Child safety & accident prevention – advice & resources for all

Child Safety Week is run annually by CAPT (usually in June) to raise awareness of the risks of child accidents and how they can be prevented.

CAPT provide a range of resources to help practitioners run local activities and events and promote safety messages in a fun and engaging way.

Events are held by a range of different organisations and individuals, including children’s centres, child minders, fire and rescue teams, hospitals, schools and many more.

• CAPT resources can help to keep conversations going with parents and families throughout the year and these can be found on their website at www.childsafetyweek.org.uk

Keeping babies, toddlers and young children safe from unseen dangers at home is a challenge for all parents and carers. There are several ways to help prevent injuries to children in the home including:

• supervising children
• being aware of the risks around the child
• creating a safe environment
• using appropriate safety equipment.

There is a good summary on the Mumsnet website at www.mumsnet.com/how-to/prevent-accidents-in-the-home

The NHS have made a video with the Child Accident Prevention Trust which explains how to make your home childproof and prevent avoidable accidents.

• This can be viewed atwww.nhs.uk/video/Accidentprevention and links to the NHS baby and toddler safety pages at www.nhs.uk/baby-safety-tips

The following links to the NHS website give advice about what to do in specific circumstances:

• how to help a choking baby or child – www.nhs.uk/helping-choking-baby – with a link to a video
• how to resuscitate a baby or child – www.nhs.uk/resuscitating-a-baby  – how to perform child CPR
• what to do if a baby or child has an accident – www.nhs.uk/accidents-what-to-do – lots of scenarios and a link to a video on dealing with burns and scalds
• first aid for all ages – www.nhs.uk/Accidents-and-first-aid – basic first aid and CPR advice.

First aid courses
Every year, too many people die in situations where first aid could have given them the chance to live. St John Ambulance offer first aid course to learn the vital skills which may mean the difference between life and death in an emergency.

• Find out more about local courses on the St John’s website at www.sja.org.uk/courses-for-the-general-public

Burns and scalds are damage to the skin caused by heat, both are treated in the same way. A burn is caused by dry heat – by an iron or fire, for example. A scald is caused by something wet, such as hot water or steam.

How long it takes to recover from a burn or scald depends on how serious it is and how it is treated; wounds can become infected.

Children don’t have the necessary reflexes to swiftly move away from something hot; their skin is up to 15 times thinner than that of an adult and consequently offers less protection. The damage tends to be more severe, because they have a smaller body surface area and so the scald or burn covers a larger proportion of the body. The greater the area covered, the more serious the injury and impact for the child.

Six toddlers are admitted to hospital every day because they have been badly burned. Babies and young children have such delicate skin that they can be burned far more easily than adults.

National Burn Awareness Day takes place in October each year – run by the Children’s Burns Trust (CBT) and the British Burn Association to promote prevention and good first aid.

There are lots of free resources, including a toolkit, posters and resources for social media, to help publicise burns prevention in the community available.

• Find more information on the CBT website at www.cbtrust.org.uk/national-burn-awareness-day  and on the British Burn Association website at  www.britishburnassociation.org

Scalds
Burns and scalds are frightening and the pain and damage caused can be devastating:

• 250 children a month need treatment for serious scalds from hot drinks and kettles
• these injuries can be life-changing – emotionally as well as physically
• to help parents and practitioners appreciate just how quickly scalds occur see
  • Gabriel’s story about hot drink scalds
  • Lily’s story about the dangers of hot water scalds
• the vast majority are preventable.

Find out more on the CAPT website at www.capt.org.uk/burns-scalds – there are also resources to help:

• develop a hot drinks policy for any setting
• run engaging sessions with parents
• hold educational sessions.

Burns from hair straighteners & tongs
Hair straighteners or tongs can cause deep burns that can scar for life:

• 1 in 10 parents of under-fives admit their child has suffered a serious burn from hair straighteners or tongs
• 1 in 20 of all admissions to specialist paediatric burns units are due to serious burns from hair straighteners
• hair straighteners can get as hot as an iron
  • so hot, you can cook bacon and eggs on them – see the video below
  • they can stay hot enough to burn up to 15 minutes after they’ve been turned off
• many straightener injuries occur when crawling babies and toddlers grab at them, step on them, sit on them or pull them down
• surprisingly, young children don’t have a reflex to automatically pull away from or drop something that is burning them – it is something that we learn.

Many parents and carers simply don’t realise how dangerous straighteners can be. To help spread the word and stop these painful injuries:

• find practical safety tips to share on preventing hair straightener burns
• watch or share the video of bacon and eggs cooking on straighteners
• follow and share safety tips via Facebook and Twitter
• the hair straightener education pack from www.capt.org.uk/shop–  provides everything needed to run engaging discussions about safety
• find out more from the Electrical Safety First website at www.electricalsafetyfirst.org.uk/guidance  and the Children’s Burns Trust website at www.cbtrust.org.uk

Button batteries are the small, round batteries found in toys and everyday appliances like remote controls and car key fobs. They can be extremely dangerous for children, and if swallowed, can kill within a matter of hours.

There are lots of different sizes and types of button batteries. Lithium button batteries are most dangerous as they are larger and more powerful. If they get stuck in a child’s throat, they can cause serious internal burns or even death within hours of being swallowed.

On the CAPT website at www.capt.org.uk/button-batteries you can view a film in which George Asan talks about his daughter Francesca, who died after swallowing a spare button battery.

Why are button batteries dangerous?
Most button batteries pass through the body without a problem. But if a button battery, particularly a lithium button battery, gets stuck in the throat or gullet, energy from the battery can react with saliva to make the body create caustic soda. This is the same chemical used to unblock drains!

This can burn a hole through the throat and can lead to serious internal bleeding and death. The reaction can happen in as little as two hours.

All button batteries are very dangerous if they get stuck in a child’s nose or ear.

NHS England issued a patient safety alert (PDF) to raise awareness of the risk of death and serious harm from delays in recognising and treating ingestion of button batteries. The alert was issued to highlight that when a button battery is swallowed severe tissue damage can result from a build-up of sodium hydroxide (caustic soda) caused by the electrical current discharged from the battery; and not as commonly supposed, from leakage from the battery. The sodium hydroxide causes tissue burns, often in the oesophagus (food pipe), which can then cause damage to major blood vessels, resulting in catastrophic haemorrhage.

A review of incident reports over a four year period identified five cases where severe tissue damage occurred after apparent delays in suspecting, diagnosing or treating button battery ingestion in small children; sadly in one case this resulted in death. The risk affects all age groups, although most cases involve children under the age of six who mistake the battery for a sweet and older people with confusion or poor vision who mistake the battery for a pill.

Although a child may not choke, if undetected the batteries can do serious damage to the gastrointestinal system. When combined with saliva, the electrical current from the battery produces caustic soda that burns through the throat or stomach and can cause further damage to other internal organs.

Safety tips:

• make sure that toys and other products using button cell batteries, such as small electronic devices, have lockable battery compartments
  • this should mean that they are safe for children to use as the batteries are locked away
• be extra vigilant with items such as musical greeting cards, flame-less candles and remote controls as they do not have lockable compartments
  • RoSPA advises that children should not be allowed to have access to these products if the battery compartment is not secure
• it is a good idea to ensure that spare batteries are locked away and used batteries are disposed of correctly.

If a child swallows a button cell battery, seek medical advice immediately and take them to A&E straight away.

Remember that the saliva in their body will react with the battery and so time is very much of the essence in these cases.

Removal of the battery alone may be insufficient action to prevent further damage as symptoms can manifest up to 28 days later. Patients need expert input, and careful monitoring and follow-up.

Find out more and what to do if you suspect a child has swallowed a button battery, or got one stuck in their nose or ear, on the RoSPA website  at www.rospa.com/home-safety/button-cell-batteries  or on the CAPT website at www.capt.org.uk/button-batteries.

The British and Irish Portable Battery Association (BIPBA) has advice in a range of languages  on their website at buttonbatterysafety.com

Each day around 40 under-5s are rushed to hospital after choking on something, or swallowing something dangerous. Food is the most likely cause, but small objects and toys can also be risky for young children.

Information and advice about suffocating and choking can be found on the RoSPA website at www.rospa.com/accidents-to-children/#suffocating

Children can swallow, inhale or choke on items such as small toys, peanuts and marbles.

• babies and young children haven’t learnt how to chew, swallow and breathe in the right order – they sometimes get them mixed up  and that can cause choking
• peanuts can be dangerous if a child chokes on them so it is best to avoid giving them to children under 6
• babies throats are narrow so they can easily choke when drinking or on small objects – they may not be very mobile but can still grip and grab! They explore the world by touching things and often putting them in their mouth:
  • bottles – it is dangerous to prop a baby up to feed; if they choke they wont be able to push the bottle away
  • toys and small objects – even small babies can grab and reach for things that they shouldn’t – coins, buttons, small batteries, small parts from toys, anything that catches their eye could end up in their mouth – it  is always best to keep small objects out of reach.
  • keep animals, especially cats, out of the bedroom and use a net on a pram
  • keep nappy sacks out of the reach of babies and young children and never store nappy sacks in or around the cot or pram
• toddlers are still learning to chew, swallow and breathe, so they can easily choke on food, especially if they are not concentrating:
  • food – even something as small as a grape can cause a toddler to choke – reconstituted meat, like hot dogs and burgers, is the one of the main dangers along with hard sweets and nuts
  • cut up food to make it safer to eat – even small food such as grapes, cherry tomatoes, blackberries and other soft fruits should cut into quarters to prevent choking
  • eating – it is easy to choke if you are wriggling around and many toddlers will be on the move while they eat; stay with toddlers when they are eating and encourage them to sit still and concentrate
  • toys and small objects – toddlers will grab for small objects and put them in their mouths in the same way that babies do – they also like to put things in their ears or up their nose. It is normal for them to try this but try to teach them not to. Keep toys designed for older children away from a toddler
• younger children (3-7) will have grown out of putting everything in their mouths by the age of 3:
  • food – although much better at eating safely, older children are still at risk from choking; hard foods like sweets or ice cubes, can be dangerous
  • toys and small objects – children are now old enough to learn not to put things in their mouths. Some parents of younger children in this age group choose to avoid all toys with small parts if their children are still keen on tasting everything but older children will be able to play with more complicated toys
• older children are less likely to choke on food at the table, at this time it is more likely that a child will choke on food while they are on the go:
  • sitting still will give older children a chance to chew and swallow properly – keep an eye out for dangerous food items such as chewing gum, bubble gum, sweets and ice cubes
  • encourage older children to keep their toys away from their younger playmates.

Nappy sacks
Nappy sacks are used to dispose of soiled nappies can also pose a risk to babies and young children. RoSPA are aware of at least 17 deaths involving these items, where babies have suffocated after a nappy sack covered their mouth and nose, or have choked after putting a nappy sack in their mouth.

Parents and carers are generally aware of the dangers posed by plastic bags, but may not make the link to nappy sacks posing similar risks. Nappy sacks or bags tend to be fragranced, are made of a much more flimsy material and do not rustle in the same way as plastic bags meaning they can be easily grasped and breathed in by young babies without parents realising.

RoSPA will provide 400 Nappy Sack leaflets (in batches of 100 including a poster) free of charge to children’s service providers; or these can be downloaded from their website at www.rospa.com/nappy-sacks.

In partnership with the British Retail Consortium (BRC), RoSPA has developed guidelines for retailers. The guidelines set out the measures that retailers can take to help reduce the risks associated with using nappy sacks products, including the inclusion of warning labels on packaging to alert parents to their potentially-deadly dangers.

These guidelines can be found on the website at www.rospa.com/nappy-sacks.

More resources and information:

• a leaflet* on Choking hazards in the home and how to avoid them can be found on the RoSPA website at www.rospa.com/choking-hazards.pdf  (*Reproduced with permission)
• RoSPA Don’t Risk It! safety posters can be downloaded from their website at www.rospa.com
• more information and links from CAPT can be found on their website at www.capt.org.uk/choking-prevention
• NHS:
  • safety tips at www.nhs.uk/baby-safety-tips_choking
  • links to ‘what to do’ videos at how to help a choking baby or child
• St John Ambulance Chokeables campaign – in just 40 seconds you can learn how to give first aid to a choking baby with the video on the St John’s website at www.sja.org.uk/baby-choking-the-chokeables

Most poisoning accidents involve medicines, household products and cosmetics. Some poisoning agents can cause breathing difficulties.

To prevent accidents with household cleaning products:

• closely supervise children in and around the home
• keep household chemicals out of sight and reach of children, preferably in a locked cupboard
  • remember this also applies to the garage and shed
• always store household cleaning chemicals in their original containers
  • replace lids and put all products away immediately after use
• dispose of unwanted household cleaning products safely
• store household cleaning products in a different place from food and medicine
• use household cleaning products according to label directions
• mixing household products can cause dangerous gases to form.

For more information on how to prevent poisoning accidents, including those caused by medication, plants and household products, download the RoSPA Take Action Today, Put Them Away fact sheet from their website at www.rospa.com/household-cleaning-products. Here you can also find the Take Action Today, Put Them Away,  safety checklist for parents, video and lots more resources and information.

See also the section on liquid laundry / detergent capsules below.

Most children love to cycle and it is a great way for them to keep fit and healthy. It takes a while to learn, but once they have got a bike many children will want to push the boundaries, cycling further and faster.

Whether it is a young child cycling in the park on their first bike; or an older child cycling to school, cycle accidents are a real risk for children and young people. Practitioners can help parents and carers identify the risks with cycling and help their child to manage those risks so they can cycle more safely.

Find out more about cycle safety in our road safety resource.

Unfortunately, there have been some very sad cases where children have been serious injured or killed by family dogs and it is important to remember that it is never safe to leave a dog alone with a child, however friendly or trusted the dog may be. Any dog can react badly to a baby or child, particularly with new arrivals to the family, when the dog will need time and help adjusting.

Find out more in our dangerous dogs resource.

Young children can be fascinated by water, and swimming is great for a child’s health and fitness.

For young children, there is a real risk of drowning in the home or garden, including neighbours’ gardens. As they get older, the risks are more with children exploring and challenging themselves around water. As children grow in confidence they can over-estimate their abilities:

• at home, younger children are most likely to drown in the bath or garden pond
  • it is important for parents to understand the risks of babies and young children being left alone, even for a moment
  • they may get no warning that something is wrong, as babies can drown silently in as little as 5 cm of water
• children under 8 need to be supervised in and around water
  • they might understand safety instructions but are likely to forget in the heat of the moment.
  • remember that children don’t cry out for help and wave to be rescued – instead they disappear under the surface of the water, often unseen
• as children become stronger swimmers, it is important to educate both them and their parents about water safety
  • they may still lack the strength and skills to get themselves out of trouble if they find themselves in strong currents or deep water, are shocked by cold water or discover too late dangerous objects lurking in the water.

Whether educating parents and carers about the risks to their children, or trying to get across messages to children about being aware of risks around water, there are lots of simple messages to share such as:

• stay with a baby at all times when they are in the bath, even if there is an older child in the bath with them
• if you have a pond and a young child or baby, they will be safer if you fill it in, fence it off or securely cover it
  • make sure your garden is secure, so a child can’t get to a neighbour’s pond
• children under 8 years old need to be supervised in and around water
  • they might understand instructions but are likely to forget if they are having fun or are excited.
• teach older children to choose safe places to swim, such as public pools and beaches patrolled by lifeguards, rather than canals, reservoirs or rivers.

More resources and information:

• RoSPA has advice and information about all aspects of water safety including garden ponds, ice safety, bath seats and child drowning on their website at www.rospa.com/water
  • includes advice to help managers and leisure providers maintain safe, well-run environments
• KidsHealth has advice aimed at older teens on their website at kidshealth.org
• Royal Life Saving Society UK has advice about drowning prevention on their website at www.rlss.org.uk
• Manchester City Council has water safety advice on their website at www.manchester.gov.uk

Children are at very little risk from electric shocks but electrical appliances can be dangerous in other ways. Old appliances and children playing with electric appliances can cause burns and fires.

Parents should be aware of how much their children have learned and what they are capable of doing with electrical appliances.

The main danger with electricity is that it can cause house fires. Faulty electrics start up to one in six house fires;  causes include loose wiring, damaged cables and leads, and faulty or misused electrical appliances.

If parents and carers are aware of the dangers of electricity, they can teach children, as they grow up, to be aware of the dangers too. But younger children might not know the dangers and they become curious before they know what they are playing with. Many parents might not know that their toddler is able to plug in an iron or electric fire.

Most accidents that happen with children and electricity can be prevented by keeping potentially dangerous devices out of the reach of young children and away from water. For example:

• electrical devices such as hairdryers and mains-operated radios should be kept out of the bathroom
• other situations where electrical equipment fails or is used incorrectly can be prevented by educating parents about the right way to use electrical appliances:
  • plug sockets should not be overloaded; be aware not just of how many plugs are going into one socket, but also how much power they are using
  • kettles and irons use more power than lamps and even TVs
• older electrical appliances can cause house fires. Check plugs, sockets and wires for scorching or fraying; if there is a problem use a registered electrician to fix them.

More resources and information:

• Electrical Safety Council provide more information on electrical safety on their website at www.electricalsafetyfirst.org.uk/guidance/safety-around-the-home
  • the website includes a ‘socket calculator’ which can be used to avoid overloading sockets and the risk of fire
• Think Safe have an electrical safety kids section on their website at www.juniorcitizen.org.uk

There is growing evidence that the liquid nicotine refills from e-cigarettes pose a significant poisoning risk to young children. Hospitals are reporting growing numbers of children accidentally swallowing liquid nicotine from e-cigarette refills.

An electronic cigarette (e-cigarette) is a small battery-operated device that can look like a real cigarette. Some look like small flashlights or fountain pens, often with a large clear chamber for storing liquid. Instead of burning tobacco, the e-cigarettes vaporize a so-called e-liquid, which is then inhaled.

E-cigarettes are made of three parts:

• an inhaler cartridge that holds an e-liquid (with or without nicotine, which is the addictive and toxic ingredient found in traditional cigarettes)
• the vaporizer, which heats and turns the liquid into a vapour that is meant to resemble and be inhaled like smoke
• a battery of varying voltage that powers the e-cigarette.

While there are no studies proving the long-term safety of e-cigarettes, many people nevertheless feel they are a healthier alternative to traditional cigarettes. If adults choose to use them there are some safety issues to be aware of, particularly the potential for children to be poisoned and fire risks.

Nicotine poisoning

• children love to watch and copy grown-ups so always keep e-cigarettes out of their reach
• there is a risk of poisoning from e-cigarette nicotine fluid and there have been cases involving children
• after swallowing nicotine fluids, symptoms are usually mild and include nausea and vomiting
• serious poisoning can happen after swallowing larger amounts, especially by small children
• if e-cigarette liquid is swallowed, contact your GP or call NHS 111 – in an emergency dial 999.

E-cigarette chargers

• poorly made or counterfeit chargers for e-cigarettes have caused house fires
• only buy e-cigarettes from reputable outlets, use the correct charger for the device, follow the manufacturer’s instructions and don’t leave an e-cigarette charging unattended or overnight
• as with other electrical devices like mobile phones and laptops, e-cigarettes should not be charged or used if they have been damaged – battery cells that are damaged pose a chemical and fire risk.

Use by under 18’s
The number of children and teens using e-cigarettes is on the rise. E-cigarettes feature ‘cool’ designs and the e-liquids are offered in a variety of candy and fruit flavours.  E-cigarettes are also used and promoted by many celebrities in magazines, movies and music videos.

• the sale of e-cigarettes to under 18’s is banned in the UK
• e-cigarettes are regulated under the Tobacco and Related Products Regulations 2016
• under the regulations, e-cigarette products are either licensed as medicines or, if unlicensed, are subject to new quality and safety standards, packaging and labelling requirements and a ban on print and broadcast advertising.

More resources and information:

• RoSPA has worked with Public Health England, the Child Accident Prevention Trust, London Fire Brigade and the Chief Fire Officers Association to publish advice for parents
  • as well as safety tips the advice includes some health considerations related to vaping at home
  • download the advice from the RoSPA website at www.rospa.com/vaping-in-the-home-advice-for-parents (PDF)
• NHS Smokefree advice can be found on their website at https://www.nhs.uk/e-cigarettes
• Public Health England advice about the use of e-cigarettes in public places and workplaces can be found on the gov.uk website at www.gov.uk
• ASH (Action on Smoking and Health)  fact sheet series of detailed referenced information and statistics on a variety of topics can be found on their website at ash.org.uk.

Falls are the most common cause of accidental injury to children:

• each day, around 45 under fives are admitted to hospital after a fall
• falls are one of the most common causes of childhood accidents
  • in 2008/09 over 16,000 under-fives were admitted to hospital after a fall
• falls are also a serious risk for older children
  • each year, around 27,000 children aged 5-14 are admitted to hospital after a fall
• they usually happen at home or in the garden and there is lots adults can do to reduce the risk
• while most falls are not serious – active children often fall over – some falls can lead to death or a long-term disability.

One of the most common reasons that young children fall is that their rapid development takes parents and carers by surprise. A toddler might take their parents by surprise when they climb on something that they had previously been unable to reach.

Whether educating parents or looking to make a nursery, children’s centre or school a safer place for young children, there are lots of things to do to minimise risks.

Simple changes to the environment can stop children from having a serious fall. These include, but are not limited to:

• safety gates and barriers to stop babies and toddlers climbing stairs and falling down them
  • these are also helpful for stopping children (and pets) going into rooms where it is dangerous for them to be, like the kitchen
  • use them until a child reaches two but when they are two or over they may be able to climb over them or open them
• window locks or safety catches to stop a window from opening too wide and a child being able to climb out
  • do not put anything under the window that can be climbed on
  • remember older children will be able to open catches or locks.
  • it is good to keep keys for locks in a place that is easy for adults reach in case there is a fire
• five point harnesses are really important to use in highchairs and pushchairs to stop a child falling out
• anti-slip products such as stickers can be put on the floor or bath; or use a bath mat
• corner protectors to help to protect wobbly babies or toddlers from hurting themselves on sharp furniture if they fall; there are lots of different types available
• nightlights to help make sure children (and adults) don’t trip over or bump into things when they are on the move in the night
• keep toys and clutter off the floor and stairs so there is nothing to trip over
• stairs should be carefully maintained
  • damaged or worn carpet should be repaired or removed
  • make sure balustrades are strong and do not have any footholds for climbing
  • stairs should always be well lit
• furniture and tall kitchen appliances at risk from being pulled over should be secured to the wall.

Most people associate death or severe injury with a fall from a high window, balcony or down stairs.  However, falls from a low height can also be very dangerous if a child lands on a hard surface like concrete or paving slabs. Some changes will reduce the severity of an injury if a child does fall. These include, but are not limited to:

• using impact-absorbent surfaces (such as bark chips) in playgrounds and gardens
• using safety equipment, such as cycle helmets, to reduce the likelihood of a serious head injury.

Teaching children to assess risks for themselves can also help to prevent injury. Helping children to recognise potential dangers in their environment means they start to develop an understanding of how to reduce risk.

More resources and information:

• KidsHealth has information about first aid for falls on their website at kidshealth.org
• NHS has information about preventing falls on their website at www.nhs.uk

Most children who die in a fire do so because they breathe in smoke which poisons them, rather than being burnt by the actual fire.

Fires can start suddenly and spread quickly, damaging the home and furniture and putting lives in danger. They are caused in a variety of ways, but there are a few simple tips to follow to prevent them starting.

• keep all fires and heaters well guarded, especially open fires
  • for fitted or portable heaters with a built in guard, give extra protection by adding a surrounding guard particularly if there are young children or older people in the home
  • for children, use a nursery guard with side clips that fit into fixed wall brackets
  • keep portable heaters and candles away from furniture and curtains; position safely where they cannot be knocked over
• do not dry or air clothes over or near a fire  or cooker
• do not smoke in bed
• many fires start in the kitchen, especially fat fires
  • never leave a pan unattended when deep fat frying and watch for overheating
  • for safer frying use oven chips or a thermostatically controlled deep fat fryer
• if there are children around, keep matches and lighters well out of reach
• fit approved smoke detectors on each floor
  • choose a smoke alarm that is mains operated or one with a long life (ten year) battery
• plan an escape route
  • remember get out, stay out and call the fire brigade out!

Safety is especially important when choosing and using heating products:

• all fuel-burning appliances use up fresh air as they burn and give off waste gases including the deadly carbon monoxide (CO)
  • never block air vents or air-bricks and service appliances annually
• be aware of the symptoms of CO (carbon monoxide) poisoning such as drowsiness and flu like symptoms
• if using a chimney or flue, or bringing one back into use, have it swept at least once a year or more frequently if  burning wood
  • never block an outside grille or rest anything against it
• if a gas flame, which normally burns blue, burns orange this may be due to a built up of carbon monoxide – have the appliance checked immediately
  • check the pilot flame regularly on gas cookers and water heaters to make sure it has not gone out
• when buying gas appliances look for the British Standards safety mark or British Seal of Approval and beware of second hand bargains and cowboy installers
• if you suspect a gas leak, open the windows, turn off the supply and call your gas supplier
  • do not operate switches as a spark could ignite the gas
• always keep a special watch on young children and elderly people when fires and heaters are in use.

Bioethanol and gel fuel burners are becoming increasingly popular and are often used as decorative items and heating sources both indoors and outdoors. The fuel, which burns with a virtually invisible flame, is mostly produced from sugar plants and is typically used for cooking, water heating and the heating of buildings. It is sold in fire pots for use in fondue sets, small fireplaces and patio torches. The high risk of accidental burns makes them unsuitable for use in the home.

Greater Manchester Fire & Rescue Service have a wealth of fire safety at home advice on their website at www.manchesterfire.gov.uk/keeping-you-safe  including links to advice on:

• Carbon Monoxide and smoke alarms
• celebrating safely – party safety; Chinese/sky lanterns advice
• electrical safety & socket overload calculator – visit the Electrical Safety Council for more information at www.electricalsafetyfirst.org.uk/guidance/safety-around-the-home/
• fire safety at home –  escape plans; safety in the  kitchen & lounge; smoking; candles; electrical equipment; heating & fires; loose clothing; night time routines
• fire safety videos – adverts, cartoons & clips for all ages, covering everything from playing with matches to student safety
• fireworks and explosives – storing and supplying
• high rise task force – fire safety reassurance for residents
• landlord responsibilities
• safe and well visit – free home safety advice for everyone in the Greater Manchester area
• seasonal – barbecues; water; countryside & camping; fireworks & bonfires; winter.

Despite annual safety warnings, firework celebrations still end in painful injuries for too many people, including very young children.

Fireworks can be great fun for families, not just around November 5th (Bonfire Night/Guy Fawkes Night) but also Diwali, New Year’s Eve and Chinese New Year.

Injury figures support the advice that the safest place to enjoy fireworks is at a large public display – far fewer people are injured here than at smaller family or private parties.

If planning a firework party at home, make the occasion fun and safe for everyone by following the Firework Code, as well as some sparkler and bonfire safety tips.

The Firework Code and safety tips for sparklers and bonfires can be found on the RoSPA websites at  www.rospa.com/fireworks-safety  and   www.saferfireworks.com

Locally  firework safety advice  can be found on the GMFRS website at www.manchesterfire.gov.uk/staying-safe/fireworks-and-explosives

Firework Code
Young people should watch and enjoy fireworks at a safe distance and follow the safety rules for using sparklers. Only adults should deal with firework displays and the lighting of fireworks. They should also take care of the safe disposal of fireworks once they have been used.

The UK Government Fireworks Code is available to download in English, Urdu, Hindi, Punjabi, Bengali, Gujarati and Chinese from the archive at webarchive.nationalarchives.gov.uk/file52753 (PDF)

Twelve children under 10 are killed or injured as passengers in cars every day. Car seats prevent deaths and serious injury.

• adult seat belts are not designed for children as they do not sit across the right parts of the body
  • if a child isn’t in the right booster or car seat, they can be injured by the seat belt in a crash
• the law says that children under 3 are not allowed to travel anywhere in a car without an appropriate child restraint – usually a baby or child car seat
• trying to hold a small baby in a car crash at 30mph would be like trying to lift 8 bags of cement at the same time
• all children under 12 years old who are under 135cm in height have to use a child restraint  – it is the law.

General car safety tips

• a child can legally travel in the front of the car but it is always safest for them to travel in the back if possible
• child car and booster seats – for children under 12 years old and less than 135cm tall – must be used on every trip in the car
  • they are known to reduce the numbers of children seriously hurt in car accidents
  • buy new and buy the correct seat for your child’s weight, height
  • if given one by a family member or friend only use it if you are very sure that it has never been in an accident, is complete, fits your car properly and you have the instructions for fitting it
• if a car is reversing in a car park or a driveway the driver may not be able to spot small children if they are below the level visible from their rear or side windows
  • it is safest to hold a child’s hand in car parks just as when crossing the road
• store car keys safely to reduce the risk of a child getting hold of them and starting the car.

More detailed information about car seats and in car safety can be found from the:

• In Car safety centre on their website at incarsafetycentre.co.uk
• RoSPA website at www.rospa.com/in-car-safety
• THINK! campaign website at www.think.gov.uk
• gov.uk website at www.gov.uk/child-car-seats-the-rules

Warning over babies sleeping in car seats
The results of a small study suggest spending long periods of time in a car seat may lead to babies having breathing difficulties. But the researchers pointed out “we cannot be certain of the clinical significance or potential risks”. This novel study used a vehicle simulator to look at the effects of placing a newborn baby in a car seat at the 40⁰ angle required for travelling.

Researchers tested 40 newborns, who were a mix of pre-term and full-term. They found that while sat at this angle for 30 minutes – either stationary or when in motion – the babies’ heart and breathing rate increased and their blood oxygen levels were lower compared with lying flat in a cot.

Dr Renu Arya, consultant paediatrician at Great Western Hospitals NHS Foundation Trust, who led the research project, said “Parents should not stop using car safety seats to transport their infants. Infants must be protected in moving vehicles, and UK law requires car seats be used whenever infants travel in cars.”

It may be a good idea to rethink leaving a baby in a car seat for prolonged periods when they are not travelling. Taking regular breaks when driving long distances is also recommended. As well as giving a baby a chance to move out of their car seat, it will also help keep the driver alert and reduce the risk of accidents. RoSPA recommends taking at least a 15-minute break every two hours.

Find out more on the NHS website at www.nhs.uk/warning-over-babies-sleeping-in-car-seats/

A recent Serious Case Review served as a poignant reminder about safer sleeping arrangements for babies.

Wigan Safeguarding Children Board (WSCB) published a Serious Case Review following a case where a child tragically died at 10 weeks old.  The child died whilst in a car seat and the coroner ruled ‘it was not possible to ascertain the cause of death’.

Dr Paul Kingston, Independent Chair of WSCB, said: “The findings highlight the difficulties faced by families in sustaining safe sleep arrangements, amidst gaps in cohesive professional advice from many sources, not least in relation to sleeping in car carry seats which is not a unique issue to Wigan.”

Read the full report on the WSCB website at www.wiganlscb.com/Professionals/Serious-case-reviews

Some of the most serious accidents happen in the home, particularly in the kitchen. RoSPA has been made aware of cases involving young children who have been injured after biting into or placing liquid laundry capsules in their mouths.  This resulted in the children being admitted to hospital because of the ingestion of liquid detergent from the capsules. In addition to children swallowing detergent, doctors have also raised awareness of the risk of injury to young children who get liquid detergent in their eyes.

Fairy Non Bio have joined forces with RoSPA to reduce the number of incidents involving liquid laundry capsules through safe storage education.  The key phrase for parents and carers to remember when it comes to storage of cleaning products is keep them up, keep them closed, keep them safe.

For more information and resources visit the RoSPA website at www.rospa.com/liquid-laundry-capsules

Why are liquid laundry capsules dangerous?
Liquid laundry detergents in soluble packaging (commonly known ‘liquitabs’ or ‘liquid laundry detergent capsules’) contain concentrated liquid detergent for single use within a soluble package which breaks down upon contact with water during a wash cycle to release the detergent product.

Such liquid laundry detergent products are small and colourful which makes them attractive to young children who may be tempted to put them in their mouth or play with them. When moist, these products can burst in a child’s hand, potentially irritating the eyes and skin. They can also dissolve quickly and may burst in a child’s mouth in a very short period of time (within seconds) causing the contents to escape quickly and if swallowed can cause severe injuries such as breathing difficulties requiring intubation.

The main symptoms and consequences of exposure can be:

• if ingested: severe vomiting, coughing, respiratory disorders, nausea, drowsiness and rash
• in case of contact with the eyes: conjunctivitis, eye pain, eye irritation
• in case of contact with the skin: skin rash, skin irritation, chemical burn.

A significant number of severe incidents of ingestion and eye damage involving infants and young children have been reported by Poison Centres in several EU countries regarding liquid laundry detergent capsules and it is noted that there is a higher accident rate with this type of laundry detergent compared to consumer laundry detergents in other packaging systems.

In response to the incidents reported, the EU Commission in 2014 adopted a new Regulation on additional safety measures for liquid laundry detergents in soluble packaging.

Safe use of laundry liquid capsules
The Health and Safety Authority recommends that:

• all detergent products are stored safely out of the reach and sight of children at all times
• capsules must be kept in their original container and fully closed when not in use
• capsules must never be left outside their original containers
• capsules must never be given to children
• labels on the packaging must be read carefully.

Visit the National Poisons Information Centre website at  www.poisons.ie/Public/Poison-Prevention-Tips for further information on poison prevention.

Nappy sacks are used to dispose of soiled nappies can also pose a risk to babies and young children. RoSPA are aware of at least 17 deaths involving these items, where babies have suffocated after a nappy sack covered their mouth and nose, or have choked after putting a nappy sack in their mouth. This was highlighted in a case in nearby Oldham.

Parents and carers are generally aware of the dangers posed by plastic bags, but may not make the link to nappy sacks posing similar risks. Nappy sacks or bags tend to be fragranced, are made of a much more flimsy material and do not rustle in the same way as plastic bags meaning they can be easily grasped and breathed in by young babies without parents realising.

RoSPA will provide 400 Nappy Sack leaflets (in batches of 100 including a poster) free of charge to children’s service providers; or these can be downloaded from their website at www.rospa.com/nappy-sacks.

In partnership with the British Retail Consortium (BRC), RoSPA has developed guidelines for retailers. The guidelines set out the measures that retailers can take to help reduce the risks associated with using nappy sacks products, including the inclusion of warning labels on packaging to alert parents to their potentially-deadly dangers.

These guidelines can be found on their website at www.rospa.com/nappy-sacks.

Advice for parents
Babies can suffocate on nappy sacks, making some simple changes can make a big difference to your child’s safety.

• Do – always keep nappy sacks and other plastic bags and wrapping away from babies and young children
• Do not place nappy sacks within babies’ reach or in baby’s cot, pram or buggy
• Never give a baby the nappy sack packet to distract or entertain them!

Find out more on the RoSPA website at www.rospa.com/nappy-sacks

Every day, 15 young children are admitted into hospital because it is thought they have swallowed something poisonous.

Adults should be aware that:

• child-resistant tops and strip and blister packs for tablets help to slow children down but they are not childproof
  • some 3-4 year olds can open them in seconds!
• swallowing medicines, like everyday painkillers that you might keep in your handbag or bedside cabinet, is the most common way for children to be poisoned
• vitamins and similar products can be harmful to small children
• the detergent capsules and concentrated liquids under the kitchen sink can harm children too – they can cause accidental poisoning but also squirt into the eyes and cause damage (see above)
  • the capsules may come in boxes that are not child-resistant.

Safety reminders – how to stop children from being poisoned
At around 6 months babies start to put things in their mouths, which means they are at risk of swallowing something harmful:

• the best place to keep medicines and vitamins is locked away and /or up high where a baby can’t come across them
• fit safety catches on any low cupboard doors and drawers
• make sure bottle tops and lids are on properly
• don’t forget the painkillers in bags on the floor, or the ones on the bedside table
• before baby starts to crawl and move around, move all cleaning products from around the toilet, or under the kitchen sink into a high cupboard out of sight
• look out for products that contain a bittering agent like Bitrex – it tastes so horrible that it means that children are much more likely to spit the dangerous chemical out
• remember, the liquid detergent capsules can be dangerous too – if children squeeze or bite them the liquid can squirt out – keep them stored safely away.

Toddlers love to explore and will copy what adults do – this means they are more at risk from poisoning than any other age group:

• keep medicines, vitamins and cleaning things locked up and /or out of reach and sight
  • ideally put them in a high lockable cupboard
• keep them in a room which people use a lot – if a toddler has climbed up on a chair or worktop to explore in cupboards they are more likely to be seen
• ‘child resistant’ caps are not ‘child-proof’ – some 3-4 year olds can open them in seconds, so make sure they are locked away
• toddlers like to copy adults so try to take medicine or vitamins when a toddler isn’t watching
• avoid pretending a child’s medicine or vitamin is a sweet, even if it’s hard to get them to take it, as it can be confusing for a toddler
• when visiting friends or relatives, take a few moments to look out round medicines, vitamins or cleaning products lying around
• even small amounts of alcohol can be harmful to small children, so clear up any glasses with alcohol dregs left in them
• remember to be careful with aromatherapy oils, perfumes and cigarettes as they can all be harmful to small children.

Children between 3 to 5 may know something about what they can safely eat, but they are still at risk from accidental poisoning -they are much more likely to be able to open child-resistant tops too:

• a child may easily be confused by colourful medicines or vitamins that look like sweets, so keep them locked safely away and in the original bottles
• do the same with cleaning products, DIY or garden chemicals, whether they are kept in the house, garage or garden shed
• plants in the garden can be confusing too – teach children not to eat anything they pick outside as poisonous berries can easily look like the ones they are given in meals.

What to look out for
Most poisoning injuries involve medicines, household products and cosmetics – the most commonly swallowed harmful substances are:

• Calpol or Nurofen – do not be fooled by ‘child resistant’ tops, many 3 or 4 year olds are capable of opening them
• painkillers, blood pressure tablets or prescription medicines belonging to parents or grandparents
• Karvol or other decongestant medicines
• household cleaning products, brightly coloured liquid tablets for washing machines and dishwashers, toilet blocks
• weedkillers, turps
• room fragrances, cigarettes and cosmetics.

Safety checks
Walk around the home looking at it from a child’s perspective (and height) to see what substances are within reach:

• keep anything that may be poisonous out of reach, preferably in a locked cupboard – this includes all medicines and pills, household cleaners and garden products
• keep cleaning products like bleach or toilet cleaner locked away, do not leave them in the bathroom
• use containers with child-resistant tops – but be aware that by three years of age, many children are able to open child-resistant tops, although it may take them a little longer
• keep all dangerous chemicals in their original containers – for example, do not store weedkiller in an old drinks bottle because a young child may mistake it for something safe to drink
• dispose of unwanted medicines – take them to a local chemist who can dispose of them safely
• dispose of unwanted chemicals carefully and correctly – visit the website www.gardenhealth.com/how-to-dispose-of-garden-chemicals-safely for information.

In the garden and outside:

• some common garden plants have parts such as seedpods, berries and leaves that are poisonous and can be fatal
  • this includes ‘ordinary’ plants like Cherry Laurel (often used as a hedge), Laburnum trees (bright yellow hanging flowers in spring), foxgloves, lilies and many more
• wild mushrooms and fungi should never be eaten – many are poisonous and look very similar to edible fungi
• teach children not to eat any part of any plant or fungi when outside
• check the Royal Horticultural Society’s poisonous plants list on their website at www.rhs.org.uk/advice
• keep garages and garden sheds locked and weed killer, slug killer, pesticides and other chemicals out of reach.

Carbon Monoxide

• you cannot see, smell or taste it but, if but if carbon monoxide creeps out from flame burning appliances it can kill children in seconds
• make sure that you have an audible carbon monoxide alarm fitted in your home – ideally one in every room with a fuel-burning appliance.

Across the UK speeding on the roads is a major problem. Speeding puts everyone in the community at risk of serious injury but the dangers are particularly acute for children, whose lack of awareness and smaller size leaves them vulnerable to fast moving traffic.

Find out more about road safety in our road safety resource.

Safety equipment can help to create a safer environment for children but it does not replace the need for supervision, especially with younger children.

• accidents are one of the biggest single killers of children in the UK -more children die every year because of accidents than illnesses such as meningitis and leukemia
• nearly half of all children who are taken to hospital after an accident, had their accident at home
• some safety equipment has been proven to save lives and reduce serious injury – this includes things like child car seats, smoke alarms and cycle helmets.

Falls

• safety gates and barriers stop babies and toddlers climbing stairs and falling down them
  • hey are also very helpful for stopping children (and pets)going into rooms where it is dangerous for them to be, like the kitchen
  • use them until a child reaches two but, when they are two or over they may be able to climb over them or open them
• window locks or safety catches can stop a window from opening too wide and a child being able to climb out
  • remember older children will be able to open catches or locks
  • it is good to keep keys for locks in a place that is easy for adults reach in case there is a fire
• five point harnesses are really important to use in highchairs and pushchairs to stop a child falling out
• impact absorbing surfaces can help protect children from being seriously hurt in a fall from play equipment
• anti-slip products such as stickers that can be put on the floor or bath, or use a bath mat
• corner protectors can help to protect wobbly babies or toddlers from hurting themselves on sharp furniture if they fall; there are lots of different types available
• nightlights can help make sure children (and adults) do not trip over or bump into things when they are on the move in the night.

Fire safety

• smoke alarms – having a working smoke alarm on each level of the home doubles the chances of getting everyone out alive if a fire starts at night – they should be checked every week to make sure they are working
• fire guards – needed for any open fire or any heater that gets really hot, to stop a child from falling into it or touching hot surfaces or flames
  • sturdy guards are best so they do not move if a child falls on or pushes it
  • fireguards need to be securely attached to the wall
• fire extinguishers – if there is a fire, get everyone out and then call 999
  • fire and rescue services do not recommend using fire extinguishers if you are not trained to use them.

Hot water safety

• thermostatic mixing valves help lower the temperature of the water that comes through the hot tap; this means it is not so hot that it could burn a child immediately
  • always check the temperature of the water first before putting a child in the bath
  • put the cold water in first
• curly or short cords for kettles are advised
  • these cannot trail over the edge of worktops where they could be pulled by small children.

Glass safety

• safety glass -it is a Building Regulations requirement for all low level glass to be safety glass and glass in new furniture will almost always be safety glass
  • if replacing any low level glass make sure it is replaced with safety glass
• safety film helps to toughen glass and stop it from splintering if it’s broken; it can be put on existing glass.

Poisons

• safety locks or catches are ideal for doors, cupboards, fridges and dishwashers; they can stop little fingers getting into medicines, cleaning products and chemicals; they also make storing matches and lighters safer
• child-resistant containers on medicines, vitamins and cleaning products; remember that they slow young children down but may not stop them completely from getting into things
• bittering agents in products such as household cleaners make them taste so horrible they prevent children from swallowing them.

Other barriers

• playpens are useful for keeping young children in one place and out of harm’s way
• door slam protectors help to stop little fingers from getting trapped
  • there are different types – some fit the latch side, some the hinge side and some are for sliding doors.

Out and about

• child car and booster seats – must be used on every trip in the car for children under 12 years old and less than 135cm tall
  • they are known to reduce the numbers of children seriously hurt in car accidents
  • buy new and buy the correct seat for your child’s weight, height
  • if given one by a family member or friend only use it if you are sure that it has never been in an accident, is complete, fits your car properly and you have the fitting instructions with it
• cycle helmets reduce the number of children’s head injuries by up to 85%
  • it is good for a child to use one every time, and no matter where, they cycle
• child-resistant gate latches are really important for stopping children getting out of the garden or play area onto roads or into next door’s pond.

Some accidents seem very unlikely – most people don’t think it is possible for their child to strangle themselves. But there are a growing number of cases of children catching themselves on blind cords or other loops, often when they are climbing. If a child gets tangled in one of these cords it could be fatal.

Babies and small children reach and grab for things that catch their eye, and this includes strings, ribbons and cords. They also get tangled in cords when climbing. In 2010 alone, at least four young children were strangled by blind cords.

Children strangle by getting tangled in cords and strings that their parents didn’t realise were dangerous. A parent might not know, for instance, putting a dummy on a ribbon around a baby’s neck, can result in strangulation. Young children have also been strangled after getting their neck caught in the loop of a blind cord or blind chain.

Whether educating parents or making a children’s centre, nursery or school a safer place for young children, there are a number of things to do to minimise risks:

• keep dangling cords and looped objects out of reach so small children can’t grab or play with the strings
  • these objects can include drawstring bags, ribbons and cords
• tie blind cords up well out of young children’s reach, for example round a cleat hook
  • bear in mind that as children develop they can climb on furniture and other objects and might reach higher than you think
• move cots, beds, highchairs and playpens away from looped blind cords and chains
  • if there’s space, try to move other furniture away from blind cords too, as young children love to climb.

When looking to buy new blinds look for those with no cords at all or with concealed cords. More information is available from the:

• Child Accident Prevention Trust  on their website at www.capt.org.uk/strangulation
• British Blind and Shutter Association on the Make It Safe campaign website at www.makeitsafe.org.uk where you can find safety videos and other resources.

Most children’s toys are actually very safe. Accidents involving toys usually happen when a young child plays with a toy that is meant for an older child, or when someone trips over toys that have been left out.

• most toys in the UK are safe if you follow the instructions. T
  • the law says all toys must have a suggested age range, so they aren’t given to children too young to play with them
• one of the main causes of toy accidents is toys with small parts
  • if a baby is given a toy designed for an older child they can break it and end up swallowing small pieces.

Find out more on the CAPT website at www.capt.org.uk/talking-about-toys-and-accidents including information about:

• which toys to buy
• which toys are suitable for the age of a child
• how to keep a child’s toys safe.

A garden trampoline is great fun for both children and adults and is a great way to keep active.

The main concern for parents and carers is trampoline safety, so it is important to follow a few safety guidelines.

Key safety points:

• trampolining is no’t suitable for children under the age of six because they are not sufficiently physically developed to control their bouncing
• trampolining injuries can occur to all parts of the body, including the neck, arms, legs face and head
  • head and neck injuries are the most serious injuries associated with trampolines
  • the most common injuries are caused by awkward landings and include sprains or fractures to the wrist, forearm, elbow and collarbone
• adult supervision is no guarantee of safety – more than half of all trampoline accidents occur whilst under supervision – a trained ‘spotter’ can greatly reduce this risk
• never combine alcohol with trampolining  – children have been hurt while bouncing with adults who have been drinking at summer garden parties
• whatever your ability level, join a local trampolining club to learn new trampolining skills, ranging from the basics of landing safely to advanced moves such as somersaults.

Find out more from:

• RoSPA on their website at www.rospa.com/trampoline
• NI Direct on their website at www.nidirect.gov.uk/trampoline-safety