The countdown to the end of school is on, with only a few weeks separating youngsters from their summer environments. That may be great news for kids, but not so welcome to parents and pediatricians since school vacations also signal an increase in accidents and injuries. Just think of the accidents just waiting to happen out there -- at playgrounds and swimming pools, on bikes,

Obviously, parents can’t go through the entire summer months worrying about the safety of their youngsters. The best defense, as usual, is a good offense -- along with some good, old fashioned common sense. Most accidents can be prevented. Some careful planning, some extra time spent going over safety rules and the principles of first aid, and good parental or care giver supervision and observation can help minimize the risk for accidents and injury.

Take an organized approach to accident prevention, starting with inside the house. During summer months, kids have more time to "explore" their surroundings so don’t relax your vigilance about things like cleaning supplies, household and garden poisons, sharp objects, unguarded stairs, electrical outlets and machinery. When it comes to young children especially, it only takes the blink of an eye for something to happen but, unhappily, the effects of a trauma can linger for years. Get down at your child’s eye-level and see what is within their reach -- its a whole different world down there! If there are toddlers at home, secure cabinet doors, cover electric outlets and put electric cords out of the way, and make sure there are no sharp objects accessible to adventuresome youngsters. Don’t forget to put away all matches, and remember, too, that a young child can suffocate in a casually discarded plastic grocery bag.

Be on the alert for backyard boobytraps, and do some childproofing here, as well. Start with the basics -- a fenced in yard is great but supervision is essential! Do you know if any plants in your yard can be poisonous to youngsters if they eat them? Check out varieties of azaleas, lily of the valley, oleander, and even jonquils and morning glories -- not to mention mushrooms and berries. If there’s a flower or vegetable garden, there are likely to be chemicals, fertilizers and insecticides nearby. Make sure they are kept out of harm’s way.

Children should never be allowed near bar-b-que pits, smokers or grills or in the area when lawnmowers are being used. The blades can kick up rocks and twigs and turn them into unguided missiles that can hurt a child halfway across the yard. Think long and hard before entrusting your child with lawnmowing chores. Yard equipment can cause serious long-term injuries.

There are also creatures lurking in the grass that can cause problems for both kids and adults. There is a massive army of flying, crawling, biting, stinging insects out there just waiting for some unsuspecting person to cross their path. There are yellow jackets, bees and wasps, fire ants, spiders, and even scorpions in some parts of the country that will sting or bite if stepped on by bare feet. Twilight brings out hoards of hungry mosquitoes that will hone in on uncovered young skin.

Some people are allergic to insect bites and stings and, unfortunately, you don’t know about this until one occurs. Insect stings can be serious, so it is important to recognize early warning signs. If there is only minor discomfort -- swelling, redness, pain or itching around the sting area -- this is probably just a local reaction. If, on the other hand, the person who was stung starts having difficulty breathing, or becomes pale and clammy and starts wheezing or vomiting, get immediate emergency attention -- 
call 9-1-1 at once. This can be a life-threatening situation if a systemic allergic reaction is in progress.

There are a lot of good over-the-counter insect repellents available today but make sure if one is to be used on young children that it contains no harmful chemicals. Some "bug sprays" are available especially for kids and may even contain a sunscreen. There has been a lot of media attention about the dangers of Lyme disease, which is caused by ticks. It almost goes without saying that any time youngsters have been camping or playing in wooded areas, parents should check them carefully for ticks -- all over -- not just their heads.

According to the National Safety Council, the number two cause of injury-related death among children is drowning. About 1000 children drown each year and another 4000 are hospitalized for near-drownings. Statistics show that most drowning accidents occur in residential pools -- at the victim’s own home. About three-quarters of the youngsters under age 5 who drown were not expected to be at or even near a pool; more than half of them were thought to be safely inside the house.

Every parent -- or, for that matter, anyone who has ever had the responsibility of caring for a child -- knows that it is impossible to watch a child every minute of every day. But is it absolutely essential that watchfulness is increased any time water is involved. That’s not just swimming pools, lakes, rivers and oceans. An alarming number of children drown in less than 5 gallons of water.

If you have a pool in your yard, know all the state and county safety regulations and follow them to the letter to keep not only your children safe, but to prevent someone else’s child from wandering in and having an accident. Pools should have a fence at least 5 feet high -- check your local requirements before building one. A young child can fall into a pool without a sound or crying for help. You know the old wives’ tale about people coming to the surface three times before going under? It’s absolutely false...the person may not rise at all. And, if you think your children are drown-proof because they know how to swim, think again. There is simply no substitute for close, competent supervision anytime kids and water meet.

When summer fun includes boating, make sure every person -- adults and youngsters alike -- wears a life preserver. There is just no reason to tempt fate. Alcohol and water activities do not mix. Adults face a much increased risk of injury to themselves and to anyone with them if they drive boats or watercraft while under the influence of alcohol. Before leaving the dock, it is also a good idea for everyone on board to review boat safety and to go over what to do in an emergency.

While you’re out in the sun, there are two other considerations when it comes to young children: the possibility of heat exhaustion and too much exposure to the sun’s dangerous rays. When children get overheated and lose a lot of fluid, they can go "downhill" pretty fast. Kids don’t sweat like adults, so they don’t have a built-in cooling mechanism. Be alert for early warning signs -- listlessness, irritability, and becoming excessively red in the face -- and get any child who exhibits them out of the sun and to a cool place at once. Replace fluids by having the youngster drink four to eight ounces of liquid every 30 minutes or so, and consult your pediatrician to make sure they recover all right. Kids aren’t the only once susceptible to heat problems -- watch adults carefully on the hot days, too.

How much direct sun exposure a child has during their early years greatly affects the youngster’s chance of developing skin cancer as an adult. Children should be taught -- by example, too -- to use sunscreen or protective clothing whenever they are in the sun for extended periods of time. That’s not only in the summer at the beach or at the pool, that’s all year long and on ski slopes, too. While you may think a suntan looks cool, it is really the skin’s reaction to damage.

Last, but hardly least, on the list of summer accidents waiting to happen are the "moving violations;" those that take place on bikes, trikes, skateboards, in-line skates, and -- especially for the younger set -- on playground equipment. Slides take top honors as the major source of injury on playgrounds for pre-schoolers. Kids fall off the top, slide into obstacles at the bottom or burn tender skin on hot metal surfaces. Sometimes older kids unintentionally harm the younger ones by letting go of a swing or seesaw abruptly, or just trying to occupy the same space at the same time.

The best advice for kids who ride anything is to wear a safety helmet and protective pads on their knees and elbows. There are some real scary statistics about the number of children who are involved in fatal bike-related accidents each year. What’s really sad is that in nine out of ten of them, the child wasn’t wearing a helmet. The American Academy of Pediatrics advises parents that 85 percent of all bike-related injuries could be prevented if young riders would just wear their helmets.

Most safety measures are simply a matter of common sense; however, that is often something youngsters have in short supply. Safety really does begin at home. If parents pay attention to -- and talk about -- safety warnings, kids soon get the message that this is important. Young people learn by watching and observing. If the role models closest to home -- Mom and Dad, older siblings, and grandparents -- are seen ignoring safety measures, they interpret this as permission to ignore them, too.

Actions taken in the first few minutes following an accident can be critical, and may help avoid complications later. Every home should have a fully equipped First Aid kit as well as another one in the car, and family members should all know the principles of emergency care. There are also excellent courses available in most communities which teach the life-saving techniques of CPR and the Heimlich maneuver. Every family should have emergency plans in place for weather and fire disasters, as well.

Remember...family safety is no accident.
 
 

Murry Fershtman, M.D. Pediatrics Physician’s Group of the Woodlands 1011 Medical Plaza Drive, Suite 120 The Woodlands, TX 77381 (281) 296-8500

Dr. Fershtman completed his undergraduate degree at The Ohio State University in Columbus, OH. He earned his medical degree from The University of Texas Medical Branch, Galveston, Texas, where he also served his pediatric internship and residency. While attending medical school, Dr. Fershtman received a grant from the National Institutes of Health and captured second place for Outstanding Clinical Related Study in the NIH/UTMB Summer Research Training Program in 1988. He is board certified in Pediatrics.