What E.R. Doctors Wish You Knew

Straight from the nation's emergency rooms, here are physician's top 10 ways to keep your child safe.

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"If only we'd . . ." It's the phrase parents wail again and again as they pace the emergency room, awaiting news of an injured child. Each year, more than 23 million kids under 15 end up in the E.R. According to the National Safe Kids Campaign, 7 million of those children suffer accidental injuries, the leading killer of children under 14. The saddest aspect of these statistics? Most of the accidents are preventable. Parents asked physicians at ten of the nation's leading children's hospitals to share the single piece of advice that could prevent a trip to the E.R. Here's what they told us.

1. JUST SAY NO TO TRAMPOLINES

Scary Stat: Trampoline-related injuries are responsible for as many as 92,000 emergency-room visits annually.

Listen to the Doctor: "At this hospital, we see about 150 to 200 children with trampoline injuries per year, split equally between boys and girls. These kids have fractures, spinal injuries, and sometimes serious head injuries. Most injuries occur not because kids fly off the trampoline, but because another child lands on them, or they do something inappropriate, such as riding a bike on the trampoline. If you do have a trampoline, only one person at a time should be on it--with supervision. As more people get on, the risk of injury increases exponentially. If one or two kids jump up, then the trampoline is like concrete for the child coming down. Kids can even break their arms or legs as they land."--Howard Kadish, M.D., pediatric emergency medicine physician at the Primary Children's Medical Center, Salt Lake City

Find Out More: Trampolines are largely unregulated, but the American Academy of Pediatrics recommends against their use at home, in gym classes, and on playgrounds. For details, log on to www.kidshealthworks.com.

2. KEEP YOUR PLAYGROUND SAFE

Scary Stat: Falls account for 90 percent of the most severe equipment-related playground injuries (mostly head injuries and bone fractures). Lack of proper supervision accounts for about 40 percent of playground injuries.

Listen to the Doctor: "The most common injuries we see are broken arms, elbows, and clavicles--almost all of which are preventable if playgrounds are properly designed and kids are supervised. Make sure children play on age-appropriate equipment. I can't tell you how many 2-year-olds I've seen who've fallen off monkey bars. What's a 2-year-old doing on monkey bars? The other big problem is poor playground maintenance. To determine if your playground is safe, check the material under it to make sure it can absorb shock: Wood chips or shredded rubber are the safest. The coverage also needs to be sufficiently wide and deep--six feet around the equipment and 12 inches down. In their backyards, many people rely on grass, which is less absorbent than these other surfaces."--Jim Chamberlain, M.D., division chair and medical director for the Emergency Medical and Trauma Center at Children's National Medical Center, Washington, D.C.

Find Out More: The Consumer Product Safety Commission Website has a "Is Your Home Playground a Safe Place to Play?" checklist. Log on to www.cpsc.gov.

3. PROPERLY INSTALL AND USE YOUR CHILD CAR SEATS

Scary Stat: Car crashes are the leading cause of death among U.S. children. Of the 1,579 kids who died in car accidents in 2001 (the latest year for which statistics are available), 55 percent were unrestrained.

Listen to the Doctor: "Car seats are 71 percent effective in reducing infant deaths in passenger cars, so using them is a no-brainer. But even in accidents where kids are restrained, about 85 percent of the time the car seat is installed improperly. It's not tight enough, or the harness straps aren't positioned correctly, or the baby is seated in a front- rather than rear-facing position. Another crucial point: Kids under 80 pounds or 8 years old must be in a booster seat. Seat belts are designed for adults; a booster raises the child so the lap part of the belt sits across the pelvis instead of the abdomen."--Nina Gold, M.D., director of safety at the Child Protection and Safety Center at St. Joseph's Children's Hospital, Paterson, New Jersey

Find Out More: The National Highway Traffic Safety Administration has child-car-seat inspection stations in many areas of the country. To locate one near you, log on to www.nhtsa.org, or call the Auto Safety Hotline at 888-327-4236.

4. EDUCATE YOURSELF ABOUT ASTHMA

Scary Stat: Asthma is the most common chronic disease in children, affecting some 5 million American kids. Asthma is also a leading cause of absences among school children, causing approximately 10 million missed school days annually.

Listen to the Doctor: "Be alert to your child's asthma triggers--perhaps he wheezes when he gets a cold, for instance--and always have the correct medicines on hand. Start treatment immediately. If you wait, he'll end up at the E.R. A lot of kids we see are barely able to breathe and end up hospitalized for prolonged therapy. Sometimes parents say, 'We ran out of medicine.' That should never happen."--Tony Woodward, M.D., medical director of transport services at the Children's Hospital of Philadelphia

Find Out More: The American Lung Association Website, www.lungusa.org, has information on childhood asthma and links to other useful sites.

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