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Guide to Clinical Preventive Services
U.S. Preventive Services Task
Force: Guide
to Clinical Preventive Services
Injury
Motor Vehicle Injuries
Drowning
Fall Prevention
Fire and Burn Prevention
Motor Vehicle Safety
Poison Ingestion
Pedestrian Safety
Recreational Safety
Injury
Household and recreational
injuries
Recommendation: Counseling (1996)
Recommendation
- Periodic counseling of the parents of children on
measures to reduce the risk of unintentional household
and recreational injuries is recommended.
- Counseling to prevent household and recreational
injuries is also recommended for adolescents and adults
based on the proven efficacy of risk reduction, although
the effectiveness of counseling these patients to prevent
injuries has not been adequately evaluated.
- Persons with alcohol or drug problems should be
identified, counseled and monitored. Those who use
alcohol or illicit drugs should be warned against engaging
in potentially dangerous activities while intoxicated.
- Counseling elderly patients on specific measures
to prevent falls is recommended based on fair evidence
that these measures reduce the risk of falls, although
the effectiveness of counseling elders to prevent falls
has not been adequately evaluated.
- More intensive individualized multi-factorial intervention
is recommended for high-risk elderly patients in settings
where adequate resources to deliver such services are
available. There is insufficient evidence to recommend
for or against the use of external hip protectors to
prevent fall injuries.
Motor vehicle injuries
Recommendation: Counseling (1996)
Recommendation
The following counseling to all patients, and the
parents of young patients, is recommended:
- Use occupant restraints (lap/shoulder safety belts
and child safety seats).
- Wear helmets when riding motorcycles.
- Refrain from driving while under the influence of
alcohol or other drugs.
- There is currently insufficient evidence to recommend
for or against counseling to prevent pedestrian injuries.
Clinician’s Handbook of Preventive Services,
2nd Ed.
Drowning
Inform parents that children can drown in
small depths of water such as may be contained in buckets,
toilets, bathtubs, and wading pools. Empty and store
buckets after use. Never leave infants in the bathtub
without supervision .
- Do not allow children to swim alone.
- Advise parents to protect their children from drowning
by installing fences around swimming pools/spas; fences
should be at least 4 ft (1.2 m) high with completely
self-closing gates.
Fall Prevention
- Safety gates: Advise parents to use safety gates
(preferably not the accordion type) across stairways
(both top and bottom), to install window guards above
the first floor, and to move furniture away from upper-story
windows so children cannot use the furniture to climb
onto the window sill.
- Baby walkers: Baby walkers are associated with more
injuries each year than any other baby product. If
they are used, strict supervision must be maintained
to avoid falls down stairwells.
Fire and Burn Prevention
- Water heaters: Counsel parents to protect their
children from scald burns by reducing the temperature
setting of their water heater to 49° C (120° F),
if possible, or install anti-scald devices on bathroom
and kitchen faucets.
- Smoke detectors: Counsel parents about the importance
of using smoke alarms to prevent residential fire injuries.
Emphasize proper installation, semiannual battery changes,
and monthly checks to make sure they work. Discuss
the use of a family fire drill and escape plan.
Motor Vehicle Safety
- Car seats: Use of child safety seats is required
by law in all 50 states. Counsel parents to install
child safety seats in the rear seat of the car, preferably
in the middle, and to use them every time children
ride. Safety seats should be used until children weigh
at least 40 lbs (18 kg). Safety seats should face backward
until children weigh at least 20 lbs (9 kg) or reach
1 year of age. Failure to properly secure either the
child in the seat or the seat in the car is common;
therefore, urge parents to take particular care when
securing both.
- Booster seats/seat belts: Advise parents to have
their children sit in the rear seat of cars and to
use safety belts every time they ride. Until children
grow tall enough so that the lap belt stays low on
their hips and the shoulder belt crosses their shoulders
or until children's ears come above the top of the
vehicle seat back, they should use properly secured
booster seats. Remind parents that children should
not ride in the cargo areas of pickup trucks, vans,
or station wagons.
- Air bags: Infants riding in rear-facing safety seats
should never be placed in the front seat of a vehicle
equipped with a passenger-side air bag. Children should
ride in a car's rear seat. If a vehicle does not have
a rear seat, children riding in the front seat should
be positioned as far back as possible from an air bag.
- Impaired driving: Advise children and adolescents
to avoid riding in a vehicle driven by anyone who has
been or is drinking. Counsel adolescents not to drink
and drive.
Poison Ingestion
- Remind parents to keep medicines and other dangerous
substances locked up and in child-resistant containers,
to have the local poison control center telephone number
posted in a prominent place near the telephone, and to
keep a 1-oz bottle of syrup of ipecac at home and to
replace it when it reaches its expiration date. Advise
parents not to administer syrup of ipecac without first
consulting with a poison control center or health care
professional.
Pedestrian Safety
- Encourage parents to teach and demonstrate pedestrian
safety to their children. Remind them that children younger
than aged 9 to 12 years need supervision when crossing
streets, depending on the density and speed of traffic.
Recreational Safety
- A safety helmet approved by the American National
Standards Institute (ANSI), Snell Memorial Foundation,
or the American Society for Testing Materials (ASTM)
should be worn by all persons every time they ride
or are a passenger on a bicycle. Helmets should also
be worn while using roller skates, in-line skates,
and skateboards.
- Wrist guards, elbow pads, and knee pads should be
worn by all children of all ages using roller skates,
in-line skates, and skateboards.
- Personal flotation devices should be worn by every
child engaged in any boating activity.
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Adolescent
& Child Targets for Health Foundation, Inc. 
