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July 4 has come and gone and now we enter the second half of summer. The emergency room has returned to its pre-pandemic volume of patients. Families and kids are interacting and traveling this summer more than any time in the last few years. For this week’s column, I wanted to share some “tips from the ER” for parents on how to summer-proof and protect your kids this season.
Choking prevention tips
Nothing gets our hearts racing more in my ER than when a “code white” is called overhead. This call indicates that the paramedics are bringing a child to the ER in cardiac or respiratory arrest. Often this is due to a choking accident. In fact, choking is a leading cause of injury and death among children under 4 years of age.
Summer is the time for BBQs and playdates with friends that often feature hot dogs, which can pose a great risk of death. Your best bet is to simply not give kids under 4 any hot dogs. If you must, cut hot dogs lengthwise or into quarters. Never cut them into round circles.
Other foods that I frequently see as causes of choking include raw carrots, hard candy, nuts and seeds. Grapes should also be cut into quarters. The key is to avoid the more dangerous round shape of any food that could become lodged in the throat.
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The best helmets for kids
A helmet is absolutely essential for any kid who is riding a bicycle, skateboarding or roller blading/skating. All helmets manufactured after 1999 must comply with the mandatory safety standard issued by the Consumer Product Safety Commission but always be sure to check the inside of the helmet for this label.
For kids who do multiple sports and activities, it’s important that the appropriate helmet is worn for the sport. Bicycle helmets are designed to withstand a single head-forward impact. Skate helmets are designed to withstand multiple impacts over time. Always retire any helmet that has been involved in a crash and buy a new one.
For biking, there are both hard- and soft-shell helmets. The main difference as you can guess is durability vs style and comfort. The hard-shell helmet may be heavier, warmer and less stylish but this is not an area where I would sacrifice durability. Choose a hard-shell helmet.
Should kids use wrist guards?
Parents should also strongly consider wrist guards for their kids. When thrown from a bicycle or falling off a skateboard, the natural inclination is to place our hands out in front of us to break our fall. In my experience in the ER, injuries to the knees and elbows are usually limited to minor skin tears or abrasions. But the wrists absorb a lot of force that can cause bone fractures in the wrist or forearm.
Safe insect repellant for the family
Summer means longer days and more time outside. It also means more exposure to mosquitos. And unfortunately, rare insect-borne illnesses like Zika and West Nile Disease are on the rise due to climate change, more extreme seasonal weather events and rapidly changing ecology.
Even without the added threat of illness, multiple mosquito bites can be painful for a child and lead to cellulitis, or infection of the skin, a frequent cause of ER visits that could require antibiotics.
As a rule of thumb, insect repellant should only be used on children over 2 months of age.
DEET is an EPA-approved and safe insect repellant. Recent research further affirmed DEET’s safety. Remember that 10% DEET provides 2 hours of protection, and 30% provides 5 hours of protection, for example. Kids should not be using a product with more than 30% DEET.
If you want to avoid DEET, insect repellants containing picaridin are also approved by the EPA. Picaridin has the additional advantage of keeping mosquitos at a greater distance, making them even less likely to land on your skin.
There’s no shortage of home and “natural” remedies that people have tried to ward off mosquitos. Researchers published this excellent 2018 study of multiple home remedies for those looking for more information on what actually works and what doesn’t.
Trampoline injuries
Just don’t. The American Academy of Pediatrics has been firm that only supervised athletes training for diving or gymnastics should use a trampoline.
An average of 100,000 trampoline-related injuries are reported a year based on a recent research study. Falls are the major source of injuries and can result in devastating cervical spine injuries with permanent damage. Bone fractures, concussions and serious sprains are also very common.
If that’s not enough to dissuade you from retiring your trampoline remember that many homeowners insurance policies do not cover trampoline-related injury.
Additional tips to summer-proof your child:
- Encourage frequent water and hydration breaks
- Reapply sunscreen often
- Children old and large enough to use the vehicle seat belt should always use lap and shoulder seat belts for optimal protection; children less than 13 should always be restrained in the rear seats
Michael Daignault, MD, is a board-certified ER doctor in Los Angeles. He studied Global Health at Georgetown University and has a Medical Degree from Ben-Gurion University. He completed his residency training in emergency medicine at Lincoln Medical Center in the South Bronx. He is also a former United States Peace Corps Volunteer. Find him on Instagram @dr.daignault
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