Recommendations for Pediatrician Patient-Counseling (Adapted from AAP guidelines, American Academy of Pediatrics)

AAP Fire Prevention Recommendations

• Close supervision of children
• Functioning smoke alarms installed and maintained—with testing every month
• An escape plan should be in place—with at least 2 exits—and practiced
• Children aged 3 and older can learn what to do in case of a fire, i.e. go outside if the smoke alarm goes off, crawl on hands and knees under the smoke, etc.
• Do not use elevators, i.e. in apartment buildings
• Teach “stop, drop, and roll” and to run cool water immediately on burns
• Adults should learn from manufacturers or the fire department how to select and use a fire extinguisher
• Automatic home fire sprinkler systems are available and affordable
• All caregivers should be familiar with all exits in the house/apartment and have all the necessary information about what to do in case of a fire

AAP Drowning Prevention Recommendations
Newborn Infants-Children aged 4

• Never leave children alone while in bath tubs, pools, spas, wading pools, near irrigation ditches or standing water
• The supervising adult should be within arm's reach of the child
• Residential swimming pools should be surrounded by fence that prevents direct access to the pool from the house—four-sided fencing that is at least 4-feet high and climb-resistant is ideal
• Swimming lessons are not equivalent to drowning prevention, and most children cannot developmentally begin lessons until 4 years of age
• Parents, caregivers, and pool owners should learn CPR and keep a telephone and rescue equipment, i.e. life preservers (not air-filled swimming aids), at poolside
• Parents should check to make sure that supervising adults will be watching their child and that they have the proper training and equipment necessary for an emergency

• Children should be taught to swim, and to never swim alone or without adult supervision
• Children should be required to use an approved personal flotation device whenever riding in a boat or fishing, or wherever they may be at risk of falling into the water
• Parents and children should know that jumping or diving into water can cause injury—knowing the water depth is critical and one should enter the water feet first
• Parents and children should know about drowning risks in colder weather, i.e. on thin ice over lakes, etc.
• Children with seizure disorders should be closely monitoring while swimming or taking a bath

• In addition to the above, pediatricians should counsel about the dangers of alcohol and drug consumption while swimming, diving, boating, etc., especially among boys as they are at greater risk
• Adolescents should learn CPR

AAP Falls Prevention Recommendations

• Supervise small children, especially if windows are open
• Install locks on windows to prevent sliding windows from opening
• Open double-hung windows from the top only
• Install operable window guards on second and higher-story windows (unless prohibited by local fire regulations)
• Discourage or prohibit children from playing on fire escapes, roofs, and balconies
• Avoid placing furniture, on which children may climb, near windows or on balconies

AAP Poison Prevention Recommendations

• Keep potential poisons out of sight and out of reach
• Always re-engage child-resistant closures in the locked mode immediately after using a pharmaceutical or consumer product
• Never transfer a substance from its original to an alternative container
• Safely dispose of all unused and no longer needed medications
• Do not refer to medicines as candy
• Post the poison control center number near the telephone
  (universal number is (800) 222-1222)

AAP Bike Helmet Recommendations

• All bicyclists should wear a helmet each time they ride
• Helmets manufactured after March 1999 must meet CPSC standards and contain the proper certification information
• Young children who ride as passengers must also wear an appropriately sized helmet, and should be at least 1 year old
• Any damaged helmet, one that was involved in a crash, one that has been outgrown, or one older than 5 years should be replaced with one that meets CPSC standards
• Parents and children should also learn the rules of road, how to ensure visibility to drivers and other safety measures in addition to wearing a helmet
• Parents and childcare providers should be encouraged to require children to wear a helmet when they begin riding tricycles, etc.
• Parents should model good behavior and be encouraged to wear helmets as well

AAP Agricultural Injuries Prevention Recommendations

• Separate children from farm hazards by fencing a play area
• Provide child care to assist farm families, or pool child care
• Prohibit extra riders on tractors, mowers, and all-terrain vehicles
• Ensure that there are roll-over protective structures (ROPS) and seat belts on tractors and other farm equipment, and that they are used at all times
• Limit children's access to large animals
• Properly store farm chemicals and cleaning agents
• Provide children who work on farms personal hearing-protection equipment, with training on its use
• Parents should be asked to consider their children’s physical and emotional readiness when thinking of work their child will do (skill set guidelines are available online from Children’s Agricultural Tasks project)
• Parental supervision on any farm task should be supported
• Pediatricians can share information on safety and development with communities and schools
• Improve EMS system to improve access to tertiary care for those residing in rural areas
• A national data system for childhood agricultural injuries should be maintained

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