Most childhood accidents happen at home with a large percentage due to falling down the stairs.
As far back as 2003, a study was done in UKM, Malaysia where it was found that there were 13,401 home injury cases in the country out of which 44 cases were fatal. Fifty percent of all home injuries occurred to children aged 10 years and below while 20.6% happened to adolescents aged 10 to 19. Injuries caused by falls such as slipping, tripping and stumbling accounted for 39%. Males had a higher incidence compared to females.
Our myHEALTH portal says that falls are the most common home accidents. Children aged between one to four are most prone to falling due to the ungainliness caused by their evolving developmental stage. Their innate curiosity of their surroundings, new found mobility and increasing independence as well as daredevil risk taking exacerbate the situation.
Earlier this year, Motherhood.com.my carried a story of the kind of death-defying stunts children get up to, just to test their newfound physical prowess. One adult interviewed revealed that when he was six or seven years old, he climbed up to the top of a very high wardrobe just so he could launch himself into space. Yes, he flew for a bit but on his way down, he hit his head at the top corner of the bedroom door. Luckily he did not fracture his skull and only gave himself a lot of pain and a huge swelling on his forehead. He still lives to tell the tale.
Injury on the Stairs
Sliding down the bannister is another game children like to play. But regardless of whether the stairs are used for their proper purpose (of providing access to other floors in the house or building) or as an opportunity for childhood fun and games, stairs and staircase accidents constitute the second leading cause of accidental injury. Staircases are steep especially when descending and anyone can lose their footing, especially when distracted by the smartphone or anything else. Accidents on the stairs is second only to motor vehicle accidents.
In fact, WebMD says there is a child injured on the stairs every six minutes. Although the statistics are taken in the US, childhood danger levels on the stairs are just as grim worldwide.
Most of the injuries are due to the child falling down the stairs on his or her own. But 25% of children under the age of one are injured while they are being carried on the stairs by an adult, and as high as 16% fall when the child is in a baby walker. It is worse when the baby walker is upstairs and the child attempts to go downstairs while in it.
In a Split Second, it Happens
In June this year, a woman’s lightning quick reflexes saves a toddler from plunging through a hole on a fourth floor balcony. Watch this heart-stopping video.
https://www.youtube.com/watch?time_continue=23&v=21IAY-NtNrA
Types of Injuries
The majority of injuries sustained (35%) on the stairs are bruises, cuts, bumps and other soft tissue injuries. Some sustain fractures. Those who fall while being carried by someone else are three times more likely to require hospitalisation. Of all the children who fall down the stairs, nearly three quarters of the injuries are to the head and neck.
Signs of Serious Injury to the Head
These types of injuries are not confined to falling down the stairs only. They could occur if and when the child topples, rolls or slips off furniture such as the bed, table, chair, the high chair, changing table and so on.
The signs that require immediate medical attention are:
- Loss of consciousness.
- Sleepiness or lethargy.
- Confusion or extreme irritability.
- Abnormal or slow breathing.
- Vomitting
- Bleeding or leakage of clear fluid from the nose or ears.
- Pupils of different sizes.
- Bulging of the soft spot on the head.
- Fits or seizures.
- Disturbance of speech or vision.
- Weakness or paralysis.
- Neck pain or stiffness.
- Headache.
- Injury to internal organs
What to Do if the Child Has Sustained a Serious Blow to the Head
Call 999 immediately or head for the hospital Emergency. If the fall is not life threatening and there is time to talk to a doctor first, you can visit DOCTOR2U and download the FREE app that enables you to Live Chat with a doctor on the team so that you can ask advice. You can arrange for the doctor to come to your home if need be. You can also call 012-5251530 if you have further questions about this service.
If your child has suffered a serious blow to his head or was knocked unconscious (even for a minute), he could have a concussion, which is a bruise to the brain. Call the doctor, who will probably recommend that you:
- Keep your child awake for the first hour or so to make sure you get a clear sense of his mental well-being before he naps or goes to sleep for the night. You want to make sure your child isn’t dizzy or confused. For a baby, this could mean he’s crying and not acting like his usual self. A toddler or preschooler could lose his balance or complain that he can’t see.
- Check on your child every couple of hours when he’s sleeping to get a look at his skin colour and breathing. If all appears normal, there’s no need to wake him. If he looks pale or his breathing seems irregular, rouse him gently. If he fusses and tries to go back to sleep, all is well. If you can’t wake him up, call 999 or the doctor. If you are unsure of his condition, it is best to take him to the doctor.
- Keep tabs on your child for the next 24 hours. Call the doctor or 999 if you notice your child is exhibiting any of the above serious head injury symptoms.
How to Treat Less Serious Head or Other Bodily Injuries at Home
If your child is bleeding or has a broken bone, here’s what to do. Bear in mind that if the injury is on the head or face, the bleeding will look bad at first glance as there are a lot of blood vessels concentrated on the head and facial region. Try your best to keep calm so that you can keep your senses about you and do the needful.
- If your child is bleeding heavily, get medical attention. If he or she cannot be moved, call 999 and keep her lying down and quiet. Have her head and shoulders slightly elevated. Put a clean cloth or sterile bandage on the wound first and apply pressure with your thumb (unless you suspect a skull fracture) for several minutes. The injury may not be as severe as it looks.
- For minor cuts and scrapes on the face or elsewhere, gently wash the area with soap and water, apply an antibacterial ointment, and cover it with a sterile bandage.
- If you see a bump on the head or if he has a sprain anywhere else, apply a cold compress (or an ice pack) for 20 minutes to bring down the swelling. You can also give the child paracetamol syrup to relieve pain. Rest the affected area.
- If you suspect the child has a broken bone, splint the area with a blanket, thick cloth or pillow to avoid movement. Use a cloth sling for any broken bones of the upper limbs. Then take him to the hospital.
How to Prevent Fall Injuries in Children
Accidents will happen and there is no surefire way to prevent a child or you yourself from falling down while carrying or not carrying a child. However there are some ways to minimise the risk.
- Block both the top and bottom of the stairs and also the house doors with sturdy, reliable childgates. If the house is split-level, think of some way to block access.
- When the child is old enough to use the stairs on his own, put a guard on balcony and stair banisters if your child can slip in between the rungs or posts.
- When carrying a child, avoid carrying other items or doing something else at the same time, like answering the phone.
- Be careful when mopping the staircase as water makes the floor slippery. A lot of falling down the stairs occurs when the staircase is being mopped.
- Prevent slippery floors by wiping all spills or wet umbrella drips immediately. Be extra careful when the floor is being mopped.
- Wash bathrooms regularly to prevent moulding which causes slippery floors. Install non-slip mats for the floor for added safety.
- Ensure that all stairs are well lit and clutter-free. Never leave toys or slippers on the staircase.
- Make sure children are not left unattended on an upper storey, balcony or any other high places.
- Never leave your toddler alone on a high piece of furniture such as a changing table or high chair. Always strap your child into the stroller and high chair or onto the changing table.
- Keep “climbable” furniture away from windows. Although Malaysian windows have grills, a child could slip through or get himself or herself stuck in between the grills.
- Avoid baby walkers: They’re dangerous. According to the American Academy of Paediatrics , there have been an average of 230,000 injuries due to walkers between 1990 and 2014. Most were head injuries. Your child may fall out of it, pinch their fingers, be able to reach higher and pull down hot or otherwise unsafe items, or fall down the stairs while sitting in it. What makes walkers especially dangerous is that they can roll very fast.
- Do not use throw rugs. They are a big tripping hazard for anyone of any age.
Watch a Demonstration on What to Do if your Child has a Serious Fall
Keep watching the video till the end to link to demonstrations on Baby CPR.
For more stories on child safety and babycare, visit Motherhood.com.my.