The 4th of July has come and gone and now we are entering the second half of summer. The ER has returned to its pre-pandemic patient volume. Families and children are interacting and traveling more this summer than at any time in recent years. For this week’s column, I wanted to give parents some “tips from the ER” on how to summer-ready and protect your kids this season.
Choking Prevention Tips
Nothing gets our hearts racing in my ER like a “Code White” being shouted overhead. This call indicates that paramedics are taking a child to the emergency room in cardiac or respiratory arrest. Often this is due to a choking accident.
Summer is the time for barbecues and get-togethers with friends, which often involve hot dogs, which can pose a major risk of death. It’s best not to give hot dogs to children under the age of 4. If you must, cut hot dogs lengthwise or into quarters. Never cut them into round circles.
Other foods I often see as a cause of choking are raw carrots, candies, nuts, and seeds. Grapes should also be cut into quarters. The key is to avoid the more dangerous round shape of foods that could get stuck in your throat.
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The best helmets for children
A helmet is absolutely essential for any child who rides a bike, skateboards, or inline skates/skates. All helmets made after 1999 must meet the Consumer Product Safety Commission’s mandatory safety standard, but always check the inside of the helmet for this label.
For children who play multiple sports and activities, it is important that the appropriate helmet is worn for the sport. Bike helmets are designed to withstand a single head-forward impact. Skate helmets are designed to withstand multiple impacts over time. Always withdraw a helmet that has been involved in an accident and buy a new one.
There are both hard and soft shell helmets for cycling. The main difference, as you can imagine, is durability vs. style and comfort. The hard shell helmet might be heavier, warmer, and less fancy, but that’s not an area where I’d sacrifice durability. Choose a hard shell helmet.
Should children use wrist guards?
Parents should also consider wrist guards for their children. When we’re thrown off a bike or fall off a skateboard, the natural tendency is to stretch out our hands in front of us to break our fall. In my experience in the emergency room, knee and elbow injuries are usually limited to minor skin tears or abrasions. But the wrists absorb a lot of force that can cause fractures in the wrist or forearm.
Safe insect repellent for the family
Summer means longer days and more time outside. It also means more exposure to mosquitoes. And unfortunately rarely Insect-borne diseases such as Zika and West Nile disease are increasing due to climate change, more extreme seasonal weather events, and a rapidly changing ecology.
Even without the added risk of illness, multiple mosquito bites can be painful for a child and lead to cellulitis, or an infection of the skin, a common cause of emergency room visits that might require antibiotics.
As a rule of thumb, insect repellents should only be used on children over 2 months old.
DEET is an EPA-approved and safe insect repellent. Recent research has further confirmed the safety of DEET. Remember, for example, 10% DEET provides 2 hours of protection and 30% provides 5 hours of protection. Children should not use a product with more than 30% DEET.
If you want to avoid DEET, insect repellents containing picaridin are also EPA-approved. Picaridin has the added benefit of keeping mosquitoes at a greater distance, making them even less likely to land on your skin.
There is no shortage of home remedies and “natural” remedies that people have tried to use to ward off mosquitoes. Researchers have published this excellent 2018 study of several home remedies for those looking for more information on what actually works and what doesn’t.
trampoline injuries
Simply not. The American Academy of Pediatrics has ruled that only supervised athletes training for diving or gymnastics should use a trampoline.
According to a recent research study, an average of 100,000 trampoline-related injuries are reported annually. Falls are the leading cause of injury and can result in devastating cervical spine injuries with permanent damage. Broken bones, concussions and severe sprains are also very common.
If that’s not enough to deter you from retiring your trampoline, remember that many home insurance policies don’t cover trampoline-related injuries.
Additional tips to get your child summer ready:
- Encourage frequent water and hydration breaks
- Reapply sunscreen frequently
- Children who are old and large enough to use vehicle seat belts should always use lap and shoulder belts for optimal protection; Children under the age of 13 should always be buckled in the rear seats
Michael Daignault, MD, is a board-certified emergency room physician in Los Angeles. He studied global health at Georgetown University and holds a medical degree from Ben-Gurion University. He completed his residency 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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