Looking to keep your kids safe this summer? In this exclusive Q&A session, KPRC 2 spoke with Dr. Katherine Leaming-Van Zandt, the Medical Director of the Texas Children’s Hospital West Campus Emergency Center, about the top reasons kids visit the ER in Houston during the summer months.
Q: What are the most common reasons children in the Houston area visit the Emergency Room during the summer months?
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A: Throughout the year, children will visit the emergency center for a variety of reasons, including fever, colds, cough, difficulty breathing, vomiting, diarrhea, dehydration, and rashes. During the summer months, we do see an increase in the number of injuries, such as scrapes, deep cuts, broken bones, head injuries, drownings, heat-related illnesses, and insect and animal bites.
Q: How does the summer season impact the types of cases you typically see in the ER?
A: Many children are out of school, allowing them plenty of time to engage in sports, outdoor activities (i.e. – visiting a park and/or playground, riding their bicycles/scooters/skateboards, jumping on trampolines), water sports/activities, summer camp, and family vacations. By not following recommended safety measures and/or without appropriate parental/caregiver supervision, many of these fun activities can lead to a variety of childhood illnesses and injuries.
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Q: With the warmer weather, what are some key safety tips parents should keep in mind to prevent their children from ending up in the ER?
- Depending on the summertime activity and age and development of the child, it is important to ensure you have appropriate parental/caregiver supervision.
- To prevent the spread of colds and other infectious illnesses, encourage children to wash their hands, cover their noses/mouths when sneezing or coughing, and avoid sharing utensils/dishes and cups/straws.
- When heading to the playground, ensure the playground has appropriately sized, safety-tested mats or loose-fill materials, the equipment is carefully maintained (and, without any exposed bolts/screws or sharp edges), swing seats are made of soft materials and there are at least 6 feet of free space on either side of a swing, and metal/rubber/plastic surfaces and equipment aren’t hot enough to burn/scald a child’s skin.
- If riding a bicycle, skateboard, or scooter, make sure children are wearing a properly fitted, safety-certified helmet and other protective gear (i.e. – wrist, elbow, and kneepads). If on a sidewalk or near the road, the child should ride on the right, facing the same direction as traffic, and should be taught to obey all stop signs and other traffic control devices. Parents and caregivers should survey the terrain for obstacles such as potholes, rocks, and uneven surfaces.
- If children are jumping on a trampoline, they should be supervised by a responsible adult, and only one child should be on the trampoline at a time. Most trampoline-related injuries happen on the trampoline, not from falling off.
- Drowning is quick and silent and can happen to any family. Please see tips/recommendations below for water safety.
- Fireworks are not toys! Typically, the types of fireworks that cause the most injuries are firecrackers, sparklers, and bottle rockets. Ensure fireworks are legal in your area prior to buying or using them…and, never use illegal, unlabeled, or homemade fireworks! If using fireworks at your home, be sure to follow the instructions on each firework. Light fireworks one at a time and at arm’s length, then move back quickly. Never try to re-light or pick up fireworks that have not ignited fully. Light/ignite fireworks in a clear, flat area away from houses, spectators, leaves, and flammable materials. The person igniting the fireworks should wear non-flammable clothing, closed toed shoes, and safety glasses. Families should always be prepared for an emergency. Before lighting fireworks, always ensure that a bucket of water or hose is nearby…not only will water cool off spent sparklers and extinguish fireworks, but also douse any potential fires. Additionally, when using fireworks, parents should always have a cell phone and first aid kit nearby.
Q: How do heat-related illnesses factor into the cases you see during the summer, and what steps can parents take to prevent them?
A: Children do not adapt as effectively as adults when exposed to high heat stress! The reasons for these differences include:
- Children produce more metabolic heat than adults during physical activities such as walking or running.
- Children have a greater body surface area than adults, which causes a greater heat gain on a hot day.
- Children have a lower rate of sweating than in adults, which reduces the ability of children to dissipate body heat by evaporation.
- If not appropriately supervised, children are less likely to adequately replenish fluid losses during prolonged exercise.
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Heat-related illnesses include a wide spectrum of signs and symptoms! They range from mild illnesses, such as muscle cramps, to much more severe illnesses, such as heat exhaustion and heat stroke. Fortunately, heat-related illnesses, including heat stroke, are preventable! In order to prevent heat-related illnesses, children should never be left unattended in cars and those who may be exposed to hot, humid climates (i.e., athletes) should follow proper guidelines for heat acclimatization, fluid intake, appropriate clothing, and adjustment of activity according to temperature and humidity!
Q: Are there any trends or patterns you’ve noticed in recent years regarding summer-related ER visits for children?
A: Pretty consistent seasonality-related illnesses and injuries.
Q: Can you share any insights into how parents can differentiate between minor incidents that can be managed at home versus those that require a trip to the ER?
A: Knowing when and when not to take your child to the emergency center can be a difficult and stressful decision for many parents! Some examples of when parents should take their child to the emergency center:
- Breathing difficulties (include rapid breathing or increased work of breathing/shortness of breath)
- Altered or abnormal behavior such as lethargy (difficult to awaken), confusion, agitation
- Persistent vomiting and/or diarrhea AND dehydration (no tears with crying, dry lips/mouth, pale skin, no urination in > 8 hours)
- Swallowing a foreign body and difficulty breathing, drooling, vomiting, or pain
- Fever and neck stiffness
- Deep, gaping or persistently bleeding cuts
- Broken bones
- Head injury and loss of consciousness, severe headache, vomiting, or abnormal behavior/activity
Q: Are there any specific precautions parents should take regarding water safety, especially given Houston’s proximity to bodies of water like pools, lakes, and beaches?
A: Multiple layers of protection, such as environmental safety precautions, child water education, adult supervision, and emergency preparedness, should be in place to prevent water-related injuries and drownings:
- Home safety measures: Such as draining bathtubs, emptying ice chests and buckets of water, and keeping toilet seat covers down, can help prevent in-home, childhood drownings. Additionally, pool fences, covers, and alarms should be installed and used around home pools or hot tubs. A four-sided isolation fence (separating the pool area from the house and yard) reduces a child’s risk of drowning 83% compared to three-sided property-line fencing. Pool fences should enclose the entire pool or spa area with at least a 4-foot, 4-sided fence that isolates the pool from the house and the yard. The gates should be self-closing and self-latching with the latch placed at least 54 inches above the bottom of the gate. Pool alarms may provide some extra protection against drowning, but should not be relied upon as a substitute for a barrier completely surrounding the pool. Above-ground inflatable and portable pools should also be protected by removing the access ladder(s) and securing the safety cover when the pool is not in use.
- Child water education: Children should be taught to never go near or in water without adult permission, and should never swim in unsupervised, swimming-restricted areas including ocean shorelines, rivers, and lakes. Taking the time to speak with older children and teenagers about risk-taking behaviors is also important.
- Adult supervision: Drowning can happen quickly and quietly anywhere there is water (such as bathtubs, swimming pools, and buckets) and even in the presence of lifeguards. All children in or near water, especially those less than 4 years old, should be continuously supervised by an adult – even if lifeguards and other parents are present. Because young children often go unnoticed when they fall into water and are difficult to see below the water surface, adult supervisors should remain within an arm’s length of young children and provide additional “touch supervision.”
- Emergency preparedness: Ensure everyone in the home knows how to respond to water emergencies! If a child is found underwater, pull the child safely and quickly from the water. Have a bystander call 9-1-1 immediately. If the child is unresponsive, not breathing, or does not have a pulse, rescue breathing and chest compressions should be started immediately. Because immediate resuscitation can save a child’s life, all parents and caretakers should be trained in first aid and infant/child CPR. CPR information and courses for parents and caregivers are available through the American Heart Association and the American Red Cross.
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Q: Are there any misconceptions or myths regarding children’s health and safety during the summer that you’d like to address?
A: Children do not typically drown during periods of prolonged negligence, but usually occur during brief lapses in supervision. Even brief distractions, such as phone calls, friendly conversations, and meal preparation, can be deadly if they displace the parent’s attention away from the children.
Q: Can you provide some guidance on managing common summer ailments like insect bites, sunburn, and dehydration at home before seeking medical attention?
- Insect bites: Gently cleanse the skin with lukewarm water and soap. For itching, you may give diphenhydramine, also known as Benadryl, every 4 to 6 hours (read the label to ensure appropriate dosing). For swelling, you may use a cool compress or ice pack to help decrease the area of inflammation.
- Sunburn: The signs of sunburn usually appear 6 to 12 hours after exposure. If the skin is red, warm, and painful, apply cool compresses to the burned areas or bathe the child in cool/lukewarm water. You can, also, give acetaminophen, also known as Tylenol, every 4 to 6 hours (read the label to ensure appropriate dosing) to help relieve the pain.
- Dehydration: Move your child from the sun/hot environment to a shaded/air-conditioned area. Encourage your child to drink plenty of fluids, including breast milk, formula, water, pedialyte, or other electrolyte/sports drinks. Sugary, carbonated, and caffeinated beverages (such as fruit juices, sodas, and energy drinks) should be avoided.
Q: Lastly, what advice would you give parents to ensure their children have a safe and enjoyable summer while minimizing the risk of ending up in the ER?
A: Summer is a fun and exciting time! Being mindful and attentive to potential safety hazards both in and outside the home can prevent unexpected and unintentional illnesses and injuries! Always follow safety recommendations and guidelines and never assume that another adult/parent is watching your child (especially while near water and during pool parties)!
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