1. The client/caregiver can discuss child safety.
   1. Safety for infants and toddlers
      1. Things to keep away from children this age are
         • Knives and sharp objects
         • Medicine
         • Cleaning supplies
         • Houseplants
         • Plastic bags
         • Balloons (especially burst balloons)
      2. Keep the crib away from electric cords, curtains, or blind cords that could get around the child’s neck, thus preventing choking or strangulation.
      3. The room should be painted with a nontoxic paint.
      4. Crib features should be checked for safety.
         • Bars should be no more than 23/8 inches apart.
         • Railing should be at least 26 inches higher than the lowest level of the mattress support.
         • Mattress should fit snugly into crib.
         • Surfaces should all be smooth.
         • Bumper guards should be used to protect infants from the hand railing.
         • Crib should be placed away from hot radiators or cold drafts.
         • No pillows should be used in the crib.
         • Drop-side latches should not be easily released by infants.
      5. Changing table safety tips are
         • It should be sturdy, with a strap to prevent falls.
         • It should have drawers or shelves that are easily accessible to prevent turning away from the infant.
2. The client/caregiver can discuss general safety measures for children.
   1. Measures to prevent poisoning
      1. Remove any houseplants in the home that are poisonous.
      2. Give medications as a drug, and stress that they are not candy.
      3. Apply hooks to cupboards that contain dangerous chemicals, such as may be in the kitchen, laundry, or bathroom.
      4. Have emergency numbers and numbers for the regional poison center posted.
   2. Measures to prevent falls
      1. Keep children away from windows. Lock windows when possible, as screens will not prevent falls.
      2. Keep chairs and furniture away from windows so that children cannot climb up. Open windows from the top whenever
         possible.
      3. Do not let children play alone on fire escapes, balconies, and so forth.
      4. Install safety gates to block stairs.
      5. Secure area rugs.
      6. Avoid use of extension cords.
      7. Fasten safety belts on highchairs, strollers, and shopping carts.
      8. Never leave a child unattended.
   3. Measures to prevent burns
      1. Avoid hot spills from food or drinks. Turn the handles of pots and pans away from the front of the stove.
      2. Avoid the use of tablecloths with toddlers. They could pull heavy or hot items down on themselves.
      3. Establish a “no zone” area, such as in front of your stove/oven.
      4. Unplug irons (curling and clothes) when not in use. Keep out of children’s reach.
      5. Test food and beverage temperature. Microwave can heat unevenly.
      6. Childproof electrical outlets.
      7. Never leave a grill unattended.
      8. Secure matches and lighters away from children.
      9. Be careful with cigarettes.
      10. Use space heaters with care.
      11. Place candles away from the reach of children, and never leave them unattended.
      12. Place the “totfinder” symbol in the child’s bedroom window.
      13. Have smoke alarms and fire extinguishers in the home.
   4. Measures for yard and water safety
      1. Home playground equipment should be age-appropriate.
      2. Equipment should be surrounded 6 feet in all directions by loose material such as shredded rubber or wood chips.
      3. Install four-sided isolation fencing with self-closing and self-latching gates around pools and spas. Wading pools should be emptied after each use. Always supervise children when around water.
      4. Keep ignition keys out of riding movers, vehicles, and so forth.
      5. Look before going backward in a motor vehicle.
      6. Remove poisonous plants, pesticides, pool chemicals, and so forth from the reach of children.
      7. Use sunscreen and insect repellent carefully after reading directions for use.
   5. Safety measures for children when using computers at home or school
      1. Never give personal information such as your name, address, school, or phone number. Never send a picture.
      2. Do not write to someone who has made you feel uncomfortable or scared.
      3. Do not meet someone or have them visit without the permission of your parents.
      4. Tell your parents or teacher if you read or view anything on the Internet that makes you feel uncomfortable.
   6. Safety tips from the National Center for Missing and Exploited Children
      1. Teach children to run away from danger yell loudly and make efforts to get away by kicking, screaming, and resisting.
      2. Never let your children go places alone. Make sure older children always take a friend with them.
      3. Know where your children are and whom they are with at all times.
      4. Remind children never to accept anything or respond to anyone they do not know.
      5. Talk openly to children about safety and talk to you or a trusted adult regarding anything that makes them scared or uncomfortable.
      6. Have a list of family members who could be contacted in case of an emergency.
      7. Report any suspicious persons or activities to law enforcement.
      8. Maintain a recent photograph of a child. The photograph should be in color. Often local law enforcement agencies will offer a free program to fingerprint children. Both pictures and fingerprints should be stored in an easily accessible place.
      9. Teach the child the home address and phone number.
      10. Get references for babysitters.
   7. General wellness care should include the following:
      1. Have routine exams to monitor growth and development.
      2. Vision and dental exams are recommended before beginning school.
      3. Keep immunizations up to date.
   8. Car safety measures
      1. An appropriate car seat is required for all children less than 40 pounds.
      2. Seatbelts should be worn for all children over 40 pounds.
      3. Children under the age of 12 years should be placed in the back seat.

Resources

Child Safety Publications. U.S. Consumer Product Safety Commission
www.cpsc.gov/cpscpub/pubs/chld_sfy.html

American Academy of Pediatrics

Consumer Product Safety Commission

National Center for Missing and Exploited Children
www.missingkids.com/missingkids

Federal Bureau of Investigation
www.fbi.gov/kids/k5th/safety1.htm

References

Canobbio, M. M. (2006). Mosby’s handbook of patient teaching . St. Louis: Mosby Inc.
Muscari, M. E. (2005). Pediatric nursing. Philadelphia: Lippincott Williams & Wilkins.
Novak, J. C., & Broom, B. L. (1999). Maternal and child health nursing. St. Louis: Mosby, Inc.