U.S. Department of Health and Human Services
Indian Health Service: The Federal Health Program for American Indians and Alaska Natives
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IHS Head Start Program
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Providers - Injury Prevention

C. Everett Koop, the former Surgeon General of the United States, once noted, "If a disease were killing our children in the proportions that injuries are, people would be outraged and demand that this killer be stopped."

Many of us assume that most injuries are random events. But the conditions that lead to so-called accidents can be avoided. When parents and caregivers are armed with caution and the proper information, most injuries can be avoided in the first place. It is clearly tragic that injuries are the leading cause of death for American Indians and Alaska Natives (AI/ANs) between the ages of one and 44. According to the Centers for Disease Control and Prevention (CDC), this group has a death rate from injury that is three times higher than the rest of the US population.

Furthermore, the CDC reports that car crashes are the leading cause of fatal accidental injury for AI/AN individuals. Other fatal injuries are caused by poisoning, drowning, falls, burns and suffocation. Many dangers threaten the health and the lives of AI/AN children and families. What are the answers to the safety risks that now cause hundreds of thousands of hospital visits and deaths every year?

These answers start with finding danger spots and taking steps to reduce safety risks. Families and communities need to know how to stay safe and healthy at home, at school, at work and on the road. Car seats, smoke alarms, baby- and child-proofing of homes, playground safety, CPR training, swimming pool and water safety, and helmets are all vital aspects of injury prevention promoted by the Indian Health Service (IHS) Head Start Program.

A word about Car Seat Safety

To ensure that your children are safe while riding in vehicles, always ensure that they are seated and properly strapped into their car safety seat. Each year thousands of young children are killed or injured in car crashes. Proper use of car safety seats helps keep children safe. But with so many different car safety seats on the market, it's no wonder many parents find this overwhelming. A few general rules to follow are:
  • Always install child safety seats according to the manufacturer's guidelines.
  • Infants must always ride in the back seat in rear-facing car safety seats until they are 1 year of age and weigh at least 20 pounds.
  • Children 1 year of age and at least 20 pounds can ride in forward-facing car safety seats in the back seat.
  • Children should ride in safety seats with a harness as long as possible, and then they should ride in belt-positioning booster seats until the age of at least 8 years.

A Word about Home Fire Safety

To ensure the safety of children in a home, parents and caregivers must install and maintain working smoke alarms, safely store lighters and matches out of children's reach and sight, and practicing a fire escape plan with small children.
  • When fire breaks out, you have only seconds to escape its powerful heat, blinding smoke and deadly gases.
  • Families can dramatically increase their chances of surviving a fire simply by installing and maintaining working smoke alarms.
  • Install and maintain smoke alarms on every level of your home and outside of sleeping areas.
  • Test your smoke alarms monthly and replace the batteries at least once a year.
  • If you keep the door of your baby's bedroom closed, keep a working smoke alarm in the room and use a baby monitor so you can hear when the alarm sounds.

A Word about Playground Safety

We must continuously ask ourselves, "What more can we do to reduce playground-related injuries at our Head Start centers?" Playground inspections should be completed annually on each playground at Head Start centers. This annual inspection identifies any hazards that may exist with the equipment, the surface material and the area surrounding the playground. According to the Consumer Product Safety Commission, over 150,000 children are admitted to emergency rooms every year for playground-related injuries. How many of these injuries could have been avoided? The answer to that question may never be known, but we do know that if we complete simple daily inspections, playground hazards can be identified and corrected prior to our Head Start children using the playground equipment.
  • To assist the Head Start staff, and to facilitate compliance with the Head Start Performance Standards, specifically 45 CFR 1304.53(a)(10)(viii), all Head Start programs should read and adhere to the Public Playground Safety Handbook issued by the US Consumer Product Safety Commission.
  • Environmental health specialists must use the Public Playground Safety Handbook as their guidance document during inspections.
  • The IHS Head Start Program has developed a Daily Playground Inspection Form. This Daily Playground Inspection Form simply assists Head Start staff in identifying hazards that may arise due to vandalism, age of playground and ancillary equipment, weather, unauthorized playground access, etc.
  • As a reminder, the Administration for Children and Families released a Standards for Playground Use Zone Safety (Log No. ACF-PI-HS-07-02) that states, "…For those jurisdictions not already covered by State, Tribal, or local law, beginning in January 2008 we will monitor compliance against the minimum standards for playground surfaces specified in the Handbook for Playground Safety," which is now titled Public Playground Safety Handbook. This document can be found and downloaded from the Consumer Product Safety Commission's Web site Exit Disclaimer – You Are Leaving www.ihs.gov .

Head Start Playground Safety Resource:

Playground Safety Link:

A Word about Water Safety

Drowning is the second leading cause of accidental death among children ages 1 to 14. Children can drown in a variety of circumstances - during water recreation (such as swimming and boating) or when a young child is left unsupervised for even seconds in the bathtub or around the home with access to pools and hot tubs.
  • Do not leave children unattended in the bathtub.
  • Do not leave children unattended in a swimming pool or lake.
  • All children should wear a personal flotation device (life jackets) when swimming in a pool or in a lake.
  • All children should wear life jackets when boating.

Water Safety Link:

What can you do in your center to promote injury prevention?

  • Encourage all parents to use age- and size-appropriate car seats while transporting their child.
  • Ensure that children are transported in school buses or allowable alternate vehicles with height-and weight-appropriate child-restraint systems and a reverse beeper.
  • Provide developmentally appropriate training for parents and children in pedestrian safety.

General Injury Prevention Links:

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