Ah, summer: the kids are out of school, the hot dogs are on the grill and the drinks are cold. It’s a time of outdoor fun. It’s also is a time of vastly increased emergency department visits, and that correlation is… ahem, no accident. Around our emergency department, we call summer “trauma season.” Outdoor fun comes with risks.
Knowing the risks is the key to prevention, we asked Dwayne Smith, our Injury Prevention Program Manager, to identify a few of the major trouble spots for traumatic injuries and how to steer clear of them. Here’s his top five:
A visit to the pool or the lake is one of the best things about summer. But open water is also dangerous in a potentially deadly way people tend to underestimate, and during the summer, the incidence of children drowning goes up dramatically.
And when it happens, it’s not like in the movies. There’s no shouting or splashing or struggle. Because the victim is under water and can’t breathe, there’s almost never any sound at all. It’s a silent killer, and it happens in a matter of seconds.
How to prevent: Nearly nine out of 10 drowning incidents occur during a brief lapse in supervision. “At least one adult should be watching kids in the water at all times — not texting, not dozing, not reading a book, not talking to another adult. Doing nothing but keeping eyes on kids in the water,” says Smith, who suggests assigning one adult to be a “water watcher” in 15-minute shifts. Making the shifts short avoids distraction and fatigue.
It’s also a great idea to get kids in swim lessons. Most kids will need several cycles of lessons before they become proficient swimmers, however. And if a child goes missing anywhere near a pool, immediately check the deep end first.
What you should know about "dry drowning"
The phrase "dry drowning" can be anxiety-provoking for parents, yet it is frequently used in the news and on social media. While dry drowning is not a true medical term, it is helpful to understand the symptoms associated with a dry drowning incident.
How is drowning different from dry drowning?
Drowning is a process of breathing impairment that occurs after being submerged in water. Drowning deaths result from decreased oxygen to the brain, which leads to the heart stopping (regardless of whether there is water in the lungs).
The term "dry drowning" highlights the fact that, very rarely, children may develop drowning symptoms shortly after a drowning episode in which they are under water for a prolonged time or get a significant amount of water in their lungs by breathing it in.
Symptoms of dry drowning
Most delayed drowning symptoms are obvious within a few hours of the suspected drowning event and will be present within the first 24 to 48 hours. These symptoms may include: a persistent cough (not just one or two times), breathing faster or working hard to breathe, extreme fatigue or persistent vomiting. Don't forget, however, that most kids will be a little tired after swimming and it's often common to throw up one or two times from swallowing water. Seek medical care if your child is having any of these symptoms.
2. Bike and wheeled sports injuries
“Bikes are woven into the fabric of American life,” says Smith. “Nearly every kid has a bike, or at least shares a bike with siblings.” People ride bikes for recreation, for exercise, for transportation. And in Denver, a higher-than-average number of kids ride bikes to school.
But we’re not born knowing how to ride a bike any more than we’re born knowing how to walk. And just as it takes babies a while to get their walk down, it takes kids a while for kids to develop the coordination and balance skills necessary to ride a bike competently. In fact, bikes are associated with more childhood injuries than any other consumer product except cars.
Prevention: The most important thing by far is a properly fitted helmet. “Make sure kids have a helmet that fits their current head size,” says Smith, “not one he or she will grow into.” Also, teach your kids the rules of the road — walk on the left, ride on the right — and how to anticipate where traffic might come from.
“During the school year, kids have 15 minutes of supervised, structured time on a playground,” says Smith. “During the summer, there’s 15 hours of daylight, and kids are playing on playgrounds throughout the day.” Just the increased time is bound to lead to increased injuries.
At the same time, windows are open to the breeze and people are spending more time on decks and balconies — all things toddlers tend to fall from.
Prevention: As any parent knows, if there’s equipment to be used, kids will figure out a way to misuse it. Kids use the monkey bars like a ladder and walk across the top, climb equipment not intended for climbing. “Even toddlers try to walk up the slide,” says Smith. Take kids to playgrounds with cushioned surfacing like pea gravel or rubber mats (Colorado regulations require safe surfacing at public playgrounds) and keep an eye on them to make sure they’re using the equipment right.
Inside, install gating on open windows a toddler could access, and keep doors shut and locked to balconies and decks.
4. Motor vehicle crashes
“The safest vehicle on the road is a school bus,” says Smith. “It’s big, it’s heavy, it’s mostly on neighborhood streets, and it’s got a speed governor on it so it can’t go very fast. Nine months out of the year, kids that ride a school bus travel in a safe vehicle. Then summer comes.”
Especially on vacation, people tend to let their guard down and be more lax about safety. It’s a hassle to lug a car seat through an airport, so it’s common in rental cars for kids not to have the appropriate restraint. In the meantime, tired, distracted parents are driving an unfamiliar car in an unfamiliar place.
Prevention: The biggest thing is to stay vigilant and buckle up. Make sure kids are properly restrained. “Kids need to be in an age- and size-appropriate car seat — rear-facing for infants, forward-facing for toddlers over 2 years old, booster seats for little kids, safety belts for bigger ones,” says Smith. “Every trip, every time.”
5. Pedestrian injuries
Developmentally, kids under about age 10 can’t accurately assess speed and distance. So while they may see the car coming down the street, they are cognitively unable to judge how quickly it will reach them and how long it will take to cross the street.
“Watch a Little League game,” says Smith. “There’s a pop-up in the outfield, you’re going to see these 7-year-olds milling around trying to anticipate it. They can see the ball in the sky, but their brains aren’t equipped to effectively judge how fast it’s coming or where it’s going to land.” The same goes for an oncoming car.
Prevention: Drivers typically aren’t looking for pedestrians — they’re looking for other cars — and kids are smaller than adults. Teach kids to make themselves visible to drivers: raise and wave their hand, stand on the curb and make eye contact with the driver of a vehicle to make sure they see you.
Kids should cross the street only at designated crosswalks, and, because of their cognitive limitations, “We don’t recommend kids under age 10 cross the street alone,” says Smith.