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Keep your kids safe this summer

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Summer has arrived. And for all its pleasant, warm-weather pastimes--pool parties, barbeques, bicycling, and more--an emergency department near you is feeling the usual seasonal spike in children's unintended injuries and deaths. No wonder summer is known in the medical business as "trauma season."

Childhood deaths from unintentional injuries, reassuringly, are rare. But add up the pain of broken bones (plus the angst of a childhood summer spent in a cast), parents' time taken off from work to nurse an injured kid, medical bills--not to mention the use of ER resources--and the possibility of a lasting disability from, say, a brain injury sustained in a bicycle accident, and you've got a costly impact on families and society.

Marie Lozon, division director of pediatric emergency medicine at the University of Michigan Health System, tends not only to the young patients who are rushed through the doors of her emergency department but also to shocked parents. "Every day I hear, 'I just turned my back for a second,'" she says. A brief lapse in supervision is often a critical factor in kids' visits to the ER during trauma season.

Between conversations with Lozon and another expert, Chrissy Cianflone, director of program operations at Safe Kids USA, U.S. News has compiled a list of some common trauma-season causes of unintentional injury to kids--and simple ways to avert such disasters:

1. DROWNING

Lack of adult supervision and drowning go hand in hand. In summer, kids drown at nearly twice the rate that's typical for the rest of the year--reflecting a steeper summertime increase than exists for any other kind of unintentional injury to kids.

The most basic, common-sense advice to prevent children from drowning is to have an adult watching the water at all times. Sounds obvious, like something any parent would do instinctively, but Cianflone says a kid drowning is usually "a matter of everybody was watching, but nobody was watching." The solution, she says: Having a designated adult with his or her eyes on the water at all times and the ability to jump in quickly.

Both Lozon and Cianflone recommend that backyard pools be surrounded by fencing on all sides and have a self-locking gate so kids cannot wander out the back door and jump into the pool. Children who go swimming in lakes, oceans, and rivers need life jackets, says Cianflone, and parents need to model the behavior for young kids.

2. BIKE ACCIDENTS

Deaths related to biking increase about 45 percent in summer, compared with other times of the year. Certainly, riding around in the warm weather is a favorite childhood pastime, but doing so without wearing a properly fitted helmet could be asking for trouble.

Cianflone recommends buying a helmet that meets the standards of the Consumer Product Safety Commission, which should be evident by a CPSC sticker inside the helmet. Bell Sports, she adds, makes a helmet for kids called True Fit that requires only one step to adjust the helmet for a proper fit.

3. MOTOR VEHICLE-RELATED ACCIDENTS

Motor vehicle crashes are the leading cause of death among kids ages 3-14 in the U.S. In 2005, according to the U.S. Centers for Disease Control and Prevention, 1,335 passengers ages 14 and younger died and 184,000 were injured in motor vehicle crashes. That's a daily average of four deaths and 504 injuries.

A number of factors are involved, including high-traffic holidays--in particular, Memorial Day, the Fourth of July, and Labor Day--an excess of drinking, and parents who don't bring their children's car seats on vacation.

A properly fitted car or booster seat is essential to preventing a child's injury or death in an accident, says Cianflone. (Safe driving, obviously, is as well.) Size matters--only kids who are at least 4-foot-9 and weigh 80 to 100 pounds can safely wear a seat belt. It is estimated that 73 percent of car seats are either installed wrong or aren't used correctly.

Speed and collisions aren't the only hazards with motor vehicles. Between 1998 and 2004, an annual average of 33 children died of heat stroke because they were left in an unattended vehicle, Cianflone says. Sometimes a child playing hide-and-seek or mimicking her parents will pull down the back seat and climb into the trunk. In other instances, a parent might leave a child in the car to run a quick errand, or they might simply forget their child in the back seat.

Recreational vehicles and riding lawn mowers also come out of the garage this time of year, and they pose their own dangers. They have a high center of gravity and are easy to tip over, she explains. Plus, the rider is not protected by a shell, as they would be in a car. Lozon sees numerous head and neck fractures, and kids can be crushed by an ATV rolling over them.

4. PEDESTRIAN ACCIDENTS

Kids are out and about more often in the summer, frequently unsupervised, and that contributes to a 16 percent spike in child pedestrian deaths this time of year. Again, a child's level of development plays a role in their risk: Research suggests that before age 10, children are particularly impulsive and also cannot judge speed, spatial relationships, or distance very well.

Close to 10 percent of child pedestrian injuries occur in a driveway during the summer, according to Safe Kids. Nonfatal injuries related to vehicle backovers landed approximately 2,500 kids ages 14 and younger in the ER per year between 2001 and 2003, according to the CDC. Nearly half of those incidents took place at the child's home. And don't trust the car camera that allows a driver to watch a screen on the dashboard for a shot of the field to the rear. It has blind spots, too.

5. BURNS

Fireworks, barbeques, campfires, and fire pits are all integral parts of summer. Parents just need to keep the heat away from the kids. Another common injury Lozon's emergency department gets this time of year results from kids spraying lighter fluid into the barbeque. The fire can light the arc of fluid all the way up to the container, which can explode in the hand.

And of course, the Fourth of July is notorious for injuries related to fireworks. According to the CDC, a third of individuals injured by fireworks are under the age of 15. One of the most common such injuries Lozon sees is when the fuse on a firework is lit incorrectly--or doesn't appear to catch--and someone goes back to re-light or fiddle with it. The firework explodes and fingers are blown off or the face, eyes, or head gets burned.

6. FALLS

They're the leading cause of nonfatal unintended injury to children year-round, bringing about 8,000 kids into the ER daily, says the CDC. And fall-related deaths spike in the summer, up 21 percent over the average during the rest of the year, according to Safe Kids. Warm temperatures mean more open windows, more time on the jungle gym, and more kids hanging out on balconies or fire escapes.

There are two easy ways to prevent children from falling, says Cianflone: supervision and window guards. Exploring, climbing, touching, pushing, and grasping at the world around them is how children grow and develop, she says, so risk can't be completely eliminated. But watching kids and removing the hazards in their environment can help prevent a mishap. Keep furniture (including the baby's changing table) away from windows, install bars or a childproof gate on windows, and don't allow kids to play on balconies or roofs.

Going to the playground has its perils, too. On an annual basis, kids 14 or younger make 200,000 visits to the emergency departments in the United States because of playground accidents, according to the CDC. A few precautions can keep kids safe. To avoid trips and lost balance (and heads banged painfully into pieces of metal equipment), ditch the Crocs and flip-flops in favor of sneakers with adequate rubber on the soles, says Cianflone. As with adult supervision around the pool, says Cianflone, adult eyes focused on kids on the playground equipment is key.

7. ACCIDENTAL STRANGULATION

Keep your kids from wearing hooded sweatshirts or anything dangling around their necks on the playground--it's a strangulation hazard if it gets caught in a piece of equipment. In fact, strangulation caused about 56 percent of the 147 playground-related deaths between 1990 and 2000; falls accounted for 20 percent, says the CDC.

8. TRAMPOLINE INJURIES

Just like swimming pools, trampolines get uncovered during the summer months. Their power to injure needs to be heeded. "It's a physics lesson," says Lozon. "You've got motion, height, and bodies colliding." Heads smash together, ankles and elbows get stuck between the springs and the rim of the equipment, bones break, and bodies get launched off the trampoline.

A recent study in the British Medical Journal found that the risk of injury increases with the number of bouncers. If a trampoline is a must for your family, Lozon suggests getting one with safety walls and coverings over the springs. Allow only one bouncer at a time, she says.

(c) 2009 U.S. News and World Report

Copyright © 2014, The Baltimore Sun
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