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Keeping Kids Safe: What Parents Need to Know

New York (Sep 22, 2010)

child on bicycle

As summer wanes and fall begins, children will continue to spend more time in outdoor activities before the winter cold sets in. For parents, it's important to remain vigilant to ensure their children's health and safety.

Bicycle Safety

The importance of wearing safety helmets when bike riding cannot be overemphasized. According to the Centers for Disease Control and Prevention, each year more than 500,000 people in the United States are treated in an emergency department, and more than 700 people die as a result of bicycle-related injuries. Children are particularly at high risk, yet only 20 percent of them wear helmets. In New York State, children from age 1 to 14 are required to wear a certified bicycle helmet when bicycling. Protective gear is also critical when in-line skating, operating a non-motorized scooter or skateboarding.

"Wearing helmets would substantially reduce fatalities if more children wore them," says Shari L. Platt, MD, Chief of Pediatric Emergency Medicine at the NewYork-Presbyterian Phyllis and David Komansky Center for Children's Health. "Studies show that children are more likely to wear a helmet if their parent wears one. Parents should set the example."

Dr. Platt offers the following safety tips:

  • Make sure the helmet fits snugly and covers the mid-forehead.
  • Do not ride at dusk or at night.
  • Wear bright colors and reflective devices.
  • Avoid traffic and streets when possible, and always walk across the street.
  • Learn to stop and utilize proper hand signals.
  • Obey road signs.
  • Check that all bicycle parts and brakes are functioning properly.
  • Ride safely - don't perform tricks or stunts.

Insect Bites and Stings

"Most of the time, insect bites and stings are benign, and require no medical intervention," says Dr. Platt. "Bites on the eyelid may cause swelling because the eye has the ability to collect a lot of fluid. We still worry about infection, so if the eyelid is very red or if fever is present, seek medical attention. If the site is puffy and soft and doesn't hurt a lot, it's probably just a bug bite."

Signs that a severe reaction to a bite has occurred include:

  • swelling
  • difficulty swallowing or speaking
  • chest tightness, wheezing or difficulty breathing
  • dizziness or fainting
  • abdominal pain, vomiting

"Everyone gets mosquito bites and they basically look the same - little red bumps," says Dr. Platt. "Some people are allergic and they get huge, hard welts that are very red and tender. Treatment is an antihistamine to reduce the itch, but it won't necessarily make the redness go away. However, call 911 immediately if there is any difficulty breathing, speaking, dizziness, wheezing, the tongue and mouth feel strange, or swelling around the lips."

When stung by a bee, remove the stinger by gently scraping the skin, wash well and apply ice. "Bees are attracted to scented soaps, perfumes and bright colors, especially yellow," adds Dr. Platt. "Children should also avoid playing near garbage cans and be wary when drinking from a soda can where a bee can crawl into. Be careful at a picnic or outdoors, and don't walk barefoot in the grass. Use bug spray that does not contain DEET. And if parents don't want to use bug spray, there are other products to choose from, and many are for children."

Lyme Disease

Lyme disease is a tick-borne illness, transmitted by tiny ticks - the size of a sesame seed or pencil point - that live on deer, sheep, and horses. If bitten by one of these ticks, they can transmit the Lyme infection (Borrelia Burgdorferi spirochete) they carry into the blood causing Lyme disease. Though the disease can be contracted year round-predominantly in northeastern and north - central states - it is particularly prevalent during the months when people are active outdoors.

"It's important to note that the majority of deer ticks don't carry Lyme disease," says Dr. Platt. "If a child has a tick and it's been attached less than 24 to 48 hours, first remove the tick using tweezers to grasp the tick firmly near the child's skin. Pull firmly and steadily out—do not twist it. Do not use petroleum jelly, a lighted match, or nail polish to 'kill' the tick. Then wash the area with soap and water."

If the tick has been on for more than 48 hours and it's engorged, says Dr. Platt, the risk for exposure to Lyme disease increases. Symptoms include flu-like feelings of headache, stiff neck, fever, muscle aches, and fatigue, as well as a target-shaped rash at the site of the bite that can appear within one to four weeks. "There's a lot of controversy about whether to treat or not," she says. "After 48 hours consider prophylactic treatment with an antibiotic, because the test for Lyme doesn't turn positive for up to six weeks after an infection develops. Plans for treatment should be discussed with your pediatrician."

Poison Ivy

In addition to posing a problem for children playing in a wooded area, poison ivy, poison oak, and poison sumac can also be a hazard to gardeners, hikers, campers, and anyone spending time outdoors. The first step is to recognize these plants and avoid them by wearing long sleeves and pants in areas of thick vegetation. "Parents should limit their child's exposure to woody areas that you aren't familiar with," says Dr. Platt.

Contact with urushiol oil found in the leaves, roots and stems of these plants causes a contact dermatitis - an allergic rash with itching, burning, and blisters and bumps that appear in lines and streaks. "If you know that you or your child has been exposed, wash the oil off the skin and under the nails, and wash the clothes as fast as possible," says Dr. Platt. "Once the oil is washed off, the rash is not contagious, however, it can be passed on if the oil is still on skin or clothes."

Treatment includes applying calamine lotion (not Caladryl if you are also taking Benadryl); keeping nails short and clean; and using cool compresses to reduce the itch.

"In more serious cases, oral steroids may be prescribed," adds Dr. Platt. "Parents should bring their child to the doctor if they are really miserable or if it's very widespread."

Faculty contributing to this article:
Shari L. Platt, MD, Chief of Pediatric Emergency Medicine at the NewYork-Presbyterian Phyllis and David Komansky Center for Children's Health at NewYork-Presbyterian Hospital/Weill Cornell Medical Center, and Associate Professor of Clinical Pediatrics, Departments of Pediatrics and Emergency Medicine, Weill Cornell Medical College

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