MAJOR CHANGES IN HEALTH AND SAFETY PRACTICE SINCE THE RELEASE OF CARING FOR OUR CHILDREN, 2ND EDITION IN JANUARY 2002
The National Resource Center for Health and Safety in Child Care, in coordination with its partners American Academy of Pediatrics, the American Public Health Association and the Maternal and Child Health Bureau will post major changes in health practices, since the release of CFOC, 2nd Ed. and Stepping Stones, 2nd Ed., supported by current, authoritative research that greatly effects the health and safety of children in out-of-home child care. Each entry will have date of posting, subject/issue area, supporting research and links to the Standards that were affected by the change in health practice. Please check this site periodically for updated information.
| Posting Date | Issue | Brief Description | Supporting Documentation/ Resources |
Standards Affected |
| 3/18/04 | Syrup of Ipecac | Syrup of Ipecac shall not be used to induce vomiting and shall not be included in first aid kits or available at a child care program. | American Academy of Pediatrics Policy
Statement http://aappolicy.aappublications.org/ cgi/reprint/pediatrics;112/5/1182 archives/novpoison.htm |
3.050
Syrup of Ipecac 5.093 First Aid Kits 8.047 Preadmission Information Appendix U – Poisonous Plants and Safe Plants Glossary – Syrup of Ipecac |
| 3/18/04 | Influenza Immunizations | Influenza immunizations are recommended for healthy children between 6 and 24 months of age, for household contacts and out-of-home caregivers of all children younger than 24 months of age, and for health care professionals. | American Academy of Pediatrics Policy Statement http://aappolicy.aappublications.org/ cgi/reprint/pediatrics;113/5/1441.pdf influenzafinal.pdf |
Child Care Providers 1.045 Pre-employment… 3.007 Immunization of Child Care Providers Appendix E – Child Care Staff Health Assessment Children |
| 3/16/06 | CPR Training (Cardio-Pulmonary-Resuscitation) |
The American Heart Association's 2005 national guidelines recommends a significant change to the ratio of chest compressions to rescue breaths - from 15 compressions for every two rescue breaths in the 2000 guidelines to 30 compressions for every two rescue breaths in the 2005 guidelines. The 30-to-two ratio is the same for adults, children and infants (excluding newborns) for a single rescuer. Child care providers should anticipate this change in the next training they receive.
Also, CPR is recommended for unresponsive individuals of all ages, even though in most cases, infants and children suffer from a respiratory problem which can lead to death.. (In adults, CPR is more likely to be needed because ofa sudden cardiac arrest). Rationale The consensus of national experts is that instructions for layperson CPR must be simplified. Studies of the performance of laypersons after CPR training show that many are unable to recall and perform just-learned skills. The most likely use of CPR is in situations where an unresponsive adult has a problem with heart beat. When the heart is not beating properly, the most effective remedy is to push oxygenated blood through the heart to bring oxygen to the blood vessels that supply the heart and brain, and to apply an Automated External Defibrillator (AED) to attempt to correct the heart beat problem. Therefore, new recommendations that apply to all age groups are for 30 chest compressions between two breaths. This approach in an infant or child who may have a heart beat is unlikely to affect heart function. |
The American Heart Association 2005 Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care http://www.americanheart.org/presenter.jhtml?identifier=3035517 2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Comparison chart of key changes http://www.americanheart.org/downloadable/heart/ 1132781451610Comparison%20Chart%202005 %20guidelines%20FINAL.pdf |
1.014 General Qualifications of Directors 1.017 Qualifications of Education Coordinators, Lead Teachers, and Teachers 1.019 General Qualifications of Family Child Care Caregivers 1.026 First Aid Training for Staff 1.027 Topics Covered in First Aid Training 1.028 CPR Training for Swimming and Wading 1.030 Continuing Education for Small Family Child Care Home Providers 1.039 Orientation for Substitutes for Small Family Child Care Homes 2.029 Competence And Training Of Transportation Staff |
| 2/1/07 | Safety Helmets | All children shall wear approved safety helmets while riding tricycles, bicycles, and other riding toys. Approved helmets shall meet the mandatory standards of the U.S. Consumer Product Safety Commission (CPSC). Rationale: Injuries occur when riding tricycles, bicycles and other riding toys. Helmet use is associated with a reduction in the risk of any head injury by 69%, brain injury by 65%, and severe brain injuries by 74%, and recommended for all ages (1). Previous standard language (Standard 5.242) recommended helmets for all riding vehicles with a wheel-base of more than 20 inches. There is no research to suggest helmets should not be worn on smaller vehicles. CPSC issued a mandatory safety standard for bicycle helmets in 1999 (2). All helmets manufactured or imported for sale in the United States must comply with the standard. |
(1) Thompson DC, Rivara FP, Thompson RS. Effectiveness of bicycle safety helmets in preventing head injuries. A case-control study. JAMA. 1996; 276:1968–1973. (2) Safety Standard for Bicycle Helmets. 63 Federal Register 11711-11747 (1998) (codified at 16CFR 1203) http://www.cpsc.gov/BUSINFO/frnotices/fr98/10mr98r.pdf American Academy of Pediatrics Policy Statement http://aappolicy.aappublications.org/cgi/reprint/pediatrics;108/4/1030.pdf Consumer Product Safety Commission http://www.cpsc.gov/cpscpub/pubs/bike.html |
5.242 Safety Helmets |