SAFE-T from Babe to Sage: Injury Related Anticipatory Guidance

Across the Age Continuum

SAFE-T / Pediatric / Geriatric
Infant / Toddler - Preschool / School-Age / Teen / Trigger Conditions / Prevention
(watch) / ·  Wander / Roll, reach, cruise / Child Proof home / Supervise play / Know where the teen is;
know the friends / Dementia / Door locks/ door alarms
Safe return bracelet;
Radio Transmitter;
Wander guard/alarm system
Silver Alert
·  Alternate caregivers / Safe, nurturing daycare / Safe, nurturing daycare / Safe, nurturing daycare / Appropriate supervision / Dementia & cognitive impairment, caregiver requiring conditions
Abuse / Child help Child Abuse hotline: 1-800-4-A-CHILD (422-4453)
National Suicide Prevention hotline: 1-800-273-TALK (8255) / Administration on Aging's National Center for Elder Abuse Help Hotline: 1-800-677-1116
·  Emotional/Mental / Read to your baby / Read to your toddler / Support reading;
healthy relationships; personal safety / HEADSS screening / Behavioral problems,
cognitive impairment,
depression, social isolation/poor network, caregiver burden, poverty / Exercise; Socialize;
Assess Alcohol: CAGE
·  Neglect – of others / self / Limit screen time to <2 hours per day / Limit screen time to <2 hours per day / Limit screen time to <2 hours per day / Assess Nutrition;
Screen IS PATH WARM[1]
·  Physical / Bruising not normal until infant cruises / Avoid corporal punishment / Discipline- avoid harsh and physical punishment; teach about bullying / Teach about dating violence; expect respect / Assess Predictors = social isolate; finances; past hx;
·  Sexual / Proper names for body parts;
teach about privacy / No bad secrets; tell if someone tries to touch inappropriately / Teach healthy relationships; caution about dating violence / Condoms 1:10 HIV > 50;
Rx impact
(Steer Clear) / Avoid open windows and screens on upper floors / Ask if Fallen < 1 year!
Check Vitamin D Deficiency
·  Cords / Infants reach & wiggle;
protect against falls / Cords out of reach / Avoid tangled cords / Avoid tangled cords / Dementia, stoke Parkinsons/movement d/o; arthritis, vision d/o, / Remove from walking path; Secure dangling cords
·  Lighting / Use lighted ways when carrying baby / Night lights / Night lights / Vision impairment / Nightlights;
Prevent Glare via indirect lights;
window tx
·  Rugs/Carpet / Watch for changes in height/slipperiness when carrying baby / Change in height/texture of floors can cause falls / No wheeled devices indoors / No wheeled devices indoors / PD/mvt d/o, stroke,
vision d/o / Remove; secure to floor:
double stick tape;
anti skid pad;
·  Stairs/Bathroom / No walkers; Protect from falls; keep toilet seats down / Baby gates; Keep toilet seats down / Avoid playing on banisters / PD/mvt d/o, stroke, cardiopulm dz,
arthritis / 1 ½” Round & elbow height; extend beyond stairs; Grab bars for toilet; tub; shower
SAFE-T / Pediatric / Geriatric
Infant / Toddler - Preschool / School-Age / Teen / Trigger Conditions / Prevention
(BeWARE GASP) / ·  Burns / Grab at 3 months; never carry with a hot liquid;
hot H2O heater 120° / Don’t carry child while carrying hot liquid / Supervise cooking and microwave use / Kitchen safety / Dementia, neuropathy, functional impairment, stroke, caregiver / H20 < 120 or low setting;
D/C Therapy heating device
Cooking: Use timer; short/sleeved shirt/tight clothing; D/C on O2 or sedatives; No Halogen Bulbs;
·  Water/drowning / Never leave alone in water / Pool risk; bucket risk; never alone around water / Swimming lessons; water safety; avoid fast moving water;
life jacket; don’t swim alone / Never swim alone; avoid diving into unknown waters / Dementia, functional impairment, stroke, caregiver / Supervise; grab bars; flotation vest
·  Alarms/Detectors / Smoke and CO alarms / Smoke and CO alarms / Smoke and CO alarms / Smoke and CO alarms / Dementia, Sensory impairment, caregiver / Multi-modal alarm warning
(e.g., alarm; flashing light)
·  Rx – Medications / Check with Dr. before using / Use child-proof containers / Use child-proof containers / Avoid Rx for other youth / Dementia, vision impairment, arthritis, polypharma, caregiver / Pillbox; Vibrate/Loud reminder alarms;
Wrist Alarm
·  Emergency Plan / Have a home emergency plan / Have a home emergency plan / Have a home emergency plan and practice it / Have a home emergency plan and practice it / Cog impairment, terminal conditions, caregiver / Lifeline or equivalent;
Phone: enlarged buttons, amplified, visual ringer
·  Guns / Avoid, but if present: unloaded, locked; ammo locked separately / Avoid, but if present: unloaded, locked; ammo locked separately / Avoid; gun safety if guns in home; safe storage / Cognitive impairment, depression, vision impairment, caregiver / Remove Firearm from Home/Residence
·  Asphyxia/choking / Keep small objects away / Small objects & food are a choking hazard / Plastic bags / Avoid choking game / Cog impairment, depression, Parkinsons/movement d/o, stroke, swallowing d/o, polypharma, O2 use / Multi-modal Smoke & CO Detectors; Assess chewing & swallowing: Dry mouth; dentures; Gingival disease;
·  Sleep / Back to sleep in a sleep space designed for infants; start sleep routine / Crib; transition to toddler bed 2-3 y/o or when climbing out / Ensure adequate sleep; regular bed time / Ensure adequate sleep; still needs 8 hours; Supervised when sleeping over / Cog impairment, depression, prostate, fall risks, polypharma / Assess sleep satisfaction/fatigue; Sleep partner complaints; Incontinence; Rx
·  Poisoning
National (& WI) Poison Control Hotline:
1-800-222-1222 / Read medication directions carefully / Medicine and cleaners out of reach / Educate about avoiding drugs and prescription meds / Use a screening instrument such as POSIT / Cog impairment, vision & sensory d/o, polypharma, caregiver / Lg Print Rx; Pill Box & Alarms; Assess /Remove Meds, Alcohol (CAGE), Cleaning Products
Travel Transportation / ·  Protective Gear / Rear-facing car seat / Back seat car seat every time / Bike helmets; street safety; sport gear / Sports gear; Reflective gear / **all** / Lap/shoulder Belts/ Helmet
·  Car /Driver Safety / Car seat in back seat of car / Forward facing at 20 lb AND >1 year old / Booster car seat until 8 y/o and 80 lb / Drive alone; no cell phone use; always use a seat belt / Dementia, vision/sensory d/o, arthritis, mvt d/o, stroke / Dementia = D/C Driving

[1] Ideation, Substance abuse, Purposelessness, Anxiety, Trapped, Hopelessness, Withdrawal, Anger, Recklessness, Mood changes.

© 2009 Medical College of Wisconsin