Closing the Door on Finger Injury Issues
By: Geoff Mosely
How often do we think of a door as a danger to the health and safety of the children in our care?
All too often, the view of door safety has the very narrow focus of preventing unwelcome visitors and allowing maximum speed of escape in the event of an emergency. Attention to door safety has much wider implications.
Here are some statistics:
* There are more than 300,000 door-related injuries requiring hospital emergency room treatment each year.
* Around 45,000 of those will involve children under the age of 14.
* Door injuries result in an estimated 15,000 amputations.
* In just two cases, where the finger was actually reattached, the settlements had price tags of $725,000 and $600,000.
This is a door horror story that happens all over the nation a thousand times each day and yet goes without proper address.
Emergency room reports detail injuries of a minor nature when a hand is caught in the handle side of the door as someone or something, like a gust of wind, carelessly closes it. However, injuries can be much more severe. The more serious injuries involve the hinge side of the door, leading to broken bones or even amputation of fingers.
It’s a Myth
According to the American Academy of Pediatrics, if you are unfortunate enough to have to deal with a finger amputation incident, don’t put the finger on ice, as you will burn the amputated part and make matters worse. Deal with the patient first and stop the bleeding.
After recovering the severed finger, gently rinse the digit in water (saline solution would be better) to clean it; no scrubbing or physical contact with the wounded end. Wrap the digit in clean, dampened gauze from the first aid kit and place that on a plastic bag filled with ice, but do not let the finger get into direct contact with the ice. Then, get to the emergency room as quickly as possible.
Accident or Injury?
The National Safety Council refers to these events as "unintentional injuries;" they are not accidents. Accidents are, by definition, unavoidable or unexpected, but door-related "accidents" are indeed both avoidable and to be expected.
Historically, most parents have viewed such incidents as an “accident.” However, parent perception is changing, and there is an ever-growing awareness that this type of unintentional injury is preventable. With this comes an expectation that schools should be doing something about it. Just put “finger amputation lawyers” as the search string in Google, and you will get thousands of responses. This type of litigation now ranks very high in terms of parent consciousness.
Facility operators are increasingly being held responsible for injuries that occur as a result of a door not being fitted with adequate safety measures to prevent a finger pinch injury.
Assessing the risk and taking such preventive measures as required can help protect against potential high claims for medical expenses and lawsuits for damages. More importantly, they will eliminate the pain and distress suffered by the “victims” and the psychological trauma of the teachers who have to deal with these tragic incidents.
Informing your insurance company of any risk analysis performed and safety measures installed may result in insurance premium discounts related to the risk reduction improvements.
What Happens?
The pressure exerted at the hinge area of a closing door can reach as much as 40 tons per square inch. That’s enough to crack a walnut, so flesh and bones don’t stand much of a chance.
Anyone, young or old, could be playing or just standing near the hinge area of a door. Fingers innocently curl around the corner of the door or door frame. The door closes, fingers are trapped, and you have another injury to add to the many thousands that take place every year.
Safety Measures
Automatic door closers are the most well-known measure, but they do not provide the complete answer. They stop a door from slamming shut and help to prevent injuries at the latch-side; however, as the door slowly shuts, there are still dangerous traps at the hinge side. The added pressure to shut the door at the end of the closing cycle may inadvertently cause some finger-trapping accidents. Automatic door closers can also make it more difficult for a child to open a door to release fingers that have been caught in the hinge area, as they may not have sufficient strength to push the door open again.
Another often-used safety measure are latch-side, high-density foam guards that clip over the edge of a door to prevent the door from closing completely. Unfortunately, they require the intervention of a fallible human being. They frequently become lost when detached from the door, and, even when safely put to one side, they are often forgotten about and not reinstalled each and every time they are required. However, when installed, they do have one additional safety feature. They stop little ones from locking themselves in rooms and closets.
Door hinge guards cover the gaps created between the door and the door frame as the door is opened and thereby eliminate the finger pinch risk entirely. Often made of plastic, they are usually very easy to install. They fit most types of doors and gates (including wood, metal, and uPVC) and most door styles (including swing pivot doors and doors with panic bars). The more commercially orientated products are extremely durable, offer a lengthy warranty, and have UL approval for installation on fire doors and door frames.
Door safety should be considered an issue wherever children pass through or by a door. The obvious ones are access doors, restroom doors, and classroom doors. What about the janitor’s door? Nobody goes in there except the janitor, so that’s a low risk, right? Wrong! If on the other side of the janitor’s door, there is a busy corridor and if the janitor abruptly closes the door from the inside because of the noisy children outside….well, suddenly there could be a lot more noise outside.
What Are the Regulations?
“Caring for our Children” 2nd Edition, produced by the National Resource Center for Health and Safety in Child Care, provides the national guidelines for Out-of-Home Child Care Programs. This document identifies “standards that have the greatest impact on disease, disability, and death (morbidity and mortality) in out-of-home child care,” www.nrc.uchsc.edu.
Additionally, the USA General Services Administration (Public Buildings Service) produces the "Child Care Center Design Guide" for reference, www.gsa.gov.
Doors need not be a danger to children or a potential trauma risk for the teachers who have to deal with this type of incident. Door safety starts with risk assessment and ends with installing the full range of appropriate safety measures.
Geoff Moseley is a member of the DHI and one of the founders and chief executive officer of Fingershield Safety (USA), Inc., www.fingershieldsafety.com.
