First Aid

Preventing Falls

The importance of fall safety:

More than 2 million emergency rooms visit each year are related to childhood falls, while more than 400,000 adults ages 65 and over sustained injuries in a fall in 1997. Most falls are not age-related and can often be prevented, however, age does tend to play a role in the type of fall. For instance, infants are more likely to fall from furniture, while older adults tend to fall more often due to tripping. Consider the following facts:

Falls are also the most common cause of injury visits to the emergency department for young children and older adults.
Falls are responsible for more open wounds, fractures, and brain injuries than any other cause of injury.
In the United States, one out of every three adults over age 65 falls each year, and falls are the leading cause of injury deaths among persons in this age group. Because most persons also lose bone density as they age, the risk of suffering broken bones from fall-induced injuries becomes an even greater concern.

Reducing the risk of falling:

As a person ages, the risk of falling becomes greater with changes in vision and balance, coupled with other medical and physical conditions contributing to the increased risk. Certain safeguards should be taken to minimize the risk of falling, including the following:

Have your vision and hearing checked regularly.
Know the side effects of medications that could lead to loss of balance and coordination.
Limit the amount of alcohol you drink.
Wear rubber-soled and low-heeled shoes that fit properly and support your feet. Avoid wearing loose-fitting slippers that could cause you to trip.
Be careful on wet or icy sidewalks.
Exercise regularly to maintain bone strength and flexibility.

Helping older adults to prevent falls:

About 75 percent of all falls occur at home. Taking certain precautions and exercising to stay physically strong can prevent many falls. Precautions to take in the home include the following:

Remove small rugs or use double-sided tape under small rugs to prevent slipping.
Remove things that a person can trip over from walking areas.
Keep the temperature in the home at a comfortable level to avoid becoming too dizzy from the extreme cold or heat.
Keep frequently used items in reach, without needing a step stool.
Install handle bars next to toilets and bathtubs or showers.
Use non-slip mats in bathtubs and showers.
Improve the lighting in the home.
Remove electrical cords from the floor in walking areas.
Install handrails and lights on all staircases.

Helping children to prevent falls:

Consider the following safety measures to reduce your child's risk of falling:

furniture

Babies who are left unsupervised on top of beds, changing tables, and even couches, can roll off unexpectedly.
Never leave babies alone on any furniture - beds, tables, sofas, cribs with the guardrails down, or changing tables - even if they have never rolled over.
Choose baby products that meet required safety standards.
Utilize all safety straps and features.
Look for special safety features on high chairs, cribs, and other equipment.
Install padding on sharp corners.

windows
Young children are naturally curious and will explore an open window. Windows that are open just five inches pose a danger to children under the age of 10. Falls from windows tend to be the most severe and/or fatal. In addition, even a closed window can be dangerous if the child can get near it - falling through glass can cause serious and often fatal injuries.

To prevent falls from windows:

Install window guards on all windows above the first floor.
If you must open windows for ventilation, make sure your child cannot reach the open window.
Set rules with your child about playing near windows.
Remove furniture near windows that children can climb on.
Do not rely on insect screens to keep children from falling out of windows.

stairs
Infants and toddlers do not realize the danger of falling down stairs. In addition, older children who are running up and down the stairs can trip and injure themselves. Clutter on stairs poses an increased risk of falling. Use safety gates to prevent infants and toddlers from falling down stairs. Do not use accordion gates with large openings, as children can get trapped.

floor surfaces
Area rugs that are not secure, especially on bare floors, can cause a child to fall. Mats that are not slip-resistant and tubs without slip-resistant stickers can increase the risk of falling. Modify slippery surfaces and remove hazards on floors wherever possible. Secure area rugs with foam carpet backing, double-sided tape, or a rubber pad.

playgrounds
Although playgrounds can provide children with exercise and an enjoyment of the outdoors, they also pose safety hazards. Faulty playground equipment, not using proper equipment for different sporting activities, and careless behavior leads to nearly 20 child fatalities ages 14 and under each year.

To prevent playground falls:

Adults should always supervise children during trips to the playground.
Make sure playground equipment is age-appropriate. Most equipment manufactured today is made for two age groups: children from 2 to 5 years old, and children from 5 to 12 years old. Since 1994, manufacturers are required to have a sticker placed on each piece of equipment indicating the appropriate age group it is designed for.
Play areas for younger children should be separate from those of older children. To reduce the risk of injury, children under the age of 5 should not play on equipment taller than four feet. Equipment for 5- to 12-year-olds should not be taller than eight feet.
Surfaces under playground equipment should be soft enough to absorb falls. Recommended surfaces include wood chips or mulch, sand, pea gravel, rubber, and rubber-like materials that are maintained at a depth of 12 inches. Other safe alternatives include rubber mats, synthetic turf, or other artificial materials. Concrete, grass, blacktop, and packed surfaces are considered unsafe.
Surface materials should cover fall zone surrounding equipment. This usually requires a minimum of six feet in all directions from the equipment.
Playground equipment should be adequately spaced apart from one another to prevent overcrowding.
Swings, seesaws, and other equipment with moving parts should be located in areas that are separate from the rest of the playground in order to prevent children from having to cross directly in front of or behind swings to reach them.
Make sure equipment has been specifically designed for playground use.

A warning about baby walkers:

Baby walkers have killed more than 34 children since 1974. In 1998 alone, more than 12,800 children were treated for baby-walker related injuries. Consider these statistics:

Baby walkers cause more injuries than any other nursery product.
Most children that sustain injuries from baby walkers are between the ages of 5 and 15 months.
Most baby walker-related injuries are caused by falls down stairs (76 percent) or tipping over (12 percent).

In addition to increasing the risk of falls down stairs, baby walkers give small children access to hot substances on tables and stoves, as well as poisonous substances. Based on these alarming statistics, the American Academy of Pediatrics (AAP) and the National Association for Children's Hospitals and Related Institutions (NACHRI) have called for a ban of baby walkers.

Alternatives to baby walkers that are more safe include the following:

stationary "walkers," which allow the child to rotate and bounce
play pens
high chairs

Consult with your child's physician for more information.

This page was last updated on: January 25, 2008.

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