Childhood injury prevention and anticipatory guidance — formative SAQs

SAQ 1 (10 marks)

Parents of a newly walking 14-month-old attend for a well visit. The home has stairs, an openable first-floor window with a flyscreen, cleaning products under the sink, and loose button batteries from a TV remote. [1]

1. Explain why “accident” is a poor framing for this consultation. (2) [2]
2. List six high-yield hazards for this developmental stage. (3) [1]
3. For stairs, poisons and windows, give one passive and one active strategy each. (3) [3] [6]
4. State how you will close the visit to confirm understanding. (2) [1]

Model answer

1. Injury is preventable energy transfer in a host–agent–environment system. “Accident” implies fate and weakens prevention. [2]
2. Stairs/falls, windows/balconies, poisons/medicines, button batteries, scalds/hot drinks, choking on foods/small objects (also water access). [1] [4] [5]
3. Stairs: gate (passive) + supervise on stairs (active). Poisons: locked storage/child-resistant packaging (passive) + never call medicine “lollies” (active). Windows: locks/guards and furniture away from sills (passive) + never rely on flyscreens (active). [3] [6] [7]
4. Rank three actions for tonight and use teach-back; document barriers (cost, landlord, second home). [1]

SAQ 2 (10 marks)

A 2-year-old is brought after a sibling’s remote lost a button battery. The child is drooling and refusing food. Separately, the examiner asks about scald first aid myths. [5]

1. What is the immediate management priority for possible battery ingestion, and why? (3) [5]
2. What prevention steps follow once the child is safe? (3) [5]
3. Name correct first-aid teaching for a hot-drink scald and two harmful myths to avoid. (2) [8]
4. When would an injury history shift you from pure prevention counselling to safeguarding? (2) [1]

Model answer

1. Treat as time-critical emergency evaluation for possible oesophageal battery; injury can progress rapidly. Do not delay for routine counselling or non-essential tests. [5]
2. Secure battery compartments, remove loose cells, lock storage, house sweep of devices, counsel all caregivers/homes. [5]
3. Cool with cool running water; avoid ice, butter, toothpaste. [8]
4. Developmental mismatch, inconsistent history, injuries of different ages without explanation, delayed care without credible reason. Continue hazard control while activating pathways. [1]