ACCIDENTS: CAUSE AND PREVENTION
INTRODUCTION
An accident or mishap is an unforeseen and unplanned circumstance, often occurring with lack
of intention or necessity. It usually implies a generally negative outcome which may have been
avoided or prevented, had circumstances leading to the accident been recognized. Every year one
million children under the age of 18 years are taken to accident and emergency units after being
involved in accidents at home. Many of the accidents that happen in and around the home can be
avoided by identifying and understanding potential accident risk in home.
DEFINITION
According to WHO, “An accident is an event, independent of human will caused by an outside
force acting rapidly and resulting in physical or mental injury”.
COMMON ACCIDENTAL INJURY IN DIFFERENT AGE GROUPS
Infant: Falls, burns, cuts and injury, suffocation, foreign body (aspiration, ingestion, in the ear,
nose, etc.)
Toddler and pre-schoolers: Fall, burns, cuts and injuries, ingestion and aspiration foreign bodies,
drowning and near drowning, poisoning, electrocution, suffocation and strangulation, bites and
stings, vehicle or road traffic accidents, sport injury, etc.
School- age children and adolescents: Sports injury, falls, electrical or instrumental injury, road-
traffic accidents, bites and stings, drowning, etc.
MAJOR TYPES OF ACCIDENTS
Accidents can be classified, according to the required health intervention into five
categories:
1. Accidents requiring medical interventions: Drowning, burns (especially in homes), falls,
cuts and wounds, agro-industrial injuries, animal bites (dogs, snakes), poisoning
(insecticides, rodenticides, kerosene oil, drugs, acids, etc.)
2. Accidents requiring surgical interventions or observations: Head injuries, burns, soft
tissue injury (faciomaxillary injuries) fractures, trauma to abdominal organs, etc.
3. Accidents involving eyes: Bow and arrow play, gulli-danda play, fireworks, stone
throwing, broom stick injury, sharp edge toys, balls, shuttle cocks, fist fighting, fall from
height, knife or scissors or needle injury, chemical or thermal injury.
4. Accidents involving ENTL: Foreign bodies, roadside accidents, corrosive poisoning (K,
oil), sudden exposure to noise causing sudden deafness, physical injuries (slap),
mechanical injuries with sharp objects, strangulation from cloths being entangled in
rotary machines, and automobiles, kite- flying causing laryngotracheal cut, loss of pinna,
etc.
5. Road traffic accidents (RTA): Careless road crossing, reversing car, playing in streets
with vehicular traffic, allowing children to stand in a car or to sit in a driver’s lap.
FACTORS AFFECTING ACCIDENTS
Age: Accidents are more common between 2-10 years of age.
Sex: Boys between 10-14 years of age are more prone to accidents.
Personality: Bright and alert children are more prone to accidents because they are eager to do
new activities.
Ordinal position: Elder and younger children are more protected but middle ones are
neglected, so they are more prone to accidents.
Time of day: Most accidents occur in afternoon.
Weather condition: Accidents occur more in rainy season.
Place: Accidents may occur in home or on road side.
CAUSES OF ACCIDENTS
The important causes of accidents among children are as follows:
i. Curiosity among children
ii. Lack of supervision, especially at home
iii. Lack of play grounds and over crowded streets.
iv. Impulses of the moment, e.g. boys want to show off their bravery so they often indulge in
risky acts.
v. Lack of past experience.
vi. Inability to judge danger.
COMMON CHILDHOOD ACCIDENTS
Following are the most common childhood accidents:
1. Fall: From furniture, stairs, unguarded windows, terrace, etc.
2. Burn: Children may get burnt from heating appliances like stoves, irons, heaters, etc. They
may get burnt from;
a. Open fire: Fireplaces, matches, lighters.
b. Hot liquids: Bathwater, cooking fluid, tea, coffee, etc.
c. Electric circuit: Defective wiring, unguarded outlets.
d. Strong acids and alkali’s: ammonia, hydrochloric acid.
3. Fracture and dislocation
4. Sprain
5. Cut and abrasions: Knife, scissors, large needles, broken glass, tools, etc.
1. Animal bites
2. Poisoning: Drugs (like aspirin, sedatives, antihypertensives, tranquilizers) insecticides,
cleaning agents, kerosene, etc.
3. Drowning: In bath tub, sink, wells, swimming pool, ponds, ditches, rivers, etc.
4. Motor vehicle accidents: Both as passengers and as pedestrians’ children may get injured.
5. Foreign bodies: Nuts especially peanuts, dried beans, pins, nails, screws, bolts, beads, etc.
6. Suffocation: Plastic bags, discarded refrigerators, etc.
7. Crush injuries: From wringers.
EFFECTS OF ACCIDENTS
1. Physical damage: Even a minor accident can cause cut, fracture, scar, sprain, dislocation,
etc.
2. Psychological damage: The child thinks that people will feel that he is naughty and
careless if had too many bandages on body. He thinks himself a ‘wounded hero’.
PREVENTION OF ACCIDENTS AND SAFETY PRECAUTIONS
Prevention of accidents requires three things
Forethought
Time
Discipline
1. Forethought
The anticipation of possible risk of accidents to the child.
2. Time
Needed sufficiently to supervise and watch the child and his activities
3. Discipline
Need to be well balanced to prevent the accidental hazards.
Parents play a major role in prevention of accidents and safety precautions. Family members also
need to contribute to follow the safety measures to prevent these hazards. In hospital, nursing
personnel are responsible to maintain safety precautions to prevent accidents.
Safety precautions according to various age groups are as follows:
1. FOR INFANTS:
Never leave an infant alone on cot or table or in unprotected place to prevent fall.
Never give very small things to the child.
Toys should not have removable small parts which can be aspirated or put into the ear or
nose.
Never feed solids which are difficult to chew, e.g. ground nut.
Coins, buttons, beads, marbles must not be left within child’s reach.
Never leave the infant near water tub or pond and never allow to go out alone.
2. FOR TODDLERS AND PRESCHOOLERS:
Never use negative statement for any activities, i.e. ‘don’t do that’, ‘don’t go there’, etc.
Give proper directions for activity.
Provide constant supervision.
Protect stairs by gate and keep doors closed.
Keep harmful substances like hot things, drugs, poisons, kerosene oil, electrical appliances,
sharp objects, etc. out of child’s reach.
Give adequate instructions to the caretaker to look after the child and to follow the
precautions.
Provide safe play materials and toys.
Floor should not be slippery.
Furniture should be placed firmly to prevent fall and the child should not be allowed to
climb over it.
The child must not be allowed to wear inflammable synthetic materials which may catch
fire easily.
Mother should not hold the baby in lap when drinking tea or coffee or during cooking.
Children should not be allowed to play with cord, plastic bags or pillow which may cause
suffocation.
Batteries of the torch must not be left free to avoid risk or lead poisoning.
Children must not be allowed to stand in car when in motion.
Electric switch should be out of child’s reach.
FOR SCHOOL CHILDREN AND ADOLSCENTS:
Teach safety precautions with fire, fireworks, match box, electricity, sharp instruments etc.
The child should be taught swimming as soon as he or she is old enough.
Encourage playing in safe places and supervise game whenever needed to prevent sorts injury.
Discourage the children from kite flying from rooftops and playing door banging games and
from closing the doors with a lot of force.
Children must not be allowed to play on streets, they should be taught about road safety, use of
zebra crossing and cautions in bicycles or tricycles riding.
Never left the child alone in the car unless it has been ensured that the keys are not ‘in’.
NURSING RESPONSIBILITIES IN PREVENTION OF ACCIDENTS
Health education is considered as vaccination for prevention of accidents. The significant
role of nursing personnel is to improve the level of knowledge and awareness about the
safety precautions. Parents should be taught to anticipate the risk to maintain discipline
and to provide time to supervise children. Anticipatory guidance should be provided to
the parents, family members, school teacher, grown up children and general public about
prevention of accidents.
Provision of safe environment to eliminate or reduce the hazardous conditions for the
children. It should be arranged at home, school, community and hospitals.
Safe child care should be organized and provided to prevent accidental hazards. Assessment of
child’s characteristics for accidental liability is important. Parents should be involved in safety
programme of child care. Elimination of causative factors need to be emphasized though health
education.
Assisting in medical care to prevent disabilities and handicapped condition is an important
responsibility of the nurse.
Emergency care at comprehensive trauma care unit improves the survival rate. Rehabilitation
facilities should be organized with necessary referral.
Public health measures regarding prevention of accidents should be implemented. Traffic
rules, restriction of speed, use of helmets, avoidance of alcohol while driving, regular
checking of vehicles, etc. must be strictly enforced.
Nurse should make the people aware about the strict implementation of rules.
Participate in policy making and research activities related to accidents prevention and
changing of behaviour for controlling accidents.
