as
they play, explore, imagine, and enjoy childhood!
Outdoor activities do not have to be complex. Encourage children to run around in a game of
tag, chase butterflies, climb on play equipment, or play with balls. By engaging children in a variety of
activities, you help develop their muscle groups and enhance their gross motor skills.
Infants also benefit from time outdoors. Pushing them in a stroller or infant swing is beneficial;
however, infants also should have activities that promote gross motor skill development, such as
crawling on a clean sheet placed on the ground.
Safety First
Children need freedom to explore and expend energy; however, the activities and the
environment must be safe and age-appropriate. The outdoor play environment may be an elaborate
playground, the backyard of a family childcare setting, or a community park.
To help promote a valuable and safe outdoor experience for children, consider safety
questions such as these:
Location:
 Are you in a safe area, free of vehicle traffic, noise, and pollution?
 Is the area fenced or otherwise protected by barriers?
 Can children travel to and from the play area safely, without exposure to traffic or other
hazards?
 Is the play area large enough for adequate activity and exploration?
 Can you visually supervise every child at all times?
 Is the area free of debris, tripping hazards, and other hazardous items?
 Does the play area feature sufficient protection from wind, sun and other weather-related
elements?
Play equipment
All play equipment and surfacing should meet the U.S. Consumer Product Safety Commission
(CPSC) Guidelines for Public Playground Safety. While these standards are not designed for home
playground equipment, the guidance is useful for both home and public play equipment and
surfacing.
Specifics such as height of equipment, spacing, and surfacing, are applicable to all play areas.
The National Program for Playground Safety offers information for caregivers and parents. Also,
consider having your play area inspected by an individual certified through the National Playground
Safety Institute.
Supervision
When children are outdoors, they require “active supervision,” meaning that the adult is
actively engaged in their activities. Caregivers must be able to visually supervise every child at all
times. The staff:child ratio must be the same as required for indoor activities.
Weather and Climate
Consider the weather before heading outdoors, and keep the following issues in mind.
 Cold weather. When going outside in cold weather, each child should have a coat, gloves, hat,
and other warm apparel. Caring for Our Children National Health and Safety Performance
Standards: Guidelines for Out-of-Home Child Care Programs recommends that children not
play outdoors when the wind chill is below 15 degrees Fahrenheit.
 Heat index. “Heat index” refers to the combined measurement of temperature and humidity.
Check your local weather report, and if the heat index is 90 degrees Fahrenheit or higher,
children should not play outdoors.
 Air quality index. This indicator addresses the level of pollution in the air. Children should not
play outdoors when the local air quality index is poor or “unhealthy.”
 Sun safety. Warding off ultraviolet rays is important every day, all year round, in all geographic
areas. If possible, schedule playtime to avoid the peak sun hours. Provide adequate shade,
encourage the use of protective garments (hats, sunglasses, and cover-up clothing), and
consider application of sunscreen.
 Hydration. Make sure that everyone stays hydrated, particularly in hot weather. Children often
do not notice if they are too hot or thirsty, so offer water often and watch for signs of heat
distress.
Attire
Plan ahead and encourage parents to dress their children appropriately for outdoor play.
Suggest comfortable clothing that can get dirty and closed shoes that will not slip off or cause
tripping; no sandals or flip-flops.
Provide layers that can be removed because children will get warm as they run and move
about. Avoid drawstrings on clothing, necklaces, hoop earrings, or other accessories that could catch
on equipment and cause injury.
By providing a safe and stimulating environment in which children can be active and explore,
you help stimulate development, ward off weight issues, and promote healthy exercise habits.
Fun Outdoors
Outdoor time is fun for young children! Outdoor play does not have to be organized, although it
does need to be supervised. Running, jumping, swinging, bouncing, hopping, and more are all
activities that children love to do. Safe outdoor play has many rewards and can be a fun--and fitness
filled--part of the day for young children.
From Healthy CHILDCare www.healthychild.net
Playground Safety
Dr. Anarella Cellitti, University of Arkansas, Little Rock
Outdoor playtime should be relaxing for children and provide opportunities to have fun, expend
energy, develop motor skills, and more. Other benefits to daily outdoor physical activity include
promoting fitness, increasing socialization skills, and preventing unhealthy weight gain.
The outdoor environment is an extension of the indoor learning environment. Any activities
normally done indoors can be taken outdoors to add another dimension. For example, painting and
art activities or reading to the children become new and exciting in the outdoor environment.
Safe Play
It is the childcare program’s responsibility to provide appropriate spaces, equipment, and
activities, and to assure children’s safety. Safety during outdoor play requires advanced planning and
preparation.
Early childhood program directors should consider national standards and guidelines for
playground safety when designing a new playground or enhancing an existing area:
 The American Society for Testing and Materials sets industry standards for playground
equipment, including home playground equipment (ASTM Standard F 1148).
 The recently revised Consumer Product Safety Commission Handbook for Public
Playground Safety provides guidelines for public playgrounds.
These recommendations should be followed along with any state playground requirements.
Adherence to these recommendations not only assures a safer environment for children, but may
also offer legal protection if a child is injured.
Consider how children will go to and from the playground. Can children access the playground
without crossing a street or parking lot? Is there a sidewalk or other safe path?
The playground should be enclosed with fencing or another barrier. Gates should have secure
latches, preferably at adult levels rather than within children’s reach. Playgrounds should be sun safe
with large areas of dense shade from leafy trees, shadows of buildings, roofed structures, or portable
shade canopies.
Trained staff should conduct a thorough inspection of all equipment and grounds at least
monthly. Necessary repairs should be completed immediately; children should not have access to
unsafe areas or equipment.
Many states have specific requirements about playground equipment. Check with your
licensing department, childcare health consultant, resource and referral agency, or public health
department regarding playground standards.
Daily Checks-Equipment
Caregivers and teachers are responsible for daily checks and activities to assure children’s
safety. Here are examples of safety checks:
 Inspect the playground each day before children are allowed to enter. If appropriate and safe,
consider allowing one or two children to help inspect the area. The children can point to trash,
but only the adult should pick it up. Gloves and a sturdy trash bag are essential.
 Gates should be securely latched.
 Loose-fill resilient surface materials under equipment (i.e., sand, mulch, or pea gravel) should
be evenly distributed to maintain the appropriate depth for safety.
 Look for insect nests such as wasp nests or fire ant beds. Be aware that yellow-jackets
(wasps) build nests in the ground.
 Remove potentially toxic plants such as mushrooms or poison ivy.
Daily Checks--Children
Children should wear appropriate clothing for weather. Removable jackets or clothing layers
are best for cool days. Lightweight clothing that covers more skin provides sun protection. Clothing
should allow movement without risk.
Closed, well-fitted shoes facilitate running, jumping, and climbing. Do not allow necklaces,
hoop earrings, or clothing with draw strings that could catch on equipment.
Have separate play areas or schedule play time according to children’s ages and abilities.
Know children’s individual abilities, and be aware of activities they are attempting. Prevent access to
equipment that is inappropriate for children’s age or ability.
A first aid kit must be available to childcare providers during outdoor play, but inaccessible to
children.
Supervise at All Times
Outdoor play is not break time for the adults but is a supervised play time for children. It is
estimated that more than 40 percent of playground injuries are related to inadequate adult
supervision. Supervision requires active involvement with children.
 Maintain an appropriate staff:child ratio at all times. Higher-risk activities such as water play
require additional adult supervision.
 Supervise children carefully going to and from the playground, as well as while on the
playground.
 Continually move throughout the play area, checking “blind spots” such as inside crawl-through
equipment or behind trees.
 Make frequent eye contact with each child.
 Know how many children you take to the playground, and count heads frequently.
 Be aware of weather conditions. Check the daily UV and heat indexes and take appropriate
sun-safe action. If you hear thunder, immediately take all children indoors, even if it appears to
be a clear day.
Provide Props for Playground Activities
 Provide safe, washable, and age-appropriate props for outdoor activities. Beach towels, large
soft balls, or blocks encourage individual or small group play. Playground parachutes can be
fun for larger groups of children.
 Buckets, cups, spoons, shovels are fun during sand play.
 Wheeled toys should have wide bases and secure wheels. Provide smooth riding surfaces,
and require that children wear helmets.
Encourage Fun
Early care and education professionals should interact with children while encouraging childdirected play. Provide appropriate props and give children specific ideas of tasks. Walk around the
playground and make positive comments on children’s play.
If you observe a child who is not involved, ask if he or she wants to slide, walk on the balance
beam, or color. Encourage all children to have fun.
From Healthy CHILDCare www.healthychild.net
Dr. Charlotte Hendricks, Coordinator
JCCEO Head Start
Center of Excellence in Early Childhood
Birmingham, AL
www.jcceocenterofexcellence.org
President
www.childhealthonline.org
chend[email protected]
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