Images

Accidents are the most common cause of death in children 14 years old and younger. In fact, accidents cause more childhood deaths than diseases, drugs, or violence. Fortunately, many accidents -- for both children and adults -- can be avoided if simple safety measures are taken.

FIRE SAFETY

• Install smoke detectors in hallways, sleeping areas, the kitchen, and garage. Test them once a month and change the batteries regularly.
• Do not smoke in bed.
• Keep matches and other flammable materials out of reach of children.
• Never leave a burning candle or fireplace fire unattended.
• Establish fire escape routes from every room in your house and teach family members what to do in case of a fire. Have twice-a-year fire drills to practice escaping.
• Keep fire extinguishers in handy locations. Have at least one extinguisher on each level of your home.
• Know how to use a fire extinguisher. In an emergency, you must be able to act fast.
• Teach children about fires. Explain how they are accidentally started and how to prevent them.
• Children's sleepwear should be specifically labeled as snug-fitting or flame-resistant. Using other clothing, including loose-fitting garments, increases the risk of severe burns if the item catches fire.
• Make sure household wiring is up-to-date.
• Store flammable materials away from heat sources, water heaters, and open-flame space heaters.
• Supervise children when they are using fireworks. Never assume that a child will read and follow safety instructions.

HOTEL FIRE SAFETY

• After checking into a hotel, always find the exits and fire alarm closest to your room. Point these out to the people you are staying in the room with.
• Review the hotel's safety information in your room.
• Do not smoke in bed.
• If there is a fire outside of your room, always feel the door before opening it. If it is hot, do not open it -- telephone for help.
• If you leave your room, take your room key with you so that you can get back into your room if the nearest exit is blocked.
• If you are forced to stay in your room, telephone for help, turn off the air-conditioning and heating systems, and open your window slightly for ventilation.
• To help keep smoke from entering into your room, soak sheets and towels and stuff them under the door.
• Stay close to the floor for the freshest air and hold a wet washcloth over your face.
• Do not attempt to run though smoke or flames.
• Do not use any elevators during a fire. They are electrical and could shut down, trapping you inside.

BICYCLE SAFETY

• Wear a bike helmet.
• Make sure bikes are the right size. A child should be able to straddle a bike with both feet on the ground.
• Young children should use bikes with coaster brakes -- the kind that brake when you pedal backwards. With hand brakes, a child's hands should be large enough and strong enough to use the levers.
• Avoid riding at night if at all possible. Make sure your bike has reflectors.
• Stop at stop signs, check for traffic before turning, and never ride out into a street without stopping first.
• Ride on the same side of the road as the cars.
• Be predictable and ride defensively. Ride where drivers of cars can see you. Bicycles are frequently hit by cars because the driver did not even know the bike was there. Many accidents have been avoided because the biker was watching out for cars.
• Wear brightly colored clothing so that motorists can easily see you.

CHILD SAFETY

• The space between crib bars should be no more than 2.5 inches.
• The distance from the mattress to the top of the rail should be over 2 feet.
• DO NOT put extra blankets and stuffed animals in a crib with a baby.
• DO NOT place a baby on the stomach to sleep.
• Always keep one hand on an infant who is lying on a changing table.
• Place gates at the top and bottom of each stairway.
• Cover unused electrical sockets.
• Keep cleaning fluids, bug poisons, and other chemicals well out of a child's reach. Avoid storing toxic substances in unmarked or inappropriate containers (such as food containers). If you suspect poisoning or have questions, call 1-800-222-1222.
• Buy medicines with child-resistant caps. Place all medications out of the reach of children.
• Put safety latches on cabinets that a child should not open.
• Keep knives and matches out of reach.
• Keep plastic bags away from children.
• Keep children away from hot drinks and stove tops.
• When cooking on the stove, make sure that pot and pan handles are turned to the middle of the stove. Handles that hang over the edge of the stove may be reached by a curious toddler.
• Keep toys with small parts out of the reach of infants and toddlers. This includes stuffed animals with buttons.
• Avoid putting dangerous items in a waste basket where a young child might find them.
• Keep toilet lids down.
• Never leave infants and children unattended in a bathtub.
• Check water temperature in a bath before placing a child in it.
• Set the hot water heater thermostat to no more than 125°F.
• When heating a baby bottle, always test the milk temperature to prevent burning your baby's mouth.
• Inspect playground equipment for signs of deterioration, weakness, and damage.
• Teach children what to do if strangers approach them. Teach them at an early age that no one should touch private areas of the body.
• Make sure children know their address as early as possible. Teach them to call 911 when in trouble.
• Teach children to watch for cars on streets. They must stop, look both ways and listen for approaching traffic. Children must also be very aware of cars on driveways and in parking lots. Cars backing up cannot see small children.
• Supervise young children at all times.

HOUSEHOLD SAFETY

• Wear protective footwear and eye wear when mowing the lawn, operating power tools, working with a chisel, or hammering metal on metal.
• Keep tools away from children until they are old enough to use them properly.
• All stairways should have a sturdy hand rail.
• All entryways should have bright lighting.
• Don't leave objects on stairways. Make sure that carpet on stairways is securely fastened.
• Unplug appliances (such as heating pads and electric blankets) when they are not in use.
• In the bathroom, use non-slip floor mats. Put non-slip appliques on the bathtub.
• Don't use any electrical appliances when you are wet or in the bathtub, shower, or pool.
• Make sure that each fireplace has a fire screen.
• Keep guns locked up and unloaded. Firearms and ammunition should be stored separately.
• Make sure your house number is easily visible from the street.

CAR SAFETY

• Always wear a seat belt.
• Obey traffic laws and drive defensively.
• Do not drink alcohol and drive.
• While driving, try to avoid any distractions from others in your car.
• Keep your vehicle properly serviced, especially before going on a long trip. Keep an emergency kit in your car.
• Take the weather into account before venturing out on the roads.

INFANT AND CHILD CAR SEATS

• Car seats are required by law for children under 40 pounds.
• The safest position for an infant car seat is rear facing in the back seat.
• In most models, the infant seat is used AT LEAST until the child reaches 20 pounds and 1 year of age. (Some experts recommend rear-facing child seats until the child is 30 pounds; check the weight restrictions on your specific seat.) At that point, a forward-facing seat can be used. This may require a new car seat -- it depends on the model.
• Booster seats should be used for children 40 to 80 pounds. Some states have passed laws requiring that children up to 8 years old or 80 pounds be put in booster seats.
• Read the car owner's manual to determine the safest place to fasten a car seat in YOUR car.
• Know how your car seat is designed to be used. Read the instructions carefully.
• Adapters may be needed for certain types of cars or certain seat belt types.
• For more information call your car seat manufacturer, car manufacturer, or the State Highway Safety Office.

WORK SAFETY

• Wear protective eye wear if your job carries any risk of eye injury.
• If your work environment is so noisy that you have to shout to be heard, then wear earmuffs or ear plugs.
• Be cautious when handling hazardous materials (such as asbestos) and wear appropriate masks and other protection if working in an environment where dangerous chemicals are used. Avoid any exposure to hazardous chemicals if you are pregnant or are trying to become pregnant.
• Avoid any use of illegal drugs or alcohol while on the job, particularly when operating heavy machinery.
• Sleep disorders and health problems can result from frequent shift changes (like from night to day shifts) as well as from "jet lag" due to long-distance travel. Try to minimize frequent shift changes and excessive travel if possible.

WATER SAFETY

• Learn CPR.
• Teach your children to swim, but do not assume that this alone will prevent drowning in young children.
• Never leave young children unattended, even for a minute, in a bathtub, swimming pool, lake, ocean, or stream.
• Fence all home pools and keep the gate closed and locked.
• Always wear life preservers when boating, even if you can swim.
• Avoid drinking alcohol when swimming or boating.
• Never swim alone.
• Never dive into water unless you know beforehand how deep it is.
• Know your limits. Do not over-exert yourself.
• Avoid standing on wet surfaces or being in water during a lightening storm.
• Stay out of strong currents.
• Do not overload your boat. If your boat turns over, stay with the boat until help arrives.

CAMPING AND HIKING SAFETY

• Always bring a first aid kit when camping. Know how to use it.
• Use the buddy-system. Never camp or hike alone. If you were to break a leg or fall and get stuck, a partner could go for help.
• Make sure someone knows where you plan to camp or hike.
• Be careful when exploring. Take a compass and map. Remember landmarks.
• Take whistles in case you get lost or run into trouble. Whistles can be heard further than your voice will carry.
• Be careful when chopping wood or building fires.
• Wear long-sleeved shirts and long pants to avoid bites from ticks and other insects. In cold conditions, wear many layers of thin clothing, along with a hat, boots and gloves.
• Take a supply of clean drinking water and drink it. People can become dehydrated very quickly in warm, dry, or windy conditions. Dehydration can lead to other serious complications.
• Don't drink stream or lake water.
• Avoid drinking alcohol. It tends to cause dehydration.
• Don't provoke, touch, or get close to wild animals.
• Don't eat wild berries and plants.
• Don't over-exert yourself when hiking.
• Never leave a campfire unattended.
• Before leaving a campsite to return home, make sure all fires are out and the ashes are cold. A single burning ember in a seemingly smothered fire is enough to initiate a full-blown fire.

SUN PROTECTION

• When outside on a warm, sunny day, protect yourself from the sun by wearing a hat, a water-proof sunscreen, and loose-fitting, light-colored clothing.
• Sun protection is especially important between 10 a.m. and 2 p.m.
• Drink plenty of water, but avoid drinking alcohol on hot, humid days when you are outside. Alcohol can cause dehydration.
• If you become overheated, sit in the shade, drink plenty of water, and try to keep your skin cool and moist.
• Keep very young children's skin from being exposed to the sun.
• Never leave children or pets unattended in a car in the sun -- even for a few minutes.
• Wear appropriate sunscreens -- a sunscreen rating of 15 should give adequate protection for most people.
• Remember, there is no such thing as a healthy suntan.

BURGLARY PREVENTION

• Avoid unnecessary display or talk about your valuables.
• Avoid hiding a house key under the doormat or nearby vicinity.
• Teach your family to leave the house undisturbed and call the police if they discover a burglary has been committed.
• Trim trees and shrubs to eliminate hiding places.
• Consider a security closet with a solid core door and a dead-bolt lock.
• Keep emergency telephone numbers listed on your phone.
• Install lights around the perimeter of your home.
• Lock up your ladder.

Doors and entry areas:

• Outside doors should be solid core construction.
• Entry doors should have a wide-angle viewer.
• Exterior doors should have cylinder-type dead-bolt locks.
• Doors without cylinder locks should have a heavy bolt or some similar secure device that can be operated only from the inside.
• Sliding doors should have a lock that locks both the door panels together or the active side to the frame.
• The garage door and basement door should be secured with a lock.
• Lock your garage door at night and when you are away from home.

Windows:

• All windows should be equipped with locks or be pinned.
• Keep your windows locked when they are shut.
• Put secure locks on garage windows.
• Cover garage windows with curtains.

When you go on vacation:

• Arrange for friends or neighbors to pick up newspapers and mail.
• Notify a neighbor you'll be gone.
• Arrange to keep your lawn maintained.
• Arrange to have your snow shoveled.
• Use timing devices for your lights and radio.

Car seats; Fire safety; Bicycle safety; Water safety

Rivara FP, Grossman D. Injury control. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 61.

Hoyt DB, Coimbra R, Acosta J. Management of acute trauma. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 20.

Bergen G , Chen LH, Warner M, Fingerhut LA. Injury in the United States: 2007 Chartbook. Hyattsville, MD: National Center for Health Statistics. 2008.

Updated by: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.