Falls: 3 - 4 years

Falls

 

How big a problem is it?

Slips and falls are a normal part of child development, as children are constantly running around and playing. Children are naturally inquisitive and like to jump around and climb various structures. While some falls may not be serious, many more are, resulting in broken bones, cuts or head injuries. Around nine children aged 3 - 4 years are hospitalised each week for a fall-related injury. Falls-related injuries are the number one cause of hospitalisation for babies and young children of this age. Falls from climbing on furniture, tumbling from an open window, and playing at the playground are just some of the main causes.


Who does it affect?

Children aged 0-4 are most at risk of falls in and around the home and from playground equipment. It is important to take precautions such as stair guards and window latches at home and make good choices regarding playgrounds and equipment. Children aged 3-4 years require constant supervision because they have not yet developed the ability to judge risk.


Top Tips

The severity of a fall injury depends on the height a child falls, if they hit anything on the way and what they land on. A fall heigh from as little as 90cm is a risk, so managing height risk, household objects and the quality of any fall cushioning are all key.

 

At home

  • Use approved safety gates at the tops and bottoms of stairs and attach them to the wall if possible.

  • Properly install window guards to prevent window falls. Windows above the first floor should have an emergency release device in case of fire.

  • Bunk beds encourage climbing so they should only be used by children over nine years of age. Make sure there are guardrails on the top bunk and that the opening for entering and exiting is no more than 40cm wide.

  • Take a look around your house and move any objects and furniture away from windows that could be used by children to stand or climb on.

  • Keep young kids strapped in when using high chairs, infant car seats, shopping trolleys, swings and strollers. Remember, if your toddler is in a car seat, place it on the floor, rather than on a table or other furniture.

  • Wet floors are very slippery so can be a slipping hazard for children. Wipe up spills immediately and encourage children to sit when eating and drinking to reduce spills.

At play

  • Talk to your children about how to be safe on a trampoline. We suggest the rule is ‘one at a time’ and that’s because there is a lot of evidence associating multiple users with accidents. One at a time also removes others that your child could potentially collide with. Children under six years can run into trouble on a trampoline so it’s best to find another activity to keep them entertained.

  • Find playgrounds with shock-absorbing surfaces. Playgrounds with loose-fill materials such as wood chips, mulch, rubber or sand should have a minimum depth of 30cm.

  • Steer your children to age-appropriate activities to help prevent falls from play equipment. At best the height of equipment should be 1.5m. This reduces the risk of head injury.

  • High porches, decks, stairs and balconies all have a high fall risk, so try and find alternative play areas for your children. If that’s not possible, make sure you keep an eye on them at all times.

  • Ensure your child is wearing a helmet when riding a bike, scooter or a skateboard to protect their head from a serious injury if they fall.


First Aid

If your child has had a fall they may have bone fracture or a serious head injury. If they are in pain or for any of the following reasons, call 111 immediately. Do this if your child:

  • is, or has been, unconscious (can’t be woken up)

  • is being sick or seems sleepy

  • has trouble breathing

  • bleeding and you can’t stop the bleeding

  • is bleeding from an ear.

 

There are also some things you can do straight away:

Fractures First Aid

  • Keep the injured arm or leg still. Someone who knows how to might use a splint to keep it still.

  • You can support the injured arm or leg with a pillow or sling.

  • Raise the arm or leg higher than the heart to help reduce swelling.

  • Your child will need pain relief.

  • If your child does not need an ambulance take them to the nearest hospital Emergency Department

First Aid if your child is unconscious
Follow Drs ABCD for start CPR

D Dangers? Check for any dangers to yourself such as electricity or traffic.
R Responsive? Check responsiveness by calling loudly and shaking the child's arm.
S Send for help. Dial 111 and confirm an ambulance is on its way. Use the appropriate emergency number in other countries.
A Airway. Open the airway by moving the head into a neutral position and lifting the chin. Do not tilt the head back too far.
B Breathing. Look and feel for movement of the lower chest and stomach area. Listen and feel for air coming from the nose or mouth.
C CPR. If the child is not breathing, start CPR - 30 compressions to 2 breaths. Put the child on a firm surface. Place 2 fingers of one hand (for a baby) or the heel of one hand (for a child) in the centre of the chest just below the nipples. Push down hard and fast 30 times in about 15 seconds (push down one-third of chest depth).
Once you have completed 30 compressions (pushes) on the chest, breathe into the baby's mouth 2 times. Seal your lips around the baby's mouth and nose. For a child over 1, you may need to breathe into their mouth and pinch their nose closed. Gently puff into the child until you see their chest rise.
Continue with the cycle of 30 chest compressions and 2 breaths until the ambulance arrives.
D Defibrillator. Attach defibrillator as soon as it is available and follow prompts.

If the fall is not serious, place an icepack on any bumps or bruises and give some pain relief. Let them rest for a few hours. Watch your child closely for the next 24 hours and if you notice anything unusual seek medical care immediately. For example, if they are very sleepy, complain of pain in other places, can’t focus their eyes or if they are not walking properly.


Link to Safekids resources

Falls Injury Prevention Resources

Safekids International TV

Ministry of Education information on Playgrounds and Equipment

CDC - Falls, Playground Safety

Safekids Worldwide - Playground Safety