Although summertime is still officially nearly a month away, kids are already taking advantage of the warmer weather and longer days -- not to mention the break from school. According to two pediatricians at Cedars-Sinai Medical Center, summer brings with it a special set of seasonal hazards -- and increased injuries -- to children. Injuries of all types -- including drowning, sunburn, food poisoning, insect bites and stings, barbecue burns, skateboarding, bicycling, and rollerblading accidents, and even fireworks injuries -- all increase during the summertime.
In fact, according to the National Safe Kids Campaign, tragedies peak during the summer months between May and August, with July being the highest-risk month for unintended childhood injuries and deaths.
According to Kate Perkins, M.D., Ph.D., Medical Director of the Children's Health Clinic at Cedars-Sinai, motor vehicle accidents -- including children who are hit by cars -- are the number one cause of death in children. "While motor vehicle accidents occur anytime of year, kids are hit by cars more often in the summer, especially when running out in the street to chase a ball or the ice cream truck, or when riding bicycles, skateboards, scooters, or other wheeled toys," she says.
"And speaking of 'wheeled toys,' insist that your kids always wear an approved safety helmet when riding," she adds.
In California, drowning is one of the leading causes of accidental death to children under five. According to Dr. Perkins, drownings and near drownings are much more common during the summertime, and she encourages parents to take steps to protect their little ones. Whether you're in a backyard pool, at the beach or on the river, the most important thing is to make sure that a CPR-certified adult always supervises.
"Teach your child to swim," Dr. Perkins suggests, "but remember that being able to swim doesn't necessarily mean your child is water-safe." The American Academy of Pediatrics advises parents to wait until after their youngster reaches age 4 for formal swimming lessons.
Many Californians spend weekends water-skiing, boating or jet-skiing. "Always wear an approved life jacket when on the water," says Dr. Perkins. "It's also a good idea to have a cell phone with you." If you have a backyard pool, be sure that it is securely fenced with a self-closing, self-latching gate. "Again," says Dr. Perkins, "have a phone handy poolside, never leave children alone without an adult supervisor who is prepared to perform CPR.
Even homes without pools can put toddlers at risk for drowning. "Young children can drown in bathtubs, buckets of water and even toilet bowls, so remember to supervise them at all times," says Dr. Perkins.
If you live near a canal, aqueduct or flood control channel, be sure to warn your children against playing in or near these or other areas with fast-flowing water. "Although this is not necessarily a summertime threat, it's one that parents here in California should keep in mind," she adds.
Some people are surprised to learn that nationwide, burns are a major cause of injury-related deaths in children. "Children's skin is thinner than that of adults, so kids can be quickly and badly burned at lower temperatures," says Lloyd Brown, M.D., Associate Director of the Pediatrics Residency Training Program at Cedars-Sinai, and Medical Director of the C.O.A.C.H. for Kids Program. "Whether it's heat from a fire, a 'too-hot' hot water heater, or heat from the sun, children are more vulnerable than adults."
"Teach your kids what to do in a fire," he says. "Practice the stop-drop-and-roll routine with them." Because more people are enjoying picnics and backyard barbecues during the summer, be aware that grills can be very dangerous for children and toddlers. Avoid using flammable liquids on fires, and never, ever leave kids alone near a campfire.
One source of burns that many parents overlook is the hot water heater. Dr. Brown suggests that parents lower the thermostat to 120 degrees to prevent accidental burn injuries.
Another source of burns that many people rarely think about are home fireworks. Experts recommend that you leave the fireworks to the pros. Illegal fireworks are particularly deadly, but even legal ones can cause serious burns and eye injuries.
Sunburn, of course, is always a threat to both kids and adults. It's no secret that sun exposure increases the risk of skin cancer and premature aging. However, did you know that 80 percent of a person's lifetime exposure to the sun occurs before age 21? "This is the time to be protecting your kids from excessive exposure to the sun," says Dr. Perkins.
She suggests avoiding the outdoors when the sun is strongest (10 am -- 4 pm), and having children wear protective clothing, including a hat, long-sleeved shirt and long pants. However, it's important to be aware that it is possible to sunburn through clothing, so sunscreen is still a good idea.
"Use a sunscreen with an SPF of at least 15," Dr. Perkins suggests, "and reapply it frequently -- especially if you are in the water." Many people don't realize it, but they can still sunburn on a cloudy day, so don't forget to slather it on -- even if the sun isn't shining. If you're using a product that combines an insect repellant with sunscreen, remember that Deet (the ingredient in most repellants) lowers the effectiveness of sunscreens, so choose a screen with a higher SPF.
Heat exhaustion is another threat during the summer. Dr. Perkins suggests keeping kids indoors during the hottest part of the day (10 a.m. -- 4 p.m.). "Be sure to keep your child hydrated with plenty of caffeine free liquids," she says. "Water, sports drinks and juices are great -- but try to offer the less sugary ones."
Dr. Perkins also reminds parents that it can be deadly to leave children -- or pets, for that matter -- in the car even for a few moments. "Temperatures inside a parked, closed car can reach lethal levels extremely quickly," she says. "Don't ever leave a child or animal in the car while you run into the store or the house."
Insect bites and stings are another hazard for kids. According to Dr. Brown, kids can be bitten or stung by all sorts of insects and animals -- from mosquitoes, bees, wasps and yellow jackets to ants, jellyfish, spiders, snakes and even scorpions. And the risk of being stung or bitten increases during the summer months.
Although most bites and stings only need symptomatic treatment to help lessen pain and itching, children who are allergic to the venom can experience more serious -- potentially life-threatening -- reactions. These reactions, which are known as anaphylactic shock, can cause severe breathing problems, which can result in death. "Kids with a history of anaphylactic shock should have with them at all times an auto-injector of epinephrine, but parents should still call 9-1-1 if they get bitten or stung," says Dr. Brown.
For kids who are not allergic, applying ice or a cool compress can reduce the pain and discomfort of a bite or sting, says Dr. Brown. In addition, parents can mix baking soda or meat tenderizer with water and apply the paste to the site. "This is great for treating bee or wasp stings, or ant bites," he says. You can also soak a cotton ball in the paste and gently rub the area for 15-20 minutes. Applying a topical anti-itch product such as Benadryl gel, Campho-Phenique, or Calamine lotion can provide additional relief.
The best approach, says Dr. Brown, is to avoid the bite or sting altogether. "By keeping as much of your child's skin covered as possible, you can reduce the chances of her being bitten or stung." Long-sleeved shirts and long pants, socks and a hat can provide significant protection. Beyond that, avoid using scented soaps or other products on your child as the fragrances can attract insects.
Do use an insect repellent regularly, but choose those with less than 10 percent Deet, and wash it off of your child as soon as possible. Try to apply it to clothing rather than to your child's skin, as less will be absorbed.
If you live in a wooded area, or if you've been hiking or camping, check your child daily for ticks, as they can carry diseases such as Lyme disease.
"If your family enjoys hiking or being in the local mountains, be on the lookout for rattlesnakes," Dr. Brown advises. "There are lots of them around this year, and a bite needs immediate medical treatment."
When picnicking, use caution when drinking from soda or juice cans that have been left open, as bees and wasps can be attracted to the sugary drinks and can actually go inside of the can, stinging your child when he or she takes a drink.
The Children's Health Clinic at Cedars-Sinai Medical Center provides a team of doctors, nurses, social workers, and other care providers who are dedicated to helping kids stay as healthy as possible. The Children's Health Clinic offers many of the services your child needs in just one location, including: well-child checkups, vaccinations/shots, urgent/same-day appointments, back-to-school checkups, complete dental care, treatment of behavioral and developmental conditions, treatment of childhood problems like asthma, seizures, poor growth or development, ear infections, injuries, sickle cell anemia, cancer and Down Syndrome, parenting education, and lab test and advice with medicines and prescriptions.
For more information on any of the pediatric programs at Cedars-Sinai Medical Center, please call 1-800-CEDARS-1 or 1-800-233-2771.
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