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Return to Summer Safety and Health Tips: What Parents Need to Know Overview

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Summer Safety and Health Tips: What Parents Need to Know

New York (Aug 2, 2011)

a father holds his napping son

Summertime is upon us, and for kids, this means more outdoor activities, and for parents, it's time to be extra vigilant to ensure their children's health and safety.

Bicycle Safety

The importance of wearing safety helmets when bike riding cannot be overemphasized. According to the Centers for Disease Control and Prevention, each year more than 500,000 people in the United States are treated in an emergency department, and more than 700 people die as a result of bicycle-related injuries. Children are particularly at high risk, yet only 20 percent of them wear helmets. In New York State, children from age 1 to 14 are required to wear a certified bicycle helmet when bicycling. Protective gear is also critical for in-line skating, operating a non-motorized scooter or skateboarding.

"Wearing helmets would substantially reduce fatalities if more children wore them," says Shari L. Platt, MD, Chief of Pediatric Emergency Medicine at NewYork-Presbyterian/Phyllis and David Komansky Center for Children's Health. "Studies show that children are more likely to wear a helmet if their parent wears one. Parents should set the example."

Dr. Platt offers the following safety tips:

  • Make sure the helmet fits snugly and covers the mid-forehead.
  • Do not ride at dusk or at night.
  • Wear bright colors and reflective devices.
  • Avoid traffic, when possible, and always walk across the street.
  • Learn to stop and utilize proper hand signals.
  • Obey road signs.
  • Check that all bicycle parts and brakes are functioning properly.
  • Ride safely – don't perform tricks or stunts.

Swimming Safety

Drowning is the second leading cause of injury-related death in children under the age of 14, with a substantial number of children under the age of 18 drowning each year. "And a significant number of children under five drown each year, with more males than females, generally because they take more risks," says Dr. Platt. "The most common site of drowning is their own swimming pool while under the care of one or both parents. My experience is that adults feel they are watching their children just by being present at the pool; they don't realize that danger can occur in a split second if their eyes leave their child." Parents need to be extremely vigilant, and Dr. Platt recommends that parents have a designated watcher at the beach or pool, and especially at parties.

Other water safety tips include:

  • Check safety barriers around pools to ensure:
    • they are intact and effective
    • the fence or gate is latched
    • door alarms are functioning
    • safety covers and thermal pool tarps are in working order

Remember, these "barriers" are not "childproof."

  • Never leave a child unsupervised.
  • If a child is missing, FIRST check the pool.
  • Flotation devices are not a substitute for supervision.
  • Learn CPR (cardiopulmonary resuscitation).
  • Store rescue equipment near the pool.
  • Keep emergency phone numbers handy (police, fire and ambulance departments).
  • Remove toys near the pool when pool is not in use.
  • If a person is entrapped (hair or clothes) in a pool, Jacuzzi, or hot tub, pry a hand between the body and the barrier to break the suction seal. Turn off the pump.
  • Get out of the pool in thunderstorms.
  • Never swim alone in lakes or ponds.

Sun and Heat-Related Safety

Sunburns and heat-related health issues are largely preventable if protection is practiced early and consistently. Unprotected exposure to ultraviolet (UV) rays causes damage to the skin, eyes, immune suppression and can cause skin cancer. "Even children with dark skin are at risk for skin cancer and should be wearing sunscreen," notes Dr. Platt. "A study at our Hospital of sunscreen used on children with different shades of skin found that children with darker skin were less likely to use sunscreen, when, in fact, they have the same risks as children with lighter skin. They may not burn quite as easily, but they still have similar risks for skin cancer."

Children with moles, freckles, fair skin and hair, or who have a family history of skin cancer, or who participate in water activities are all at a high risk for sunburn, and should be particularly cautious.

To prevent sunburn:

  • Avoid the strongest rays of the day between 10 am and 4 pm.
  • Wear protective sunscreen of SPF 30 or greater.
  • Always use sunscreen when outside, even on cloudy days.
  • Infants under 6 months should avoid sun exposure and sunscreen (titanium dioxide, no PABA). Babies can also burn while in the shade.
  • Reapply sunscreen after swimming and sweating, and every two to three hours.
  • Wear protective clothing, hats, and sunglasses (with verified UV protection on the labels).

"Children are also at higher risk for heat-related injury [heat exhaustion and heat stroke] because they can't regulate their body temperature, which can rise three to five times faster than adults," says Dr. Platt. "They also don't know to sit in the shade, take a break, and/or drink water, especially if they are in the middle of a game or distracted. So it's important for parents to make sure their children rest and drink."

There are different levels of heat-related injuries. Signs of heat exhaustion include:

  • Severe thirst
  • Muscle weakness
  • Nausea and vomiting
  • Irritability
  • Headache
  • Sweating
  • Cold, clammy skin

The signs of heat stroke, which is potentially fatal, are:

  • Severe, throbbing headache
  • Weak, dizzy or confused
  • Difficulty breathing
  • Decreased responsiveness
  • Little or no sweating
  • Flushed, hot, dry skin
  • Temperature more than 105 degrees F

"Every year children – most of them three years or younger – die inside cars where they've been left or forgotten," says Dr. Platt. "Parents may leave a child, thinking it will be just for a few minutes while mom or dad runs into the house or a store. The next thing you know you are distracted by something, or waiting on line behind someone. Meanwhile, the temperature in a car can rise by 10 to 30 degrees in only 15 to 30 minutes. And cracking the window open has no effect whatsoever. Never, ever leave a child, or pet, alone in the car, especially in the summer."

To treat a child with heat-related illness:

  • Remove the child from heat.
  • Remove clothing.
  • Place the child in a cool, tepid bath (do not use cold water).
  • Give cool liquids.
  • Use a fan to cool your child.
  • Monitor the child's temperature.
  • Seek emergency care if the temperature does not subside, the child is disoriented or has a change in mental status, or if you suspect symptoms of heat stroke.

"If you can't get your pediatrician on the phone to guide you, then go to an emergency department," says Dr. Platt. "Call 911 or drive yourself if you can get there faster. Use your best judgment – you will never be faulted for seeking emergency care if you are concerned about your child."

Insect Bites and Stings

"Most of the time, insect bites and stings are benign, and require no medical intervention," says Dr. Platt. "Bites on the eyelid may cause swelling because the eye has the ability to collect a lot of fluid. We still worry about infection, so if the eyelid is very red or if fever is present, seek medical attention. If the site is puffy and soft and doesn't hurt a lot, it's probably just a bug bite."

Signs that a severe reaction to a bite has occurred include:

  • Swelling
  • Difficulty swallowing or speaking
  • Chest tightness, wheezing or difficulty breathing
  • Dizziness or fainting
  • Abdominal pain, vomiting

"Everyone gets mosquito bites and they basically look the same – little red bumps," says Dr. Platt. "Some people are allergic and they get huge, hard welts that are very red and tender. Treatment is an antihistamine to reduce the itch, but it won't necessarily make the redness go away. However, call 911 immediately if there is any difficulty breathing, speaking, dizziness, wheezing, the tongue and mouth feel strange, or swelling around the lips."

When stung by a bee, remove the stinger by gently scraping the skin, wash well and apply ice. "Bees are attracted to scented soaps, perfumes and bright colors, especially yellow," adds Dr. Platt. "Children should also avoid playing near garbage cans and be wary when drinking from a soda can where a bee can crawl into. Be careful at a picnic or outdoors, and don't walk barefoot in the grass. Use bug spray that does not contain DEET. And if parents don't want to use bug spray, there are other products to choose from, and many are for children."

Lyme Disease

Lyme disease is a tick-borne illness, transmitted by tiny ticks – the size of a sesame seed or pencil point – that live on deer, sheep, and horses. If bitten by one of these ticks, they can transmit the Lyme infection (Borrelia Burgdorferi spirochete) they carry into the blood causing Lyme disease. Though the disease can be contracted year round – predominantly in northeastern and north-central states – it is particularly prevalent during the months when people are active outdoors.

"It's important to note that the majority of deer ticks don't carry Lyme disease," says Dr. Platt. "If a child has a tick and it's been attached less than 24 to 48 hours, first remove the tick using tweezers to grasp the tick firmly near the child's skin. Pull firmly and steadily out – do not twist it. Do not use petroleum jelly, a lighted match, or nail polish to 'kill' the tick. Then wash the area with soap and water."

If the tick has been on for more than 48 hours and it's engorged, says Dr. Platt, the risk for exposure to Lyme disease increases. Symptoms include flu-like feelings of headache, stiff neck, fever, muscle aches, and fatigue, as well as a target-shaped rash at the site of the bite that can appear within one to four weeks. "There's a lot of controversy about whether to treat or not," she says. "After 48 hours consider prophylactic treatment with an antibiotic, because the test for Lyme doesn't turn positive for up to six weeks after an infection develops. Plans for treatment should be discussed with your pediatrician."

Poison Ivy

In addition to posing a problem for children playing in a wooded area, poison ivy, poison oak, and poison sumac can also be a hazard to gardeners, hikers, campers, and anyone spending time outdoors. Wear long sleeves and pants in areas of thick vegetation. "Parents should limit their child's exposure to woody areas that they aren't familiar with," says Dr. Platt.

Contact with urushiol oil found in the leaves, roots and stems of these plants causes a contact dermatitis – an allergic rash with itching, burning, and blisters and bumps that appear in lines and streaks. "If you know that you or your child has been exposed, wash the oil off the skin and under the nails, and wash the clothes as fast as possible," says Dr. Platt. "Once the oil is washed off, the rash is not contagious, however, it can be passed on if the oil is still on skin or clothes."

Treatment includes applying calamine lotion (not Caladryl if you are also taking Benadryl); keeping nails short and clean; and using cool compresses to reduce the itch.

"In more serious cases, oral steroids may be prescribed," adds Dr. Platt. "Parents should bring their child to the doctor if they are really miserable or if it's very widespread."

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