Accidents waiting to happen: A review of unintentional household injuries in children

Generally, boys have a higher rate of unintentional household injury compared with girls, and although the leading cause of unintentional household injuries differs by age, most occur in children 5 years and younger. Based on consistent evidence from observational studies as well as consensus (evidence quality B), effective strategies for drowning prevention include 4- sided pool fencing, using protective flotation devices (eg, life jackets), developing water competency through swimming lessons when age and developmentally appropriate, and attentive supervision including lifeguards. (7)(10)(12)(13)(14) Based on some evidence from observational studies as well as consensus (evidence quality C), the highestrisk groups for unintentional suffocation in infants younger than 1 year include those that bring an infant into an adult bed to sleep, use soft bedding, and place the infant in a prone position. The tenants of Safe to Sleep should be promoted. (19)(22)(23) Based on expert opinion (evidence quality D), safe storage practices for all hazardous household products include keeping products in their original containers, secured in a locked, inaccessible storage area, with the lid properly placed for closure. (27)(28) Based on consistent evidence from observational studies (evidence quality B), children younger than 5 years are at higher risk for burns because they are at a developmental stage characterized by sensorimotor exploration with less capacity to understand potential hazards. (36)(38)(39)(41)(42)(43) Based on expert opinion (evidence quality D), for burns that result in blistering (which implies partial-thickness tissue injury), do not apply ointment but cool with tepid water and then seek medical care. Based on some evidence from observational studies as well as consensus (evidence quality C), principles of safe gun storage include keeping the gun unloaded in a locked space and storing the ammunition in a locked space separate from the gun. (50)(51)(54) Based on strong research evidence (evidence quality A), office-based counseling is effective in preventing injuries caused by firearms. (55) Based on some evidence from observational studies (evidence quality B), infants and children have the highest rate of injuries caused by falls. (58) Based on some evidence from observational studies (evidence quality C), office-based counseling is effective in promoting the use of safety gates and furniture corner covers with the goal of decreasing the rates of injuries due to falls among children in the home.