A 2-year-old boy is brought to the office by his parents for a well-child check. This is the child's first appointment since the family purchased a new house, and the parents want guidance on how to best child-proof the home. They moved into a single-story house built in 1985 in a quiet neighborhood. Outside, there is an in-ground pool in the backyard and a private well used for drinking water. The father is a police officer and keeps his handgun unloaded and inside a safe in the home office. There is an electric water heater, central air conditioning, and grounded electrical outlets throughout the home. Which of the following is the best recommendation to provide safety for their child?

Question

A 2-year-old boy is brought to the office by his parents for a well-child check.  This is the child's first appointment since the family purchased a new house, and the parents want guidance on how to best child-proof the home.  They moved into a single-story house built in 1985 in a quiet neighborhood.  Outside, there is an in-ground pool in the backyard and a private well used for drinking water.  The father is a police officer and keeps his handgun unloaded and inside a safe in the home office.  There is an electric water heater, central air conditioning, and grounded electrical outlets throughout the home.  Which of the following is the best recommendation to provide safety for their child?

Quizplus · Accepted Answer

11ec25c8_d705_051a_bc81_5d2fd1a6c649_MD0003_00 Drowning is the number one cause of injury-related death in children age 1-4, and most cases involve home swimming pools. Anticipatory guidance for water safety should be addressed at every well-child visit. A fence is the most effective way to prevent drowning in a swimming pool by blocking unanticipated access. The fence should be ≥4 ft in height, surround all 4 sides of the pool, and separate the pool from the yard and house. A child should not be able to fit through the slats or climb the fence. Access to the pool should be through a self-closing gate that opens away from the pool and has a self-closing latch too high for a child to reach. The gate should be locked when the pool is not in use. Gate alarms, pool alarms (which detect water movement), and pool covers may also be used but not as a substitute for a fence. Children can drown by slipping under a pool cover or in water that has collected on top. During any water activity (eg, pool, bath), a reliable supervising adult should be present and paying constant attention to children in water. Other safety measures include swim lessons for children age ≥1, CPR training for parents, and life jackets (not "floaties" that may provide a false sense of security). Parents should also ensure that safety measures are in place if visiting family or friends with pools. (Choice B) Power outlets should be covered or blocked but do not need to be removed. (Choice C) Lead-based paint was banned for use in houses in 1978; therefore, this house built in 1985 does not need to be repainted with lead-free paint. (Choice D) To prevent scalding injuries, the water heater temperature should be set to a maximum of 49 C (120 F). (Choice E) Safe storage of a handgun includes keeping the gun unloaded and locked, with ammunition stored separately. (Choice F) Well water may not contain adequate fluoride but is safe for drinking. Fluoride supplementation may be advised, but bottled water is unnecessary and typically lacks fluoride. Educational objective: The most effective way to prevent children from drowning in swimming pools is to install a 4-sided fence around the pool with a self-closing gate and latch. A reliable supervising adult should be present and paying constant attention to children during any water activity. References: Drowning prevention in pediatrics. (http://www.ncbi.nlm.nih.gov/pubmed/29538784)

A 2-Year-Old Boy Is Brought to the Office by His