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TRANSCRIPT
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http://www.who.int/entity/violence_injury_prevention/child/injury/world_report/What_you_can_do_english.pdf
http://www.cdc.gov/SafeChild/Fact_Sheets/Overview-Fact-Sheet-a.pdf
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http://www.who.int/entity/violence_injury_prevention/child/injury/world_report/What_you_can_do_english.pdf
http://www.cdc.gov/SafeChild/Fact_Sheets/Overview-Fact-Sheet-a.pdf
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http://www.who.int/entity/violence_injury_prevention/child/injury/world_report/What_you_can_do_english.pdf
http://www.cdc.gov/SafeChild/Fact_Sheets/Overview-Fact-Sheet-a.pdf
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65 artigos / 1964 a 1991
18/20 artigos: Efeito positivo da orientação preventiva
5 estudos randomizados/controlados:
10 estudos controlados/não randomizados:
3 estudos descritivos ou série múltipla:
Aconselhamento para prevenção de injúrias em cuidados primários: Uma revisão crítica da literatura
Bass J, Christoffel K, Widome M, Boyle W, Scheidt P, Stanwick R, Roberts K
Pediatrics 1993;92:544-50
2 com aumento do uso de assento infantil de segurança
6 com aumento do uso de assento infantil/cinto de segurança
2 com intervenção comunitária e diminuição de injúrias
1 com intervenção comunitária e diminuição de injúrias
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103 estudos / 1966 a 1998
22 estudos randomizados e controlados
Estratégias de prevenção de injúrias físicas no nível individual e no âmbito clínico
DiGuiseppi C, Roberts I
The Future of Children 2000;10:53-82
Orientação no âmbito clínico é efetiva na adoção de práticas de segurança: Uso de assento infantil de segurança
Instalação de alarme de incêndio
Ajuste da temperatura da água para níveis seguros
Não foi demonstrada efetividade na redução do número de injúrias físicas.
Unintentional Injuries in Children http://www.futureofchildren.org
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42 artigos / 1995 a 1999
1 artigo: Acalmação do tráfego
2/5 artigos: Melhora na segurança de pedestres!
10 artigos: Capacete para ciclistas
5 artigos: Intervenção comunitária não específica (?)
Atualização das evidências: Uma revisão sistemática do que funciona na prevenção de injúrias físicas não intencionais em crianças
Towner E, Dowswell T, Jarvis S
Injury Prevention 2001;7:161-4(Pt 1) e 2001;7:249-53 (Pt2)
2 artigos: Legislação sobre assentos de segurança
11 artigos: Segurança no lar (detectores de fumaça, uso de dispositivos de segurança, envenenamentos)
3 artigos: Mídia ConhecimentoInjury Prevention http://ip.bmjjournals.com/
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18 estudos publicados até 2004 (atualização 2006)
5 estudos em casas com crianças
Modificação do ambiente do lar para a redução de injúrias
Lyons RA, John A, Brophy S, Jones SJ, Johansen A, Kemp A, Lannon S, Patterson J, Rolfe B, Sander LV, Weightman A
Cochrane Database of Systematic Reviews 2003, Issue 4.
Um estudo relatou a redução de injúrias e perigos, mas os achados não puderam ser vinculados.
Nenhum dos outros estudos focados em crianças demonstrou redução de injúrias que pudesse ser atribuída à adaptação ambiental no lar.
http://www.cochrane.org/reviews/en/ab003600.html
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80 estudos (62% ERC / 32% metanálise)
Educação foi efetiva em aumentar a proporção de famílias com termostatos em faixa segura (OR 1,35 - 95%CI 1,01-1,80), alarmes de fumaça funcionantes (OR 1,85 - 95%CI 1,24-2,75), armazenamento seguro de medicamentos (OR 1,58 - 95%CI 1,18-
2,13) e produtos de limpeza (OR 1,63 - 95%CI 1,22-2,17), xarope de ipeca (OR 3,34 - 95%CI 1,50-7,44) e telefone do centro de controle de intoxicações acessíveis (OR 3,66 - 95%CI 1,84-7,27), portões nas escadas (1,26 - 95%CI 1,05-1,51), tomadas elétricas cobertas (OR 3,73 - 95%CI 1,48-9,39) e objetos cortantes fora de alcance (OR 1,52 - 95%CI 1,01-2.29).
Educação para a segurança do lar e fornecimento de equipamentos de segurança para a prevenção de injúrias Kendrick D, Coupland C, Mulvaney C, Simpson J,
Smith SJ, Sutton A, Watson M, Woods A
Cochrane Database of Systematic Reviews 2007, Issue 1.
http://www.cochrane.org/reviews/en/ab005014.html
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Cadeia de Sobrevivência Pediátrica
2005 American Heart Association (AHA) Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care of Pediatric and Neonatal Patients: Pediatric Basic Life Support. Pediatrics 2006;117;989-1004
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Newborn Visit
Bright Futures GuidelinesBright Futures GuidelinesPriorities and Screening TablesPriorities and Screening Tables
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World reporton
child injury prevention
An overview
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Goals of the report:
• Raise awareness
• Present what is known about
effectiveness of interventions
• Make recommendations
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The evidence base
• Simply reproducing safe strategies that are relevant to adults will not protect children sufficiently.
• Prevention programmes that take into account the vulnerability of children.
• Prevention programmes should be multi-disciplinary.• The most successful have been those that combine:
– Legislation, regulation and enforcement; – Product modification; – Environmental modification; – Education and skill development; and – Appropriate emergency medical care.
• The World Report grades interventions as: effective, promising, insufficient evidence, ineffective or harmful.
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Key approaches to addressing child injuries
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Road traffic injuries: What works?
• Minimum drinking-age laws.• Lower BAC limits for novice drivers and zero tolerance.• Graduated driver licensing systems.• Helmets. • Seat-belts, child-restraints.• Speed reduction. • Separating road users. • Daytime running lights.
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Drowning: What works?
• Removing (or covering) water hazards.
• Requiring isolation fencing (four-sided) around swimming pools.
• Wearing personal flotation devices.
• Ensuring immediate resuscitation.
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Burns: What works?
• Setting (and enforcing) laws on smoke alarms.
• Developing and implementing a standard for child-resistant lighters.
• Setting (and enforcing) laws on hot tap water temperature, and educating the public.
• Treating patients at a dedicated burns centre.
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Falls: What works?
• Redesigning nursery furniture and other products.
• Establishing playground standards for the depth of appropriate surface material, height of equipment and maintenance.
• Legislating for window guards.• Implementing multifaceted
community programmes such as ‘Children can't fly’.
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Poisoning: What works?
• Removing the toxic agent.• Legislating for (and enforcing)
child-resistant packaging of medicines and poisons.
• Packaging drugs in non-lethal quantities.
• Establishing poison control centres.
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Overall recommendations1. Integrate child injury into a comprehensive approach
to child health and development.
2. Develop and implement a child injury prevention policy and a plan of action.
3. Implement specific actions to prevent and control child injuries.
4. Strengthen health systems to address child injuries.
5. Enhance the quality and quantity of data for child injury prevention.
6. Define priorities for research.
7. Raise awareness of and target investments towards child injury prevention.
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Orientação preventiva dos pais
Usar preferentemente material impresso.
Iniciar o mais precocemente possível!
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Orientação preventiva dos pais
Usar preferentemente material impresso.
Ensinar regras básicas de segurança.
Iniciar o mais precocemente possível!
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Orientação preventiva dos pais
Usar preferentemente material impresso.
Instruir sobre revista da casa sob a ótica preventiva.
Ensinar regras básicas de segurança.
Iniciar o mais precocemente possível!
Telefones de emergência!
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• Serviço de assistência médica de urgência
• Pediatra
• Dentista
• Centro de informação toxicológica
• Vizinho
• Telefone da própria casa
0800-721-30000800-721-3000
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Orientação preventiva dos pais
Usar preferentemente material impresso.
Instruir sobre revista da casa sob a ótica preventiva.
Ensinar regras básicas de segurança.
Iniciar o mais precocemente possível!
Telefones de emergência!
Doses de reforço periódicas.
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