Summer safety tips from your pediatrician

Kids are still kids, even during a pandemic – they play, they get sick and sometimes they get hurt. We spoke to Dr. Angela Dangvu, a CHOC Children’s pediatrician, about what parents can do to keep kids safe this summer.

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Dr. Angela Dangvu, a CHOC Children’s pediatrician

COVID-19 precautions

With no vaccine currently available, the best way to prevent illness is to avoid being exposed. In addition to practicing proper handwashing, people should watch for symptoms and avoid going out if they feel ill. When outside the home, people should physically distance from others whenever possible, and wear a face covering. The Centers for Disease Control and Prevention recommends the use of cloth face coverings in public for those over age 2. The governor of California has mandated that face coverings be worn by the general public when outside the home. Read the full order, including exemptions, here.

Be safe around water

A child can drown in as little as 2 inches of water – so keep an eye on all bodies of water like bathtubs and ice chests, in addition to pools. Assign a “water watcher” who knows how to swim and can provide constant, uninterrupted supervision. Learn more about water safety.

Wear your sunscreen

Everyone over 6 months should wear sunscreen when they’re outdoors. Infants younger than 6 months should be kept out of the sun.

Apply a sunscreen with SPF 30 at least 15-30 minutes before you go outside. Reapply every two hours or after swimming or sweating. Wide-brimmed hats and sunglasses offer extra protection. Limit time spent outside between 10 a.m. and 4 p.m. to minimize down on sun exposure. Also be aware that surfaces like sand and water reflect sunlight, so it’s possible to get burnt even when you’re in the shade. This is especially true for infants.

Review family emergency preparedness plans

Emergencies are not on pause just because there is a pandemic. Create and practice a fire escape plan with your family. Double-check smoke alarms and carbon monoxide detectors.

Practice poison precautions

Avoid household poisoning hazards and save the Poison Control Center’s phone number in your cell phone: 1-800-222-1222 for serious emergencies or simple questions. Store medicine and vitamins up high and out of sight. Remind children that medicine is not candy.

Helmet safety

Most serious head injuries can be avoided by wearing a properly fitting helmet. By law in California, everyone under 18 years of age must wear a Consumer Product Safety Commission-approved helmet while bicycling, riding a scooter, skateboard, or using roller-skates or in-line skates. Parents should enforce this rule even when kids are riding in areas where they don’t expect to encounter vehicles.

Learn more about the most common summer injuries that send kids to the emergency department – and how to avoid them.

If your child is ill or injured during the COVID-19 pandemic, rest assured that it is safe to seek the care they need. Here’s a guide on deciding where to go for care during COVID-19.

This article was updated July 22, 2020.

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The most common summer injuries that bring kids to the emergency department

Summertime for many kids and adolescents means the excitement of water activities, fun in the sun and spending as much time as possible outdoors. Yet summer is also known as “trauma season” among pediatric experts like Dr. Ted Heyming, chair of emergency medicine at CHOC Children’s. According to Safe Kids Worldwide, a leading children’s safety organization, summer season represents millions of emergency room visits by children 14 and younger due to unintentional injuries, many resulting in death.

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Dr. Ted Heyming, chair of emergency medicine at CHOC Children’s

To help avoid unintentional injuries, Dr. Heyming recommends that parents and caregivers be on high alert and supervise children extra closely. The following are the top injuries Dr. Heyming and his team see in the Julia and George Argyros Emergency Department at CHOC Children’s Hospital during the summer season and tips to avoid summer injuries:

Head injuries
The risk of head injury is high in adolescents and especially common in the spring and summer months with popular outdoor activities such as bicycle riding, in-line skating and skateboarding. The injury can be as mild as a bump, bruise or laceration, or can be moderate to severe due to a concussion, deep cut or open wound, fractured skull bone(s), or from internal bleeding and damage to the brain. Parents should seek emergency medical attention for their children should any of the following occur after a head injury:

  • Vomiting more than once
  • Alteration in mental state
  • Increased irritability, fussiness
  • A seizure
  • Weakness in parts of the body, such as in an arm or leg
  • Bad headache

How to prevent head injuries:

Wearing a helmet whenever riding a bicycle, in-line skates, or a skateboard should be an automatic habit. Helmets should fit properly on your child’s head and also be fastened correctly. A helmet that fits and is fastened properly does not move around on the head. Worn properly, helmets are effective in preventing severe head injuries. Here’s a video with tips on how to properly fit a helmet.

Facial injuries 
Children may get minor cuts, wounds, and lacerations to the face while engaging in play or sports activities. Most of these injuries can be handled at home with simple first-aid treatment. Seek immediate medical attention for cuts and wounds on your child’s face if accompanied by any of the following:

  • Heavy bleeding that does not stop after 5 to 10 minutes of direct pressure
  • The injury involves the eyelids or eyes
  • Wound is gaping.
  • Injury is caused by a puncture wound, or dirty or rusty object or embedded with debris such as dirt, stones or gravel
  • The wound is caused by an animal or human bite
  • If your child indicates the wound is excessively painful, or if there’s a possibility of a fracture of the head or any other bone
  • Your child shows signs of infection such as increased warmth, redness, swelling or drainage

Help prevent facial injuries by teaching your child the following:

  • Not to poke or place objects in his ears or nose
  • Not to walk or run while holding an object in her mouth
  • Not to suck or chew on hard, sharp or pointed objects
  • Wear protective eye, ear, or face guards for sports activities that could cause injury

Wrist and elbow fractures
A fracture is a partial or complete break in the bone and can result from falls, trauma or a direct blow or kick to the body. Wrists, forearms and elbows are vulnerable to these injuries, and they are especially common among children ages 2 and older. Many occur with popular summer activities such as basketball, bicycle riding and skateboarding. The following symptoms in the injured area might indicate a fracture that requires immediate medical attention:

  • Pain
  • Swelling
  • Obvious deformity
  • Difficulty using or moving the injured area in a normal manner (unable to walk)
  • Warmth, bruising or redness

How to prevent wrist and elbow fractures this summer:

Although fractures are a common part of childhood for many active children, you can take steps to help prevent them through simple safety precautions such as making sure kids always wear safety gear like helmets and wrist guards when participating in sports.

Drowning

Summertime water activities are fun, but always present a risk for drowning. Drowning can happen without a sound. It is the leading cause of accidental death for children under the age of 5 and can happen in less than 2 inches of water. In 2018, Orange County had 36 drownings in children less than 5, and five of those were fatal.

How to prevent drowning

  • Never leave a child unattended near water in a pool, tub, bucket or ocean. There is no substitute for adult supervision.
  • Teach kids survival swimming skills.
  • Kids that are not strong swimmers should wear US Coast Guard-approved, well-fitting life jackets.
  • Make sure kids have constant supervision when they’re in or around water. Always designate at least one adult as a “water watcher.”
  • The home should be isolated from the pool with a fence at least 60 inches tall, with a self-closing, self-latching gate.
  • In 2015, Orange County created the Drowning Prevention Task Force, of which CHOC is a member, to develop recommendations on methods and strategies to improve drowning prevention efforts in Orange County. Learn more here.

Bringing your child to the emergency department

The emergency department is the best place for apparent life-threatening events. Not all emergency departments take care of children on a regular basis. It is best to go somewhere that specializes in children’s health with specialized training and equipment made just for kids.

This article was updated on May 15, 2020.

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Keeping children safe in and around cars during COVID-19

Under COVID-19 stay-at-home orders, children are spending more time at home and playing outdoors, increasing their potential access to unlocked cars. Parents who are worried about bringing children into stores or pharmacies might also consider allowing them to wait in the car.

Both these scenarios put children at risk of heatstroke, which can happen when body temperature rises to dangerous levels and it isn’t able to cool itself quickly enough. A child’s body warms three to five times faster than an adult.

In the past two years, more than 100 children died of heatstroke because they were left alone or became trapped in a hot car. Nearly every state has experienced a child vehicular heatstroke death.

These tragedies are preventable. Community educators at CHOC Children’s recommend the following tips for avoiding heatstroke:

  • Never leave your child alone in the car, for any amount of time. In California, it’s against the law to leave any child younger than 6 alone in a vehicle without a person who is at least 12 years old.
  • During this pandemic, consider having an older sibling watch younger children at home if you need to leave the house for an essential errand. Another option might be having essential items delivered to the home.
  • Remember that cracking open a window will not cool down the car and therefore will not prevent heatstroke.
  • Children as young as 1 and 2 are known to climb into unlocked cars and in trunks to play, but they can’t always get out. Teach children not to play in cars and keep your car doors and trunk locked so they can’t get in on their own. Keep key fobs out of reach, so children cannot open locked cars on their own.
  • Create reminders for yourself not to forget your child in the backseat of your car. Leave an important item in the backseat near your child, like a wallet or cellphone that is needed at your final destination.
  • If you notice a child alone in a car, call 911.

Parents can retain these tips by remembering to ACT

Avoid leaving your child alone in the car.

Create reminders, such as one that ensures you dropped your child off at daycare that morning.

Take action. If you see a child alone in a car, calling 911 could mean saving their life.

Heatstroke symptoms include dizziness, disorientation, agitation, confusion, sluggishness, hot and dry skin that is flushed but not sweaty, loss of consciousness, rapid heartbeat and hallucinations. These symptoms can progress to seizures, organ failure or death if not immediately treated.

If a child is experiencing heatstroke, there are several things you can do until medical assistance arrives. Take the child to a cool place, remove as much of their clothing as possible, and apply cold packs or ice to areas with large blood vessels (neck, groin, armpits) to accelerate the cooling process.

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How to keep kids safe on the playground this summer

The sun is shining, the days are long, and kids have seemingly endless stores of energy.

Summertime at the outdoor playground makes for perfect family memories, but it can also bring up a lot of worries for parents of active, adventurous kids.

Here are some tips from the American Academy of Pediatrics to help keep your children playground-safe all summer, whether at the neighborhood playground, a best friend’s house or a family barbeque at the park.

Look underfoot
A quick inventory of the playground equipment can help tell you whether a playground is kid-safe. Start with what’s under it. A safe playground will have safety-tested mats or loose-fill materials such as shredded rubber mulch, sand, wood chips or bark at least nine inches deep. These materials should extend at least six feet in all directions around the playground equipment—and further around swing sets or slides.

Mind the metal
Keep an eye out for any protruding bolts or open “S” hooks, such as those that fasten to swing set chains or tire swings. These metals can be not only sharp, but also extremely hot on summer days.

Go for soft swings
Swings should be made of soft materials—think rubber, plastic or canvas—rather than rigid materials such as wood.

Test the temp
Take a stroll around the area and test the temperature of all materials before letting your little one dive in. Metals, plastics and even rubber can get extremely hot in the direct heat.

Pick sturdy shoes
Make sure your kid wears sturdy shoes and never goes barefoot. It’s easy to miss something sharp or hazardous on the ground, especially if the ground is covered by sand or wood chips.

Look out for swings
Kids can easily get caught up in the fun and run straight into the path of a high-speed swing. Teach kids to always pay attention to what’s around them and allow a wide berth, especially around swings and slides.

Check what your child brought
Children should take off bike helmets, necklaces and anything else looped around the head or neck. Also, be sure they leave behind any leashes, jump ropes or other long objects that could be a strangulation hazard if caught up in equipment.

Ditch the trampolines
As fun as flying feels, trampolines pose a serious safety threat—and that’s something even supervision and safety netting can’t fix. The safest bet is to avoid home trampolines at all costs, both in your own yard and in yards your child visits.

If you must bounce…
If the thought of giving up trampolines is too much to bear, follow these trampoline safety musts:

  • Supervise: Supervision won’t prevent every trampoline injury, but it can help ensure kids jump as safely as possible.
  • One at a time: 75% of trampoline injuries occur when more than one kid is jumping at a time. Allow only one child at a time—no exceptions.
  • Check your insurance: Ensure your policy covers trampoline-related claims for yourselves and others. Coverage is highly variable, and a rider may need to be obtained.

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    Making the case for sending kids to summer camp

    Choosing the right summer camp for kids and summer camp for teens can be a big decision for parents. A pediatric psychologist weighs in to discuss the social and developmental benefits of summer camp.

    “As children and teens grow up, they’re tasked with developing social skills and maintaining positive relationships,” says Dr. Sabrina Karczewski, a pediatric psychologist at CHOC. “Schooltime may not be able to fully address these needs, since so much time there is focused on academic and life skills. This is where extra-curriculars, including summer camps, come in to add enrichment to children’s lives.”

    Another benefit of summer camp is their tendency to offer a culture based around positivity, where any negative attitudes fizzle because positive participation and upbeat attitudes are positively reinforced.

    Summer camp is also an opportunity for children to explore new or deepen their interest in familiar activities.

    “Camp often provides structured activities with the ability for children to have the freedom of choice to explore what interests them,” Karczewski says. “It’s also a good environment for kids to take healthy risks and try something new, without the influence of pre-existing peer groups or family expectations. This helps them foster independence and hone their decision-making and problem-solving skills.”

    How to find a good summer camp

    Parents should look for high-quality camps that provide a safe space with adult supervisors who are energetic, accepting, supportive and who set appropriate boundaries, she adds.

    A good summer camp provides a supportive social environment that is often dedicated to peer interaction and cooperation.

    “At camp, children are exposed to others who may be similar or different to them, which can be a jarring and initially uncomfortable experience,” Karczewski says. “By sticking with it and developing new relationships, children are required to test-drive their social skills and adapt, thus building social competence and social comfort.”

    Creating new friendships may also broaden a child’s perspective on how they view themselves, she adds. Camp friendships can be long-lasting, despite changes in a child’s day-to-day home or social life.

    The benefits of special interest camps

    Special interest camps – like science camp, outdoor camp, or creative camp – are a different opportunity for youth with a specific interest to take a deep dive into their passions.

    “Meeting other youth with similar drives and abilities can help to push a child who may be used to being at the top of their class or help them develop new levels of mastery they may not have thought they could reach,” Karczewski says. “Developing new creative, academic or outdoor skills can broaden a child’s horizons and change their perceptions of their own limits.”

    The benefits of special population camps

    Special population camps – like camps for kids with chronic illnesses, autism, learning differences, or behavioral challenges—are another opportunity for kids and teens to meet others and normalize their unique experiences.

    In these environments, a child’s special needs are supported, and campers have the chance to just be kids, all while reaping the same benefits of a traditional summer camp environment. These camps may offer special sessions for family members and siblings to foster connection and social support among those encountering similar challenges.

    “Many families have told me that their experiences at these special needs camps were life-changing, and that they found lifelong friendships,” Karczewski says.

    Regardless of the type of camp, length of program, or location, many skills that children and teens develop at camp can be sustained even after they return home or after the program ends.

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