HOW TO SAVE YOUR CHILD’S LIFE
Accident is a greater child killer than any disease yet many parents don’t seem to realize that the modern home is almost as dangerous as a battlefield
THE COUNTRY’S biggest killer and crippler of children is no longer a disease with a Latin name—the word is accident. Every year accidents, most of them in the home, kill about fifteen hundred Canadian children and damage, sometimes for life, nearly a quarter of a million others. Usually the tragedy is a common one—struck by a car or train, trapped in a burning house or drowned but often the children die from ordinary household hazards which many parents seem to overlook, like the hot water pouring into a bathtub, an open electric outlet or a bottle of cleaning fluid.
This year about 450 children will die under cars or trains; 280 will be drowned, an astonishing number of these in the months outside the swimming season; 145 will perish in burning homes; 110 will die as a result of burns or scalds; 110 will choke to death on something solid they swallowed; 80 will die of falls; 50 will die of eating or drinking something poisonous; 30 will be claimed by the careless use of guns and five will be electrocuted. Another 250 or so will die of deaths so bizarre they cannot be classified, like the seven-year-old girl who was twirling in a swing, got her neck caught between the twisting ropes and silently strangled.
Accidents take twice as many lives of children over one year as the second biggest single killer, tuberculosis, which accounts for 638 child deaths a year. Other big killers are the respiratory diseases, such as pneumonia, which combined kill a total of 751 children, and the diseases of the digestive tract such as diarrhea and enteritis which combined kill 780 children annually.
Once a baby reaches his first birthday— a period which still claims about fifteen thousand infants every year chances are nearly certain that he will live to go to high school, barring accidents. At the turn of the century one fifth of the babies died before they were old enough for school. Medical research has in fifteen years reduced deaths among infants forty-four percent. A statistic untouched by this life-giving progress is the one covering deaths due to accidents. In the past twenty years in Canada accidental deaths have increased approximately fifty percent.
Deaths by vehicular accidents and in burning buildings have more than doubled in this period, canceling out the lives saved by improved methods of treating burns and poisons. No remedy can ever be found for a body smashed by a truck or blackened by fire. Pediatricians and safety authorities, alarmed by this waste of our young, are working together toward the only cure: prevention.
The two greatest dangers for children are traffic and train accidents and drownings and these two categories have certain qualities in common. Both types of accidents are concentrated on school children in the age groups from five to fourteen and surveys have shown that a particular type of child is most often involved. The child generally is a boy—boys are hurt or killed accidentally four times more often than girls and the kind of boy who is aggressive and proud of his daring. He’s the first boy out on the thin ice on the pond and the last to leave a street game of hockey when a car comes. He is concerned about being the leader of the gang and maintains his prestige by showing off. Psychiatrists are interested in this boy because he often lacks the element most necessary to a child—the sense of being important to his parents. He is substituting being important outside his home and, in some of his deeds, there is even a suicidal tinge, a feeling of “If you don’t love me I’ll make you sorry.”
Not every child struck by a car or drowned in a river answers this description, naturally. Many of the victims are normal levelheaded youngsters caught by a whim of fate as they hurry along the road at dusk to finish their paper routes or lose their balance while fishing off a lonely pier.
Safety authorities are still working out methods of saving such children. Swimming lessons can be given earlier than most people suspect: two and three-year-olds have become proficient swimmers. Most cities provide supervision for children crossing the street on their way to and from schools. Ottawa has had marvelous results with training senior students to help at intersections and lecturing about forty thousand children on safety rules. Such precautions have saved many lives—during school hours. When the safety patrolman has gone away the child is on his own.
The main hope for the reduction of traffic accidents appears to be discipline. A joint convention of safety authorities and pediatricians in Chicago recently observed that a well-disciplined child, thoroughly familiar with traffic and water hazards before he is permitted to wander the streets, is not often involved in accidents.
Falls and crushings also kill more
Continued on page 35
Continued from page 22
school-age children than toddlers and do an incalculable amount of damage to spines, arms and legs. Young boys climb trees as naturally as monkeys and even a fall from a low branch can be fatal. A ten-year-old boy once fell out of a small fruit tree, landed awkwardly on his head and shoulder and broke his neck.
An eight-year-old boy who fell off a roof while pursuing pigeons provided Sick Children’s Hospital in Toronto with a scene its doctors will never forgée. The boy had compound fractures of his left arm, jagged edges of the slender bone had slashed through the flesh and were showing. The boy was taken to the operating room and there his shirt was unbuttoned. Five pigeons promptly flew out and the staff spent a half hour rounding them up and putting them under a box. An interne who came along later innocently picked up the box and the farce had to be repeated. The stalking of the pigeons was hilarious but the doctor who put the boy’s arm together again recalls that the arm was ruined beyond repair.
Babies suffer a great many falls as well but rarely suffer damage because they fall relaxed and their bones are soft. Babies have died, however, as a result of falling only seventeen inches off a bed and these deaths can often be prevented if the mother can recognize soon enough that her baby has fractured his skull or suffered a brain hemorrhage. The signs to watch for are drowsiness, bleeding from the ears, irritability, vomiting, paralysis, twitching or convulsions. An older child who has hit his head might complain of headaches or that he can’t see properly. Often a fractured skull can be felt; in an older child it is an actual break in the skull and in the baby it is a dimple that doctors call a pingpong fracture because the bone can be popped back into shape like the dent in a ping-pong ball.
Doctors warn against trying to straighten an arm or leg that is obviously broken, or else the jagged ends of the bone will cut through nerves and tissue and greatly complicate recovery. The procedure, if a fracture is even suspected, is to slip a board or a slat under the broken arm or leg and, keeping the limb in the same position, bind it to the board with bandages. The child can then be removed to the hospital for X-rays.
Never move a child if he has hurt his back. Permanent paralysis may result from moving an injured spine. Leave the child until an ambulance can be brought, keeping him warm to protect him from shock. It is not advisable to lift his head to put a pillow under it.
The other major kill er in the accident field is fire and here matches are the chief danger. Matches have a fascination for children that parental warnings can never entirely dissipate. The obvious solution is that matches should never be within a child’s reach. Public opinion is so strong on this subject that manslaughter charges have been laid against parents whose children, left alone in
the home, have burned to death through playing with matches.
Coal-oil lamps and overheated stoves cause a high proportion of the fires that kill children, but electric irons, an unsuspected menace, can be equally dangerous in the hands of a little girl pressing her doll’s clothes—with her mother next door chatting to a neighbor.
The bulk of the deaths due to burns, poisonings and suffocation occur to pre-school children and it is estimated the mother is responsible for these accidents more than eighty percent of the time.
“Accident prevention in childhood begins with one-hundred-percent protection,’’ Dr. Harry Dietrich, of the Los Angeles Children’s Hospital, once said in a speech on accident prevention. “The infant under one year of age, who is not adroit at dodging, is completely at the mercy of its custodians ... In the span from one to five the completely protected, wholly dependent one-year-old must be transformed into the safely independent school child whose vulnerability to accident has not been increased by too much protection. It is apparent that this period is marked by bravely decreasing protection and dramatically increasing education.”
Dietrich believes that split lips, technicolor bruises, chipped teeth, bloody scalps and even simple fractures must be expected by parents and their value appreciated. “Lessons learned in pain are not soon forgotten,” he adds.
Absolute protection, however, must be maintained against lethal and crippling hazards in which the modern home abounds. Small children are scalded to death in reaching up to the handle of the boiling potato pot on the stove. Water at a temperature of one hundred and forty degrees is sufficient to burn a child severely and many children have been scalded to death by the water in their bathtubs. Early this spring a child was fighting for his life in Toronto’s Sick Children’s Hospital because he fell in the pan of water his mother was using to scrub the floor. Every spring and fall hospitals all over the country admit toddlers whose buttocks have been burned when they squatted in the water their mothers were using in the semiannual house cleaning.
A burn of this type is an agony for the youngster. The burned area is red and often blisters and new skin must be grafted in a series of operations before he is well again. A badly burned area turns dead white, because the blood is cut off. and the child is grey and sweating. Children rarely survive burns this serious.
The emergency treatment for burns is to cover the burned area with a clean cloth or bandage and rush the child to hospital. If this isn’t possible it is important to keep air away from the burn by placing the injured part in water at body temperature with a bit of salt added. The soaking will also minimize the pain. The burn can be dressed with bandages which are kept moist with vaseline or a saline solution of a dessertspoon of salt to a quart of sterile water. Air is definitely harmful to a burn.
A twoor three-year-old, alert and full of confidence that nothing will hurt him, must be protected from his own curiosity. He is anxious to test every object in his mouth and the consequences may be fatal. In the case of solid objects, such as detached parts of toys, marbles, pebbles, buttons, coins, pins, bits of glass, fragments of bone, nails and toy knives and forks, the child may choke while the object is in his throat and it may then enter his windpipe and cut off his breathing. If the child swallows the
object safely, however, there is rarely any further difficulty. Open safety pins usually have to be removed by surgery but most other objects wend their way through the intestinal tract, causing colicky pains en route, and reappear in from a day to two weeks. One child had a closed safety pin in her intestines for eight months without harmful effect.
Poisons are numerous in the average household. The following are all poisonous to children: household bleach,
lye, ammonia, copperand silver-cleaning fluids, dry-cleaning fluid, iodine,
cathartics, sedatives, kerosene, rubbing alcohol, paint remover, lead, DDT and other insecticides, moth balls and camphorated oil, some antiperspirants, nail-polish remover, roach or rat poisons, shoe polish, most crayons, apple, peach, plum and cherry seeds and carbon monoxide.
The chief point to remember when a child has swallowed a poison is to determine the type of poison. In getting the child to tin* doctor, take the label of the poison. Many children die or are damaged by poisons whil the doctor guesses at the antidote.
The best emergency treatment for most poisons except for kerosene or caustic-alkali poisons which can do as much damage coming up as they did going down — is to make the child vomit. This can be done either by putting a finger down the back of his throat or by making him drink an emetic of one tablespoon of mustard or two tablespoons of salt in warm water. Kerosene and caustic alkalis are both dangerous poisons and the child must be rushed to hospital immediately. An interim treatment for kerosene can be mineral or olive oil.
For the alkali administer lemon or grapefruit juice followed by milk and egg white.
Poisons are in sixth place among the accidental causes of death in children, but doctors feel that since they are always preventable they shouldn’t be on the list at all. Authorities like Dr. C. Collins-Williams, a Toronto pediatrician who has studied the problem of accidents and written several articles on the subject, feel that medicine cabinets should be kept locked or else all medicines should be kept out of reach even of a child standing on a chair.
Of the one hundred and forty-one poisoned children admitted to the Hospital for Sick Children over a five-year period (during which nine hundred were treated in out-patient clinics) forty - seven had swallowed medicines prescribed for other members of the family, such as atropine, codeine, Nembutal, Aspirin, phénobarbital, belladonna, laxatives, stilbestrol and Amytal. Incredibly enough sometimes these medicines were administered by the parents themselves, confusing them with the child’s medicine.
Mothers are also warned never to leave their children alone when the elect ric wringer is in operation. Mangled hands and arms from wringer accidents are common and though they are rarely fatal (once a three - year - old whose sweater caught in the wringer was strangled) they are a horrible crippler. The Sick Children’s Hospital sees sixty to sixty-five of these victims every year, the skin stripped off their arms like a glove. Older type wringers with no give can churn away the nerves and tissues in a child’s armpit, ruining the arm forever.
Extra Careful With Guns
It’s a wise precaution to check the wiring in a home when the baby starts to creep. Ragged electric cords can cause burns or death if the baby’s damp fist happens to close on a vulnerable spot. Since small children are apt to poke pins in electric outlets, all empty sockets should be taped over or provided with dummy plugs. Dr. Collins-Williams also warns against the habit of disconnecting an electric iron at the end of the cord next to the iron, leaving the other end plugged into the wall socket. Many children have put the plugs into their mouths and the current has burned off their lips.
If an electric shock has caused the child to stop breathing, artificial respiration should be begun immediately and kept up until the child starts to breathe again or for at least four hours.
About thirty children die every year through the careless use of guns. Sometimes a child will pick up a gun, innocently aim it at a brother or sister and pull the trigger. If it is necessary to have a gun in the home where there are children it should be kept in a locked cupboard, even when it is unloaded.
The uncanny timing of some fatal accidents, like the boy in Victoria who was cycling along the street and was killed by a falling telephone pole, or the boy in Ottawa who was caught by a train on a trestle bridge only seconds from safety, defies understanding. The difference between a normal incident in home life and a nightmarish catastrophe is so intangible that parents often gamble it will never happen - that Jeannie will never fall into the water-filled drainage ditch, that baby won’t strangle on the loose screw nail in his crib, that Janet won’t fall down the cellar stairs.
They can gamble, but they’re gambling their children’s lives. ★