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Triad emergency rooms see patient increases during summer months

News & Record (Greensboro, NC) - 7/4/2015

July 04--The pediatrician still recalls a recent drowning victim.

"The child got away from parental supervision and had wandered down to the lake and had either fallen in or gotten into the water and drowned," said Dr. Ross Kuhner, the director of the pediatric emergency department at Moses Cone Hospital.

"It (the water) wasn't very deep, but it doesn't require very much," Kuhner, said of drowning.

Statistics show the number of deaths and injuries for children 14 and younger increases more than 50 percent in the summer.

"We do call it our trauma season," said Dr. James O'Neill, a pediatric emergency medicine specialist at Brenner Children's Hospital, the pediatric arm of Wake Forest Baptist Medical Center in Winston-Salem.

But many of the injuries are preventable, according to the U.S. Centers for Disease Control and Prevention.

Although these and other medical experts constantly are pushing their safety messages, not everyone is taking heed.

Just ask the emergency room doctor who couldn't revive the youngster who slipped unnoticed into the neighbor's pool and drowned; the burn center nurse whose pediatric patient was in danger of losing an eye after his parents allowed him to light a firecracker; the pediatric surgeon whose patient lost a limb after he fell off someone's lap while riding a lawn mower.

They have plenty of insight.

"I was a resident in Philadelphia in the emergency department, and a 5-year-old child was brought in because he had picked up an M-80 (firecracker), and it exploded in his hand," said Dr. Rob Poth, the chief of pediatrics at High Point Regional. "He had pretty much blown up his hand."

Poth said he knows it's not just the children who come across a stash of firecrackers without their parents knowledge that are handling firecrackers, because photos circulating on social media and in newspapers often show smiling youngsters holding sparklers with adults nearby.

He said what we're also doing is sending children a mixed message.

"Any other time we would tell them to stay away from fire, it's dangerous," he said. "Handing them a lit sparkler or wand, or whatever you want to call it, isn't much of a difference."

Holiday fireworks

Generally, novelty firecrackers that don't explode, leave the ground or fly through the air are legal in North Carolina. That would include sparklers, which produce colored flames. But that doesn't mean children should handle them or be close by when adults handle them.

"People tend to think they are safe since they are allowed," said Leigha Shepler, the coordinator of Safe Guilford, a local injury prevention coalition. "But (those novelty items) like sparklers that we let our kids have can get up to 1,200 degrees -- hot enough to melt glass."

The U.S. Consumer Product Safety Commission estimates that, on average, 230 people go the emergency room every day with fireworks-related injuries in the month around the Fourth of July holiday.

Let the professionals do it, Shepler said of fireworks.

Part of the problem is that adults often slip into a laid-back routine during the summer, and that often includes letting their guard down, say Shepler and others.

"We hear that a lot -- 'It never happened to me' or 'You never heard about that happening when I was a kid,'?" Shepler said. "But the reason we want to get these messages out is because we do see those cases come through our emergency departments," she said.

"It does happen to our neighbors and the people in our communities, and a lot of it can be prevented."

Safety equipment

One of those dangers is riding a bike, scooter, ATV or skateboard without a helmet and padding. Children also should never be allowed to operate ATVs, they warn.

With bikes, scooters and skateboards, a lot of the accidents will happen as close as the driveway, Kuhner said.

"A 10-year-old was riding his bike (without a helmet) and sustained a skull fracture and bleeding around the brain," Kuhner said. "A helmet would have prevented that from happening."

Lots of times it's the helmet only that ends up cracked.

Sometimes after these types of accidents, children leave the hospital with permanent brain injuries.

Children can't be kept in a bubble all summer for their safety, the experts agree. Simply stay vigilant, Kuhner said.

Water can be deadly

With families headed to the beach during the summer, one of the bigger water dangers -- besides sharks -- is watching children in the ocean and at the pool.

Don't simply put your child's life in the hands of a lifeguard.

Rule of thumb: If the child cannot swim, he or she always should be within arm's reach. If they can swim, they should be supervised.

Drownings are the leading cause of injury death for young children ages 1 to 4, and three children die every day in the summer as a result of drowning, according to the CDC.

"The lifeguard is one person surrounded by a bunch of kids," Shepler said.

Instead, for every group of children there should be a "parent water watcher" whose assignment is to watch the children, she said.

"And they're not reading or talking to other adults," Shepler said.

It's also important to know what a drowning might look.

"People who are drowning do not always look like you would expect," said O'Neill, the Wake Forest Baptist doctor.

They may not have the energy to splash around enough to grab anyone's attention or be able to call out for help because they may not have enough oxygen in their lungs, he said.

So can heat

Parents should remember to think like a child as they go about their activities.

When grilling, for example, never remove the grate after cooking until it has cooled down.

"They took it off and set it on the ground -- and not thinking about their toddler being curious -- the toddler put her hand on it and got burned," Shepler said of one emergency department visit.

And just accept the fact that traveling with a child might not be convenient.

For those parents tempted to make a stop and leave their children in the car with the windows cracked: Don't.

On average, 38 children die in hot cars each year from heat-related deaths after being trapped inside motor vehicles, according to the nonprofit Kidsandcars.org. A car's windows act like a greenhouse, trapping sunlight and heat, according to the National Highway Traffic Safety Administration.

And for those adults who transport children, have a plan for making sure all children are accounted for at the destinations or before locking up. If a child is riding in the back seat of a car, use a reminder system -- possibly one of that child's toys sitting on a purse or cellphone in the front seat.

"I can see them," Kuhner said of his experiences with those children accidentally left in vehicles. "The only thing that you can say is that you can't leave a child in a car for any length of time."

Those who work with injured children say accident prevention is often as simple as keeping kids off hot metal slides in the heat of the day and keeping children off lawn mowers, even if they're riding in grandpa's lap, because they can -- and do -- end up in emergency departments.

Contact Nancy McLaughlin at (336) 373-7049, and follow @nmclaughlinNR on Twitter.

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(c)2015 the News & Record (Greensboro, N.C.)

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