In the ER, we call winter “cold and flu” season - and summer? That’s “accident season” - especially in a children’s ER.
Summer is remarkably predictable for this – which while it may sound scary, is *actually* good news – because it means that if you (as a parent) know what I know (as an ER doctor), then you can make the handful of preparations needed to keep summer fun, while also making it safer.
Injuries on Wheels: Fast, Common, and Often Preventable
Roughly 220,000 children visit the ER every year for bike-related injuries — that’s about 600 a day [Nationwide Children’s/CPSC]. And 9 out of 10 bicyclists who die in crashes were not wearing helmets. Sometimes they didn’t have a helmet, and sometimes they’re like a 4-year old I took care of the other day. Here’s the story: he was sitting astride his bike while mom started to put on the helmet, but he picked up his feet and started rolling down the hill before the helmet was on – and then fell and hit his head HARD. He came into the ER not speaking – and didn’t say a word for 1-2 hours (terrifying his mom). We ended up doing a CT scan because he wouldn’t speak. Fortunately, it was clear, and he was ok and likely just badly concussed – but it was a terrifying incident for mom and a reminder that toddler accidents happen SO quickly.
What to do: ALWAYS wear the helmet when bicycling – and for any activity, ALWAYS put on the protective gear BEFORE you put on / get onto the equipment.
Plus, right before summer season, do a quick helmet check. Kids grow. Last year’s helmet may not fit, and an ill-fitting helmet barely works. A properly fitted helmet reduces the risk of head injury by up to 85% — but only about 42% of kids always wear one when riding.
Falls and Play Equipment
When Safehome.org analyzed summer 2023 ER visits in kids, bicycles led the list (~43,000), followed by swimming-related injuries, trampolines (~26,000), and playground equipment [NEISS data]. We talked about bicycle injuries above, and will discuss swimming in our next article, so here, let’s talk trampolines.
What to do for trampolines:
- Only 1 child jumps at a time (when there are multiple, this is often when we see the worst injuries, and often to the smallest child)
- Always with a grownup watching
- No flips or somersaults
- Just like you close the gate for a pool, when no one is jumping, pull away the ladder if you can, so that littles cant go up and jump alone
- Place the trampoline far away from objects such as trees, walls, or buildings
Burns You Don’t Think About
Burns from sources parents don’t think about — hot asphalt, metal car-seat buckles left in the sun, fire pits, grills, and sparklers (which burn hotter than a stovetop).
What to do:
- just like you keep your little one away from the oven, use the same rules around the grill – which can get extremely hot to the touch
- If your grill is not secured, be especially careful, as a child could potentially pull it onto themselves or it could tip onto a child.
Driveways: The Overlooked Risks
Driveway and parking lot injuries — I have a 2-year old, and every single time I move my car, I make sure that he’s either IN the car with me, or another adult is holding him. I’ve seen those awful awful moments that a toddler was right behind the car – too short and too close for the camera – and – a parent NEVER ever forgives themselves. Sadly, every year, we hear incidents of these, including one that I heard of through my ER colleagues group just this month, in which a toddler was killed when he was playing in the driveway and a reversing car did not see him.
What to do: I know it sounds excessive – but always – if you have toddlers in the home, ALWAYS check around the car before you drive out. Do not rely solely on your cameras – always check.
Pro tip: Getting Older Kids on Board
Honestly? Kids ALWAYS fight you on the safety rules. And as they get older, it doesn’t necessarily get any easier BUT you can reason with them (sometimes). Discuss with them about how helmets and seatbelts aren’t about not trusting them — they’re about respecting their brain enough to protect it. I tell my kids: “What’s inside your head is irreplaceable, and I love you too much to not be careful.” That lands better than a rule.
Model it. If I want my kids in helmets, I wear one. If I want them off their phone in the car, mine is tucked into the console. Kids will absorb your behavior long before they absorb your speech. (One reason teen helmet use is so low: only 29% of adults always wear one when biking. Kids are watching.)
Give them the data, which respects their intelligence. Concussions and traumatic brain injuries land harder than “be safe.” Explain that a properly fitted helmet reduces head injury risk by up to 85% — and that your brain doesn’t get a do-over.
Let them choose. If helmets feel uncool, let them pick one they actually like. A custom-graphic helmet they wear beats a “safer” one in the garage.
Invite them in as protectors. Ask older kids to help teach a younger sibling about pool rules, helmet rules, or sunscreen. Kids who feel like protectors of others tend to internalize the same standards for themselves.
The Bottom Line
You don’t need to add a hundred new fears to your summer. You need to focus on the small handful of things that drive the overwhelming majority of injuries — and prepare for those well.
All my best,
- Dr. Darria
