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Bright Futures in Practice: Physical Activity

INJURY BFPAIC_ILP46

Prevention of injury to infants, children, and adolescents during physical activity is a responsibility shared by parents, physical education teachers, coaches, recreation program staff and, as they get older, children and adolescents themselves. Health professionals need to screen and assess the risk for injury and counsel families on how to reduce this risk. Appropriate safety equipment is essential for safety and injury prevention. Batting helmets in baseball, bicycle helmets in biking, shin guards in soccer, wrist guards and elbow and knee pads in in-line skating, and goggles in handball and raquetball are common. Following are tips for families for preventing the most common injuries that occur in infants, children, and adolescents.

Counseling

Infancy and Early Childhood

Choking

  • Do not give toys that are small enough to be placed in the mouth.

  • Make sure that toys do not have parts that can become detached.

  • Keep toys with small parts or sharp edges out of reach.

  • Make sure that infants and children sit while eating; eating while walking or running may cause choking.

Strangulation

  • Keep dangling telephone, electrical, blind, and drapery cords out of reach.

  • If a mesh playpen or crib is used, make sure that the openings in the weave are less than 1/4 inch. Never leave an infant or child in a mesh playpen or crib with the drop-side down.

  • Make sure children do not wear bicycle helmets or clothing with drawstrings while on playground equipment.

Bruises, Cuts, Strains, Sprains, and Fractures

  • Lock doors or use safety gates at the top and bottom of stairs, and use safety locks and guards on windows above the ground floor.

  • Teach children how to safely use stairs and climb on and off furniture.

  • Supervise infants and children when they use stairs and climb on and off furniture.

  • Make sure that playgrounds are safe and carefully maintained and that equipment is in good condition. All playground equipment should be surrounded by a soft surface (e.g., fine, loose sand; wood chips; wood mulch) or by rubber mats manufactured for this use.

  • Supervise children when they use playground equipment. Make sure they play only on developmentally appropriate equipment.

  • Make sure that infants and children play with balls that are soft (i.e., not made from leather or hard materials).

Heat-Related Illness

  • Recommend that children (1) drink before they feel thirsty, because mild dehydration occurs before thirst sets in; (2) drink cool water before, during, and after physical activity; (3) drink 4 to 8 oz of water 1 to 2 hours before participating in physical activity; and (4) drink 4 to 8 oz of water every 15 to 20 minutes during physical activity lasting longer than 1 hour.

  • Encourage children to participate in outdoor physical activity during the coolest times of the day (i.e., before 10:00 a.m. and after 6:00 p.m.) during extremely hot weather.
  • Encourage children to avoid outdoor physical activity if weather conditions are extreme.
  • Encourage physical education teachers, coaches, and recreation program staff to cancel or delay activities during extremely hot weather. (See Heat-Related Illness chapter.)

Drowning

  • Closely supervise infants and children when they are in or around water. Do not read, play cards, talk on the phone, mow the lawn, or engage in any other distracting activity while supervising infants and children who are in or around water. Never drink alcohol while supervising infants and children who are in or around water.

  • Teach children to swim. After their fourth birthday, children may be enrolled in swimming
    classes.

  • To prevent choking, never permit children to chew gum or eat while diving, swimming, or playing in water.

  • Make sure that apartment, house, and community swimming pools are surrounded by a fence with a self-closing and self-latching gate. The fence should be at least 4 feet high. Do not allow infants and children to have direct access to swimming pools. Closely supervise infants and children using a pool, and insist that others do too.

  • When boating with infants and children, make sure that they use personal flotation devices (e.g., life jackets) approved by the U.S. Coast Guard, regardless of the distance traveled, size of the boat, and swimming ability of children.

  • Do not use air-filled swimming aids (e.g., water wings) in place of personal floatation devices for infants and children. Air-filled swimming aids are toys and are not designed to be personal flotation devices. These aids can deflate when they be-come punctured or unplugged. They can give parents a false sense of security, which may increase the risk of drowning.


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